CPT 64612 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 • 50 - Bilateral Procedure • LT - Left side of body |
| Complexity Level | Low |
National average reimbursement for CPT 64612 by major payers:
$178.21
$194.86
$206.15
$239.23
| 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 64612 | ||||||
United | 64612 | $135.00 | 1326374844 - CREEKSIDE SURGERY SUITE | 680319558 - (CA) SHAHRIAR MABOURAKH, M.D. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $180.00 | 1265964050 - SCHAUMBURG SURGERY CENTER, LLC | 813061805 - (IL) SCHAUMBURG SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $123.00 | 1427020213 - TOLEDO ENDOSCOPY ASC LLC, NORTHWEST OHIO ENDOSCOPY CENTER | 621734002 - (OH) TOLEDO ENDOSCOPY ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $106.36 | 1316708365 - BRENT BLAND | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 64612 | $106.36 | 1962641431 - LARESSA BAZZELL | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 64612 | $106.36 | 1588437230 - CASSIDY JACOBS | 350593390 - DEACONESS HOSPITAL INC | IN | Family Nurse Practitioner (363LF0000X) |
United | 64612 | $106.36 | 1356886832 - JEREMY HENRIE | 350593390 - DEACONESS HOSPITAL INC | UT | Certified Registered Nurse Anesthetist (367500000X) |
United | 64612 | $231.49 | 1184077992 - NAYEF NIMRI | 350593390 - DEACONESS HOSPITAL INC | KY | Cardiovascular Disease Physician (207RC0000X) |
United | 64612 | $231.49 | 1639124126 - ANNE TINTINALLI | 350593390 - DEACONESS HOSPITAL INC | MI | Emergency Medicine Physician (207P00000X) |
United | 64612 | $689.00 | 1164458634 - SAINT FRANCIS SURGERY CENTER, LLC, SAINT FRANCIS SURGERY CENTER | 61641562 - (TN) SAINT FRANCIS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $79.00 | 1518916758 - MOUNTAIN LAUREL SURGERY CENTER L.L.C. | 753187461 - (PA) MOUNTAIN LAUREL SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $231.49 | 1568935344 - JAMES GILSTRAP | 350593390 - DEACONESS HOSPITAL INC | MO | Certified Registered Nurse Anesthetist (367500000X) |
United | 64612 | $557.00 | 1275536393 - MEDICAL CENTER SURGERY ASSOCIATES, LP | 621449272 - (FL) MEDICAL CENTER SURGERY ASSOCIATES LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $566.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $100.00 | 1841290103 - CENTRAL FLORIDA EYE INSTITUTE PL | 421621290 - (FL) CENTRAL FLORIDA EYE INSTITUTE PL | FL | 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 64612 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64612 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 64612 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 |
|---|---|---|
| 64611-CPT | Low | Injection Of Chemical For Destruction Of Salivary Glands On Both Sides Of The Mouth |
| 64612-CPT | Low | Chemodenervation Of Muscle(S); Muscle(S) Innervated By Facial Nerve Unilateral (Eg For Blepharo- Spasm Hemifacial Spasm) (Revised 1/1/2013) |
| 64615-CPT | Low | Chemodenervation Of Muscle(S); Muscle(S) Inner- Vated By Facial Trigeminal Cervical Spinal And Accessory Nerves Bilateral (Eg For Chronic Migraine) |
| 64616-CPT | Low | Chemodenervation Of Muscle(S); Neck Muscle(S), Excluding Muscles Of The Larynx, Unilateral (Eg, For Cervical Dystonia, Spasmodic Torticollis) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64612. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64612 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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