CPT 64630 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 • 59 - Distinct Procedural Service • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 64630 |
National average reimbursement for CPT 64630 by major payers:
$323.07
$321.93
$339.04
$405.85
| 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 64630 | ||||||
United | 64630 | $4215.00 | 1093459315 - PERFORMANCE HEALTH SURGICENTER, LLC | 881897351 - (FL) PERFORMANCE HEALTH SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $200.00 | 1821098443 - HAZLETON AMBULATORY SURGICAL CENTER LLC | 232971919 - (PA) HAZLETON AMBULATORY SURGICAL CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $953.00 | 1285215301 - LAKEWOOD RANCH SURGICAL SUITES, LLC | 842624445 - (FL) LAKEWOOD RANCH SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $450.00 | 1922531268 - AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | 814584087 - (MD) AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $893.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $416.52 | 1629207253 - MATTHEW TUCKER | 350593390 - DEACONESS HOSPITAL INC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 64630 | $520.00 | 1558339424 - PREMIER SURGERY CENTER | 352206509 - (CA) PREMIPREMIER SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $893.00 | 1841395894 - FRANKLIN ENDOSCOPY CENTER, LLC, FRANKLIN ENDOSCOPY CENTER | 383730672 - (TN) FRANKLIN ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $649.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $251.00 | 1235105248 - GURLEY SURGERY CENTER, THE GYN CENTER | 621159796 - (TN) GURLEY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $893.00 | 1326114869 - EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY, LLC | 201482218 - (TX) EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $1531.00 | 1982871935 - NORTHERN VIRGINIA SURGERY CENTER LLC | 203502477 - (VA) NORTHERN VIRGINIA SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $341.00 | 1902981558 - LANE SURGERY CENTER, LLC | 931305103 - (OR) LANE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $525.00 | 1447329990 - SEMMES-MURPHEY CLINIC PC, SEMMES MURPHEY SURGERY CENTER | 620642575 - (TN) SEMMES-MURPHEY CLINIC PC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $469.00 | 1295973006 - ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC, SUMMIT SURGERY CENTER AT ST. MARYS GALENA | 264094998 - ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC D/B/A SUMMIT | NV | 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 64630 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64630 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 64630 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 |
| 64628-CPT | Moderate | Thermal Destruction Of Intraosseous Basivertebral Nerve, Including All Imaging Guidance; First 2 Vertebral Bodies, Lumbar Or Sacral - Deny Inv/N10 |
| 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 64630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64630 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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