CPT 64494 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Nervous System |
| Common Place of Service | • 24 - Ambulatory Surgical Center • 11 - Office |
| Common Modifiers | • None • 50 - Bilateral Procedure • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 64494 by major payers:
$115.61
$125.06
$130.87
$159.33
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 64494 | ||||||
United | 64494 | $1306.00 | 1114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER | 113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $1500.00 | 1518057546 - LONG ISLAND AMBULATORY SURGERY CENTER, LLC | 200369668 - (NY) LONG ISLAND AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $133.00 | 1871868422 - PARAMOUNT SURGERY CENTER, LLC, THE CENTER FOR SPECIALIZED SURGERY | 452232749 - (FL) PARAMOUNT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $158.00 | 1457329963 - SEQUOIA SURGERY CENTER, LLC, CYPRESS SURGERY CENTER, A LIMITED PARTNERSHIP | 770326275 - (CA) SEQUOIA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $175.00 | 1053409896 - MID COUNTY SURGERY CENTER | 200465444 - (MO) MID COUNTY SURGERY CENTER | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $223.00 | 1194832949 - CHOICES WOMEN'S MEDICAL CENTER, INC. | 112715115 - CHOICES WOMENS MEDICAL CENTER IN | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $175.00 | 1972179208 - IDAHO OTOLOGIC SURGERY CENTER, LLC, SYRINGA OUTPATIENT SURGERY CENTER | 852522925 - (ID) IDAHO OTOLOGIC SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $79.00 | 1760991921 - COLUMBIA NEPHROLOGY ASSOCIATES PA | 570702722 - (SC) THE COLUMBIA NEPHROLOGY ASSOCIATES, P.A. | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $65.00 | 1144482753 - CLARKSVILLE EYE SURGERY CENTER | 261815638 - (TN) CLARKSVILLE EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $82.00 | 1376748228 - FLORIDA SPECIALTY SURGERY CENTER LLC | 203672687 - (FL) FLORIDA SPECIALTY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $132.00 | 1336143148 - MARIN OPHTHALMIC SURGERY CENTER | 680297790 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $531.00 | 1295479780 - ADVENTHEALTH SURGERY CENTER DAVENPORT LLC | 881811228 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $950.00 | 1689635757 - ATLANTICARE SURGERY CENTER LLC | 223491867 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $50.00 | 1992741300 - LINCOLN ENDOSCOPY CENTER, LLC | 470807741 - (NE) LINCOLN ENDOSCOPY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64494 | $97.00 | 1043984248 - NORTHERN OHIO SURGERY CENTER, LLC | 871114330 - (OH) NORTHERN OHIO SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 64494 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64494 code is part of the Surgery services used for Surgical Procedures on the Nervous System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 64494 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 64483-CPT | Moderate | Injection(S), Anesthetic Agent(S) And/Or Steroid; Transforaminal Epidural, With Imaging Guidance (Fluoroscopy Or Ct), Lumbar Or Sacral, Single Level |
| 64490-CPT | Moderate | Injection(S) Diagnostic Or Therapeutic Agent Paravertebral Facet (Zygapophyseal) Joint (Or Nerves Innervating That Joint) With Image Guidance (Flouroscopy Or Ct) Cervical Or Thoracicsingle Level |
| 64493-CPT | Moderate | Injection(S) Diagnostic Or Therapeutic Agent Paravertebral Facet (Zygapophyseal) Joint (Or Nervies Innervating That Joint) With Image Guidance (Flouroscopy Or Ct) Lumbar Or Sacral; Single Level |
| 64494-CPT | Low | Injection(S) Diagnostic Or Therapeutic Agent Paravertebral Facet (Zygapophyseal) Joint (Or Nervies Innervating That Joint) With Image Guidance (Flouroscopy Or Ct) Lumbar Or Sacral; Second Level (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64494. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64494 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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