CPT 64520 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 64520 |
National average reimbursement for CPT 64520 by major payers:
$255.07
$278.97
$309.60
$346.03
| 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 64520 | ||||||
United | 64520 | $433.00 | 1205839487 - INTERVENTIONAL REHABILITATION CENTER, LLC | 593673361 - (FL) INTERVENTIONAL REHABILITATION CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $411.00 | 1548679046 - GLSD MEDICAL LLC | 471373117 - (WI) GLSD MEDICAL LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $520.00 | 1982975959 - ARCHIBALD SURGERY CENTER, LLC | 453730425 - (CA) ARCHIBALD SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $539.00 | 1912982349 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, MEDICAL ARTS SURGERY CENTER AT SOUTH MIAMI | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $410.00 | 1609887041 - ZITELLI & BRODLAND PC, ZITELLI & BRODLAND ASF CENTRAL | 251549973 - JOHN A. ZITELLI, MD, PC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $1118.00 | 1235715996 - CENTRAL UTAH SURGICENTER, LLC | 862348485 - (UT) CENTRAL UTAH SURGICENTER LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $1963.00 | 1093120859 - PARK HILL SURGERY CENTER, LLC | 451484375 - (TX) PARK HILL SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $1656.00 | 1407992241 - LAKESIDE ENDOSCOPY CENTER LLC | 205544496 - (NE) LAKESIDE ENDOSCOPY CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $953.00 | 1063092047 - TAMPA BAY JOINT AND SPINE, LLC, TAMPA BAY JOINT AND SPINE SURGERY CENTER | 851259146 - (FL) TAMPA BAY JOINT AND SPINE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $293.00 | 1942458062 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $850.00 | 1568867075 - POTOMAC VIEW SURGERY CENTER, LLC | 471352116 - (MD) POTOMAC VIEW SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $537.00 | 1659526457 - NORWOOD ENDOSCOPY CENTER, LLC | 263691316 - (OH) NORWOOD ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $374.00 | 1942458062 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $985.00 | 1871895821 - GWINNETT SURGERY CENTER, LLC | 272819709 - (GA) GWINNETT SURGERY CENTER,LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64520 | $407.00 | 1306963020 - BATTLE CREEK ENDOSCOPY & SURGERY LLC | 201914507 - (MI) BATTLE CREEK ENDOSCOPY & SURGERY CENTER PLLC | MI | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 64520 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64520 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 64520 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 |
| 64484-CPT | Low | Injection(S), Anesthetic Agent(S) And/Or Steroid; Transforaminal Epidural, With Imaging Guidance (Fluoroscopy Or Ct), Lumbar Or Sacral, Each Additional Level (List Separately In Addition To Code For Primary Procedure) |
| 64495-CPT | Low | Injection(S), Diagnostic Or Therapeutic Agent, Paravertebral Facet (Zygapophyseal) Joint (Or Nerves Innervating That Joint) With Image Guidance (Fluoroscopy Or Ct), Lumbar Or Sacral; Third And Any Additional Level(S) (List Separately In Addition To Code For Primary |
| 64520-CPT | Moderate | Injec,Anes.Agent;Lumbaror Thoracic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64520 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 64520) and we'll show you how you compare in 15 minutes or less.