CPT 64590 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
National average reimbursement for CPT 64590 by major payers:
$414.17
$392.31
$421.63
$597.71
| 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 64590 | ||||||
United | 64590 | $615.22 | 1669448346 - DOUGLAS SORENSEN | 911939739 - FRANCISCAN MEDICAL GROUP | WA | Otolaryngology Physician (207Y00000X) |
United | 64590 | $402.50 | 1972700284 - TRI-CITIES COMMUNITY HEALTH | 911138675 - (WA) TRI CITIES COMMUNITY HEALTH | WA | Multi-Specialty Group (193200000X) |
United | 64590 | $793.32 | 1043476898 - ADRIENNE HECKLER | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Urology Physician (208800000X) |
United | 64590 | $226.86 | 1952525636 - NORTHWEST SPOKANE PEDIATRICS, PLLC, JOSEPH B MCMANUS MD | 911482356 - (WA) NORTHWEST SPOKANE PEDIATRICS PLLC | WA | Multi-Specialty Group (193200000X) |
United | 64590 | $345.83 | 1104048594 - PARTNER ONCOLOGY INC | 824681345 | WA | Multi-Specialty Group (193200000X) |
United | 64590 | $566.38 | 1811312812 - ANDREW GRAFF | 911352172 - MULTICARE HEALTH SYSTEM | WA | Multi-Specialty Group (193200000X) |
United | 64590 | $470.95 | 1316612609 - EYAL KORD | 262993919 - (NY) UPSTATE UROLOGY INC | WA | Urology Physician (208800000X) |
United | 64590 | $373.04 | 1063995181 - MCKENZIE FOGARTY | 911628032 - (WA) EVERGREEN EYE CENTER, INC. P.S. | WA | Multi-Specialty Group (193200000X) |
United | 64590 | $318.35 | 1609883768 - SUZANNE CLELAND ZAMUDIO | 911286274 - SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION | WA | Otolaryngology Physician (207Y00000X) |
United | 64590 | $626.10 | 1255500542 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE SURGEONS BELLEVUE EAR NOSE AND THROAT AND SOUND HEARING | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Otolaryngology Physician (207Y00000X) |
United | 64590 | $470.36 | 1518253988 - SHANE PEARCE | 941603784 - ENLOE MEDICAL CENTER | WA | Urology Physician (208800000X) |
United | 64590 | $676.96 | 1821183856 - AMY ARISCO | 911512896 | WA | Urology Physician (208800000X) |
United | 64590 | $266.16 | 1497129696 - SWEDISH HEALTH SERVICES, SWEDISH PHYSICIAN DIVISION | 912073120 | WA | Multi-Specialty Group (193200000X) |
United | 64590 | $686.15 | 1962664763 - SALVATORE TALIERCIO | 910214500 - THE EVERETT CLINIC, PLLC | WA | Otolaryngology Physician (207Y00000X) |
United | 64590 | $348.67 | 1962729525 - OBHG WASHINGTON, PC | 272341885 - (WA) OBHG WASHINGTON PC | WA | Multi-Specialty Group (193200000X) |
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 64590 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64590 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 64590 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) |
| 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 |
| 64590-CPT | Moderate | Insertion Or Replacement Of Peripheral Sacral Or Gastric Neurostimulator Pulse Generator Or Receiver Requiring Pocket Creation And Connection Between Electrode Array And Pulse Generator Or Receiver (Desc Rvsd 1/1/2024) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64590. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64590 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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