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 |
| Medicare Fee Schedule | View Medicare rates for 64612 |
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 | $106.36 | 1588136774 - JULIE LANDESS | 350593390 - DEACONESS HOSPITAL INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 64612 | $113.00 | 1487651956 - TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC, TRI-STATE DIGESTIVE DISORDER CENTER | 611192347 - (KY) TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $574.00 | 1811001860 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | 650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $210.00 | 1205080181 - NORTHWEST NEUROSPINE INSTITUTE, LLC, TWO RIVERS SURGICAL CENTER | 300474327 - (OR) NORTHWEST NEUROSPINE INSTITUTE LLC | OR | 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 | $231.49 | 1942705694 - KHALIL BEYDOUN | 350593390 - DEACONESS HOSPITAL INC | MI | Anesthesiology Physician (207L00000X) |
United | 64612 | $566.00 | 1366515504 - RIVERSIDE AMBULATORY SURGERY CENTER, LLC, THE ENDOSCOPY & COLONOSCOPY CENTER | 205227186 - (MO) RIVERSIDE AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $95.00 | 1093766289 - CAPITAL WOMENS CARE LLC, FREDERICK OB/GYN AMBULATORY SURGERY CENTER | 522112078 - (MD) CAPITAL WOMENS CARE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $102.00 | 1104857523 - SURGERY CENTER OF ST. JOSEPH, LLC | 371439847 - (MO) SURGERY CENTER OF ST JOSEPH LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $162.00 | 1497011308 - BENJAMIN CHUNG MD INC, RIVERWALK SURGERY CENTER | 454738248 - (CA) BENJAMIN CHUNG MD INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $280.00 | 1588039465 - SARATOGA SURGICAL CENTER, LLC | 471313246 - (TX) SARATOGA SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64612 | $1446.00 | 1336459353 - LONE STAR ENDOSCOPY CENTER LLC | 273635726 | TX | 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 | 64612 | $231.49 | 1720013378 - MATHIAS KOLLECK | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 64612 | $106.36 | 1588437230 - CASSIDY JACOBS | 350593390 - DEACONESS HOSPITAL INC | IN | Family Nurse Practitioner (363LF0000X) |
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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