CPT 64505 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 50 - Bilateral Procedure • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 64505 by major payers:
$180.48
$158.37
$182.33
$212.69
| 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 64505 | ||||||
United | 64505 | $87.00 | 1962459610 - CENTRAL TEXAS DAY SURGERY CENTER LIMITED PARTNERSHIP | 752477808 - (TX) CENTRAL TEXAS DAY SURGERY CENTER LIMITED PARTNERSHIP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $250.00 | 1649662206 - ADVANCED SURGERY CENTER OF ARIZONA, LLP, ADVANCED SURGERY CENTER OF ARIZONA | 471883984 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $180.00 | 1922625995 - NATIONAL SURGICAL CENTERS STOCKTON, LLC | 842979070 - (CA) NATIONAL SURGICAL CENTERS STOCKT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $75.00 | 1376513440 - FLORIDA EYE CLINIC AMBULATORY SURGERY CENTER, INC. | 592303141 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $312.00 | 1275700957 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $85.00 | 1063459451 - CARROLL COUNTY AMBULATORY SURGICAL CENTER | 522165022 - (MD) CARROLL COUNTY AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $330.00 | 1275510141 - NEOSPINE PUYALLUP SPINE CENTER, LLC, MICROSURGICAL SPINE CENTER | 203395071 - (WA) NEOSPINE PUYALLUP SPINE CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $150.00 | 1740210459 - SOUTH CAROLINA ENDOSCOPY CENTER | 562069531 - (SC) S.C. ENDOSCOPY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $521.00 | 1154460525 - VIRGINIA MASON MEDICAL CENTER, VIRGINIA MASON LYNNWOOD ASC | 910565539 - (WA) VIRGINIA MASON MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $1551.00 | 1295887727 - TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | 751047527 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $431.00 | 1013138536 - WESTERN WASHINGTON MEDICAL GROUP, INC, PS, DBA: GATEWAY SURGERY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $1394.00 | 1508974353 - SOUTHLAKE AMBULATORY SURGERY CENTER, LLLP, SPIVEY STATION SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $555.00 | 1245427228 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $3922.00 | 1548400070 - COMMUNITY ENDOSCOPY CENTER LLC | 611464136 - (IN) COMMUNITY ENDOSCOPY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64505 | $1901.00 | 1396342838 - LEXINGTON HEALTH INC, LMC IRMO ASC | 852276567 - LEXINGTON HEALTH INC | SC | 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 64505 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64505 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 64505 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 |
|---|---|---|
| 64463 | Moderate | Paravertebral Block (Pvb) (Paraspinous Block) Thoracic; Continuous Infusion By Catheter (Includes Imaging Guidance When Performed). |
| 64483 | Moderate | Injection(S), Anesthetic Agent(S) And/Or Steroid; Transforaminal Epidural, With Imaging Guidance (Fluoroscopy Or Ct), Lumbar Or Sacral, Single Level |
| 64505 | Low | Inject Anes Sphenopalatine Ganglion |
| 64517 | Moderate | Injection, Anesthetic Agent; Superior Hypogastric Plexus |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64505 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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