CPT 64580 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures • AS - PA/NP/CNS assistant at surgery • 76 - Repeat procedure by same physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 64580 |
National average reimbursement for CPT 64580 by major payers:
$456.79
$419.54
$425.38
$541.41
| 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 64580 | ||||||
United | 64580 | $832.00 | 1528035367 - EYE SURGERY CENTER OF WESTERN OHIO LLC, EYE SURGERY CENTER OF WESTERN OHIO | 311570796 - (OH) EYE SURGERY CENTER OF WESTERN OHIO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $5495.00 | 1437552643 - BEAR CREEK SURGERY CENTER, LLC | 465530768 - (TX) BEAR CREEK SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $2788.00 | 1003909789 - OREGON TRAIL EYE SURGERY CENTER, INC | 200121578 - (NE) OREGON TRAIL EYE SURGERY CENTER INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $31809.00 | 1629559208 - ORTHOARIZONA SURGERY CENTER GILBERT, LLC, ORTHOARIZONA SURGERY CENTER GILBERT | 823624585 - (AZ) ORTHOARIZONA SURGERY CENTER GILBERT LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $1273.00 | 1093053381 - NORTH COUNTRY EC LLC, NORTHEASTERN NEW YORK SURGICAL CENTER | 453715451 - (NY) NORTH COUNTRY EC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $1031.00 | 1619965324 - ADVANCED SURGERY CENTER LLC | 20669696 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $1294.00 | 1710213400 - VISION SURGERY CENTER, LLC | 371579446 - (OH) VISION SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $1985.00 | 1194999359 - JEFFREY L BOBER DPM PA, JEFFREY L BOBER DPM PA ASC | 521706931 - (MD) JEFFREY L BOBER DPM PA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $4000.00 | 1184894693 - LA/OC SURGICAL CENTER, INC. | 262108942 - (CA) LAOC SURGICAL CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $11546.00 | 1144652330 - UNIVERSITY SURGERY CENTER LLC, MALLARD CREEK SURGERY CENTER | 462574454 - (NC) UNIVERSITY SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $3119.00 | 1780791798 - LINDSAY HOUSE SURGERY CENTER LLC | 320178342 - (NY) LINDSAY HOUSE SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $9057.00 | 1538245717 - LUBBOCK COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER | 751301362 - LUBBOCK COUNTY HOSPITAL DISTRICT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $5500.00 | 1558792598 - PARIS SURGERY CENTER, LLC | 461871794 - (TX) PARIS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $5606.00 | 1255787867 - THE METROHEALTH SYSTEM, METROHEALTH SYSTEM PARMA AMBULATORY SURGERY CENTER | 346004382 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $1313.00 | 1538101373 - DANVILLE POLYCLINIC, LTD, DANVILLE POLYCLINIC LTD ASTC | 370967248 - (IL) DANVILLE POLYCLINIC, LTD. | IL | 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 64580 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64580 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 64580 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 |
|---|---|---|
| 64575-CPT | Moderate | Open Implantation Of Neurostimulator Electrode Array; Peripheral Nerve (Excludes Sacral Nerve) (Desc Rvsd 1/1/22) |
| 64580-CPT | Moderate | Open Implantation Of Neurostimulator Electrode Array; Neuromuscular (Desc Rvsd 1/1/22) |
| 64581-CPT | Moderate | Open Implantation Of Neurostimulator Electrode Array; Sacral Nerve (Transforaminal Placement) (Desc Rvsd 1/1/22) |
| 64582-CPT | High | Open Implantation Of Hypoglossal Nerve Neurostimulator Array, Pulse Generator, & Distal Respiratory Sensor Electrode Or Electrode Array - Nurse Review |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64580. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64580 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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