CPT 64625 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 • 11 - Office |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 64625 |
National average reimbursement for CPT 64625 by major payers:
$618.66
$681.27
$668.52
$828.24
| 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 64625 | ||||||
United | 64625 | $2353.00 | 1316508252 - MINIMALLY INVASIVE SURGICENTER LLC | 842130499 - (FL) MINIMALLY INVASIVE SURGICENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $390.00 | 1861596967 - G.I.ENDOSCOPY CENTER | 581862189 - (GA) GIENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $2859.00 | 1447797105 - SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS, LLC, SOUTH DENVER SURGERY CENTER | 364821257 - (CO) SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $1025.00 | 1295015212 - MOSC, LLC | 452913174 - (AZ) MOSC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $1300.00 | 1275132094 - COASTAL CARDIOVASCULAR CENTER, LLC, COASTAL CARDIOVASCULAR CENTER | 845144651 - (TX) COASTAL CARDIOVASCULAR CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $1100.00 | 1871941468 - AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC | 812463581 - (MD) AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $1500.00 | 1487280871 - MARYLAND AMBULATORY SURGERY CENTER LLC | 845098442 - (MD) MARYLAND AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $3993.00 | 1699738112 - NORTH AUSTIN SURGERY CENTER, L.P. | 200648730 - (TX) NORTH AUSTIN SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $1819.00 | 1588619811 - LAWRENCEVILLE SURGERY CENTER, LLC | 582591488 - (GA) LAWRENCEVILLE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $3500.00 | 1992721591 - DAY SURGERY CENTER OF NORTH TEXAS LTD | 260308454 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $1490.00 | 1932856945 - UPPER VALLEY DIALYSIS ACCESS CENTER, LLC | 863328769 - (TX) UPPER VALLEY DIALYSIS ACCESS CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $1309.00 | 1699256404 - LEGACY SURGERY CENTER LLC | 831722822 - (FL) LEGACY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $1419.00 | 1609825298 - SURGERY CENTER OF IDAHO LLC | 204831740 - (ID) SURGERY CENTER OF IDAHO LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $2101.00 | 1063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER | 862679471 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64625 | $1838.00 | 1093595696 - NEW LEXINGTON CLINIC PSC, DERMATOLOGY ASSOCIATES OF KENTUCKY PSC | 611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C. | KY | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 64625 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64625 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 64625 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 |
|---|---|---|
| 64620-CPT | Moderate | Destruction By Neurolytic Agent; Intercostal Nerve |
| 64624-CPT | Moderate | Destruction By Neurolytic Agent, Genicular Nerve Branches Including Imaging Guidance, When Performed - Deny Inv/N10>=4/29/2023 |
| 64625-CPT | Moderate | Radiofrequency Ablation Nerves Innervating The Sacroiliac Joint With Image Guidance (Ie Fluoroscopy Or Computed Tomography) |
| 64630-CPT | Moderate | Destruct Neurolytic Pudendal |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64625. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64625 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 64625) and we'll show you how you compare in 15 minutes or less.