CPT 64553 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • SG - Scene to Hospital ESRD facility |
| Complexity Level | High |
National average reimbursement for CPT 64553 by major payers:
$2,140.88
$1,708.23
$2,469.81
$3,998.89
| 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 64553 | ||||||
United | 64553 | $8643.00 | 1700431798 - METHODIST AMBULATORY SURGERY CENTER OF BOERNE, LLC | 823532569 - (TX) METHODIST AMBULATORY SURGERY CENTER OF BOERNE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $4028.00 | 1982667499 - CLEAR LAKE SURGICARE, LTD | 621600411 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $9674.00 | 1689832438 - INOVA WOODBURN SURGERY CENTER LLC | 540620889 - INOVA HEALTH CARE SERVICES | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $4264.00 | 1750481453 - LONGVIEW SURGICAL CENTER LLC, PACIFIC SURGICAL CENTER | 161678767 - (WA) LONGVIEW SURGICAL CENTER, LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $1107.00 | 1629107545 - LANIER EYE ASSOCIATES, LLC, ADVANCED EYE SURGERY AND LASER CENTER | 50559435 - (GA) LANIER EYE ASSOCIATES LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $40841.00 | 1275596314 - JOHNSON COUNTY SURGERY CENTER, L.P. | 342029776 - (KS) JOHNSON COUNTY SURGERY CENTER LP | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $6087.00 | 1932636123 - TUCSON DIGESTIVE INSTITUTE LLC, ARIZONA DIGESTIVE INSTITUTE | 821568426 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $5846.00 | 1699144915 - WEST ORANGE ASC LLC, GREGORI SURGERY CENTER | 474739080 - (NJ) WEST ORANGE ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $4900.00 | 1962070896 - OAK ASC, LLC | 833101804 - (IL) OAK ASC LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $8643.00 | 1184051088 - SAN ANTONIO SURGICENTER, LLC, THE CENTER FOR SPECIAL SURGERY AT TCA | 300796793 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $8671.00 | 1316900830 - BAYONET POINT SURGERY CENTER LTD | 200670560 - (FL) BAYONET POINT SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $3500.00 | 1871581876 - OPHTHALMOLOGY LTD EYE SURGERY CENTER LLC | 411911652 - (SD) OPHTHALMOLOGY, LTD EYE SURGERY CENTER | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $4800.00 | 1033560420 - ABINGDON SURGICAL CENTER PC | 813054896 - (MD) ABINGDON SURGICAL CENTER PC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $899.00 | 1639203888 - VALLEY MEDICAL GROUP, P.C., VALLEY MEDICAL GROUP AMBULATORY SURGERY & PROCEDURES CENTER | 42945394 - (MA) VALLEY MEDICAL GROUP, P.C. | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64553 | $1056.00 | 1023005139 - ROANOKE VALLEY CENTER FOR SIGHT LLC | 541982898 - (VA) ROANOKE VALLEY CENTER FOR SIGHT LLC | VA | 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 64553 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64553 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 64553 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 |
|---|---|---|
| 64553-CPT | High | Implantation Of Cranial Nerve Neurostimulator Electrodes, Accessed Through The Skin |
| 64555-CPT | High | Percutaneous Implantation Of Neurostimulator Electrodes Array; Peripheral Nerve (Excludes Sacral Nerve) |
| 64561-CPT | Moderate | Percutaneous Implantation Of Neurostimulator Electrode Array; Sacral Nerve (Transforminal Placement)Including Image Guidance If Performed (Revised 1/1/2013) |
| 64568-CPT | Moderate | Open Implantation Of Cranial Nerve (Eg Vagus Nerve) Neurostimulator Electrode Array And Pulse Generator (Desc Rvsd 1/1/22) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64553. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64553 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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