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 |
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 | $15924.00 | 1790066876 - CAROMONT HEALTH SERVICES, INC., CAROMONT ENDOSCOPY CENTER | 561455630 - (NC) CAROMONT HEALTH SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $12458.00 | 1619576824 - SURGICARE OF LA VETA, LTD., NEWPORT COAST SURGICAL INSTITUTE | 752507129 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $24840.00 | 1528121316 - SAINT LUKES SOUTH SURGERY CENTER LLC | 201721929 - (KS) SAINT LUKES SOUTH SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $9000.00 | 1902043284 - AESTHETIC & GENERAL DERMATOLOGY OF SEATTLE | 911886576 - (WA) ELIE LEVY, M.D., P.C. DBA AESTHETIC & GENERAL DERMATOLOGY OF SEATTLE | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $2205.00 | 1447612114 - LPC SURGERY CENTER LLC | 473748606 - (IN) LPC SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $8641.00 | 1881147965 - ULNA SURGERY CENTER LLC | 813050347 - (GA) ULNA SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $11576.00 | 1114549987 - SAN LUIS WALK-IN CLINIC, INC., SAN LUIS OUTPATIENT SURGERY CENTER | 651170616 - (AZ) SAN LUIS WALK-IN CLINIC INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $5962.00 | 1457682841 - PAIN CARE OF NORTH TEXAS | 200081985 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $9324.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $10945.00 | 1063720365 - WASATCH FRONT SURGERY CENTER LLC | 800612279 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $3735.00 | 1417114117 - HOSP OF THE UNIV OF PA SPU | 231352685 - TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $9442.00 | 1518359181 - ARAPAHOE SURGICENTER, LLC | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $31809.00 | 1437156379 - SAN FERNANDO VALLEY SURGERY CENTER, LP | 200905938 - (CA) SAN FERNANDO VALLEY SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $3100.00 | 1033106612 - PSHS ALPHA PARTNERS LLC, LAKE WORTH SURGICAL CENTER | 650793962 - (FL) PSHS ALPHA PARTNERS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64580 | $3000.00 | 1710038534 - OUTPATIENT SURGICAL SPECIALTIES CENTER, LLC | 205596163 - (NE) OUTPATIENT SURGICAL SPECIALTIES CENTER LLC | NE | 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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