CPT 64595 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 • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 64595 by major payers:
$396.45
$375.93
$385.07
$503.76
| 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 64595 | ||||||
United | 64595 | $208.33 | 1326090077 - SOUTHERN ORTHOPAEDIC SPECIALISTS APMC | 720848728 - (LA) SOUTHERN ORTHOPAEDIC SPECIALISTS, INC., A MEDICAL CORPORATION | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 64595 | $285.89 | 1477512135 - KEVIN DARR | 463936183 - (LA) LMG, LLC | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 64595 | $9098.00 | 1730212879 - TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64595 | $8156.00 | 1184195877 - ALPINE SURGICENTER, LLC | 831318143 | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64595 | $1500.00 | 1942956123 - METROLINA VASCULAR ACCESS CARE LLC | 831967528 - (NC) METROLINA VASCULAR ACCESS CARE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64595 | $3887.00 | 1033468400 - WHITE FENCE SURGICAL SUITES, LLC | 460796333 - (OH) WHITE FENCE SURGICAL SUITES LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64595 | $5490.00 | 1255325817 - MIDLAND COUNTY HOSPITAL DISTRICT, MIDLAND MEMORIAL HOSPITAL | 751584559 - (TX) MIDLAND COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 64595 | $617.53 | 1093707309 - ROBERT HUANG | 720276883 | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 64595 | $1050.00 | 1144482753 - CLARKSVILLE EYE SURGERY CENTER | 261815638 - (TN) CLARKSVILLE EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64595 | $4758.00 | 1922002674 - FRISCO MEDICAL CENTER LLP, BAYLOR SCOTT & WHITE MED CNTR - FRISCO | 752865177 - (TX) FRISCO MEDICAL CENTER LLP | TX | General Acute Care Hospital (282N00000X) |
United | 64595 | $10716.00 | 1922344167 - TEXAS HEALTH ARLINGTON MEMORIAL | 750972805 - (TX) TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 64595 | $3347.00 | 1265534556 - SOUTH FLORIDA AMBULATORY SURGICAL CENTER LLC | 651093026 - (FL) SOUTH FLORIDA AMBULATORY SURGI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64595 | $175.52 | 1518961317 - GORDON MEAD | 720703150 - HIGHLAND CLINIC, APMC | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 64595 | $220.86 | 1669491288 - JOHN FAIRBANKS | 640888433 - (LA) J H FAIRBANKS MD PLLC | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 64595 | $7168.00 | 1295772259 - LAKEVIEW MEDICAL CENTER, LLC, LAKEVIEW REGIONAL MEDICAL CENTER | 621596506 | LA | General Acute Care Hospital (282N00000X) |
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 64595 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64595 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 64595 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) |
| 64595-CPT | Moderate | Insert/Replace Of Periph/Sacral/Gastric Neurostim Pulse Generator Or Receiver, Detachable Connection To - Medicaid Rn Review>12/30/2022: Rn Review=2/9/2012-12/31/2015 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64595. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64595 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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