CPT 64635 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 |
National average reimbursement for CPT 64635 by major payers:
$536.34
$593.12
$623.92
$723.19
| 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 64635 | ||||||
United | 64635 | $1267.00 | 1487629044 - RALEIGH NC ENDOSCOPY ASC LLC, RALEIGH ENDOSCOPY CENTER | 200864597 - (NC) RALEIGH NC ENDOSCOPY ASC LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $623.28 | 1275607129 - CONSULTANTS IN PAIN MANAGEMENT, PC | 300070474 - (TN) CONSULTANTS IN PAIN MANAGEMENT, P.C. | TN | Pain Medicine Physician (208VP0000X) |
United | 64635 | $2307.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $1700.00 | 1225523970 - BURNSVILLE SURGERY CENTER, P.A. | 830965169 - (MN) BURNSVILLE SURGERY CENTER PA | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $566.66 | 1609832229 - GREGORY BALL | 300070474 - (TN) CONSULTANTS IN PAIN MANAGEMENT, P.C. | TN | Pain Medicine Physician (208VP0000X) |
United | 64635 | $811.00 | 1730169657 - LEO R. MCCAFFERTY, M.D., SURGICAL CENTER | 200421646 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $1000.00 | 1972535292 - CATARACT AND LASER SURGERY CENTER, THE OPHTHALMOLOGY & SURGICAL INSTITUTE OF CENTRAL PA | 201308496 - (PA) CATARACT AND LASER SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $1250.00 | 1619971470 - ARIZONA ADVANCED SURGERY CENTER, LLC | 202770438 - (AZ) ARIZONA ADVANCED SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $2307.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $2101.00 | 1750499950 - MEDPLEX OUTPATIENT SURGERY CENTER LTD, MEDPLEX OUTPATIENT SURGERY CENTER | 760353620 - (AL) MEDPLEX OUTPATIENT SURGERY CENTER LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $2172.00 | 1508965401 - MILLENNIUM SURGERY CENTER INC | 770513445 - (CA) MILLENNIUM SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $760.00 | 1972758183 - DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE, LLC | 260448163 - (CT) DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $1098.00 | 1114990736 - TULSA OK OPHTHALMOLOGY ASC LLC, EYE SURGERY CENTER OF TULSA | 743051552 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $730.00 | 1073581880 - AMBULATORY SURGERY CENTER LLC, THE CENTER FOR SAME DAY SURGERY | 481114690 - (KS) AMBULATORY SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64635 | $1151.00 | 1669474748 - ARC KENTUCKY LLC, DUPONT SURGERY CENTER | 621754364 - (KY) ARC KENTUCKY LLC | 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 |
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CPT 64635 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64635 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 64635 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 |
|---|---|---|
| 64628-CPT | Moderate | Thermal Destruction Of Intraosseous Basivertebral Nerve, Including All Imaging Guidance; First 2 Vertebral Bodies, Lumbar Or Sacral - Deny Inv/N10 |
| 64629-CPT | Moderate | Thermal Destruction Of Intraosseous Basivertebral Nerve Including All Imaging Guidance; Each Additional Vertebral Body Lumbar Or Sacral (List Separately In Addition To Code For Primary Pro- Cedure) |
| 64633-CPT | Moderate | Once Per Dos Destruction By Neurolytic Agent, Paravertebral Facet Joint Nerve W/Imaging Guidance; Cervical Or Thoracic, Single Facet Joint- Medicaid Rn Review>=7/8/2017 |
| 64635-CPT | Moderate | Once Per Dos Destruction By Neurolytic Agent, Paravertebral Facet Joint Nerve W/Imaging Guidance; Lumbar Or Sacral, Single Facet Joint- Medicaid Rn Review>=7/8/2017 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64635 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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