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 |
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 | $410.00 | 1528604675 - SURGERY CENTER OF NORTH TEXAS, PLLC | 831353164 - (TX) SURGERY CENTER OF NORTH TEXAS, PLLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $1857.00 | 1114034006 - SURGICAL CENTER AT MILLBURN, LLC | 571166137 - (NJ) SURGICAL CENTER AT MILLBURN LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $410.00 | 1467833160 - AUSTELL SURGERY CENTER, LLC | 473077378 - (GA) AUSTELL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $934.00 | 1932636123 - TUCSON DIGESTIVE INSTITUTE LLC, ARIZONA DIGESTIVE INSTITUTE | 821568426 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $416.00 | 1265609945 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $306.00 | 1548216914 - UPPER CUMBERLAND PHYSICIANS SURGERY CENTER LLC | 450470832 - (TN) UPPER CUMBERLAND PHYSICIANS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $406.00 | 1154412120 - SURGICORE, INC. | 363567890 - (IL) SURGICORE INC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $330.00 | 1669772893 - ADVANCED EYE SURGERY CENTER, L.L.C. | 273717607 - (KS) ADVANCED EYE SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $1145.00 | 1184009326 - AMBULATORY CENTER FOR ENDOSCOPY, LLC, HUDSON BERGEN ENDO-SURGICAL CENTER | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $825.00 | 1023072824 - SOUTH JERSEY EYE PHYSICIANS, LLC, THE SURGICAL CENTER AT SOUTH JERSEY EYE PHYSICIANS, PA | 222116946 - (NJ) SOUTH JERSEY EYE PHYSICIANS, PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $410.00 | 1740700111 - M. REZA MIZANI, M.D., P.A., TOTAL VASCULAR CARE | 200743330 - (TX) M. REZA MIZANI MD, PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $893.00 | 1750565594 - PEDIATRIC SURGERY CENTER -ODESSA, LLC | 651274446 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64630 | $697.00 | 1295897106 - WESTMONT SURGERY CENTER LLC, SALT CREEK SURGERY CENTER | 364419691 - WESTMONT SURGERY CENTER, LLC DBA SALT CREEK SURGERY CENTER | IL | 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 | $1118.00 | 1235715996 - CENTRAL UTAH SURGICENTER, LLC | 862348485 - (UT) CENTRAL UTAH SURGICENTER LLC | UT | 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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