CPT 64611 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 52 - Reduced Services • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 64611 |
National average reimbursement for CPT 64611 by major payers:
$158.88
$161.03
$176.00
$221.18
| 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 64611 | ||||||
United | 64611 | $1901.00 | 1396342838 - LEXINGTON HEALTH INC, LMC IRMO ASC | 852276567 - LEXINGTON HEALTH INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $351.00 | 1609930676 - BAYWOOD MEDICAL ASSOCIATES, PLLC, DESERT PAIN INSTITUTE - ASC | 861006533 - (AZ) BAYWOOD MEDICAL ASSOCIATES, PLLC DBA DESERT PAIN INSTITUTE | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $1051.00 | 1801058292 - METROPOLITAN SURGICAL INSTITUTE, LLC | 204513856 - (NJ) METROPOLITAN SURGICAL INSTITUTE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $673.00 | 1720001928 - CAMPBELL CLINIC SURGERY CENTER, LLC | 621826300 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $368.00 | 1578146429 - BSMH AMBULATORY VENTURES II LLC, MERCY HEALTH CANFIELD SURGERY CENTER | 863462441 - (OH) BSMH AMBULATORY VENTURES II LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $150.00 | 1952373086 - CRYSTAL RIVER ENDOSCOPY ASC LP, CITRUS ENDOSCOPY & SURGERY CENTER | 621666148 - (FL) CRYSTAL RIVER ENDOSCOPY ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $47.00 | 1972535292 - CATARACT AND LASER SURGERY CENTER, THE OPHTHALMOLOGY & SURGICAL INSTITUTE OF CENTRAL PA | 201308496 - (PA) CATARACT AND LASER SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $750.00 | 1891882031 - GARDEN STATE SURGICAL CENTER, LLC | 223420171 - (NJ) GARDEN STATE SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $100.00 | 1265672356 - RIVERSIDE SURGICAL CENTER,LLC | 262228384 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $788.00 | 1275687873 - DERMATOLOGY ASSOCIATES OF KENTUCKY, PSC | 611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C. | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $122.00 | 1699711556 - ESCNC LLC, EYE SURGERY CENTER OF NORTHERN CALIFORNIA | 462800751 - (CA) ESCNC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $671.00 | 1558344846 - ALGONQUIN ROAD SURGERY CENTER, LLC | 364337493 - (IL) ALGONQUIN ROAD SURGERY CENTER | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $390.00 | 1518969773 - ARIZONA SKIN CANCER SURGERY CENTER, P.C. | 562365590 - (AZ) ARIZONA SKIN CANCER SURGERY CENTER PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $150.00 | 1376161117 - ACCESS CARE PHYSICIANS OF NJ LLC | 203639484 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64611 | $82.00 | 1104829597 - HOGAN SURGICAL CENTER, P. A. | 300399671 - (MS) HOGAN SURGICAL CENTER P A | MS | 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 64611 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64611 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 64611 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 |
|---|---|---|
| 64600-CPT | Moderate | Destruction By Neurolytic Agent, Trigeminal Nerve; Supraorbital, Infraorbital, Mental, Or Inferior Alveolar |
| 64605-CPT | Moderate | Destruct Neurolytic Trigem 2nd/3rd |
| 64610-CPT | Moderate | Destruction By Neurolytic Agent, Trigeminal Nerve; Second And Third Division Branches At Foramen Ovale Under Radiologic Monitoring |
| 64611-CPT | Low | Injection Of Chemical For Destruction Of Salivary Glands On Both Sides Of The Mouth |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64611. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64611 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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