CPT 64636 is a medical code for 'Destruction By Neurolytic Agent, Paravertebral Facet Joint Nerve(S), With Imaging Guidance (Fluoroscopy Or Ct); Lumbar Or Sacral, Each Additional Facet Joint'. It is used by healthcare providers to document and receive reimbursement for moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Where can CPT 64636 procedures commonly be performed?

CPT 64636 procedures are commonly performed in an Ambulatory Surgical Center (24) or an Office (11).

How can I find out the cost of a medical procedure?

To find out the cost of a medical procedure, you can start by contacting your insurance provider to understand your benefits, deductibles, and co-pays. You can also ask the healthcare provider's billing department for an estimate. For more detailed and specific cost information based on your location and CPT codes, you can utilize tools like Payerprice, which offers a fee schedule lookup tool to search with CPT codes and specific locations.

What is a CPT code, and why is it important?

A CPT (Current Procedural Terminology) code is a five-digit code used by medical professionals and insurers to describe medical, surgical, and diagnostic services. It's crucial because it standardizes the way medical procedures are reported and billed, ensuring consistent communication between providers, patients, and payers. Knowing the CPT code for a service can help you research costs and understand your medical bills more accurately, especially when using tools like Payerprice.

How do I know what my insurance will cover?

To determine what your insurance will cover, the best approach is to directly contact your insurance provider. You can typically find a customer service number on your insurance card or log into their online portal. Be prepared to provide details about the specific service or procedure you're inquiring about, including any CPT codes if you have them. They can inform you about your coverage limits, deductibles, co-pays, and whether a service requires pre-authorization.

What is the difference between in-network and out-of-network providers?

An "in-network" provider has a contract with your health insurance company to provide services at pre-negotiated rates. When you see an in-network provider, you typically pay less out-of-pocket, as your insurance covers a larger portion of the cost. An "out-of-network" provider does not have a contract with your insurer, meaning your insurance may cover a smaller percentage of the cost, or not at all, leading to higher out-of-pocket expenses for you. Your deductible and co-insurance may also be higher for out-of-network services.

Where can I compare prices for medical services?

Comparing prices for medical services can be challenging, but there are resources available. You can inquire with different healthcare providers for cash prices or estimates. Your insurance company might also offer tools to estimate costs for certain procedures. For a more direct approach to comparing prices based on CPT codes and specific locations, consider using tools like Payerprice. Their fee schedule lookup tool allows users to search for costs, helping you make more informed healthcare decisions.

CPT 64636 Fee Schedule

Q: What factors affect fee schedules?

Factors that affect fee schedules include 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), and Provider Type (hospital providers may have different rates than private practice).

Last Verified: October 2026

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.

Destroy L S Facet Jnt Addl, Destruction By Neurolytic Agent Paravertebral Facet Joint Nerve S With Imaging Guidance Fluoroscopy Or Ct Lumbar Or Sacral Each Additional Facet Joint List Separately In Addition To Code For Primary Procedure

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 64636
Medicaid Fee Schedule	View Medicaid rates for 64636

National average reimbursement for CPT 64636 by major payers:

$258.54

$250.00

$295.78

$341.30

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 64636.

CPT 64636

5 of 25 sample ratesHigher to lower in this preview

Centennial Asc, LLC, Baylor Surgicare At Centennial
Centennial Asc LLC
TXAmbulatory Surgical Clinic/CenterNPI 1639146541Tax ID 35-2199232
$1,446.00Published rate
Winter Haven Ambulatory Surgical Center LLC
Winter Haven Ambulatory Surgical Center, LLC
FLAmbulatory Surgical Clinic/CenterNPI 1538126362Tax ID 59-3659906
$566.00Published rate
Mercy South Asc LLC, Mercy Outpatient Surgery Center - West Bend
MOAmbulatory Surgical Clinic/CenterNPI 1255070116Tax ID 88-2512783
$213.00Published rate
Texas Midwest Endoscopy Center, LLC
Texas Midwest Endoscopy Center LLC
TXAmbulatory Surgical Clinic/CenterNPI 1104457274Tax ID 84-2574842
$150.00Published rate
Boston Eye Surgery & Laser Center Trust, Boston Eye Surgery & Laser Center
Boston Eye Surgery & Laser Center Trust
MAAmbulatory Surgical Clinic/CenterNPI 1639215502Tax ID 43-092292
$66.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

This code appears in 1 published specialty market.

Explore state-level rates by specialty

CPT 64636 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 64636 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 64636 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
64633-CPT	Moderate	Destroy Cerv Thor Facet Jnt, Destruction By Neurolytic Agent Paravertebral Facet Joint Nerve S With Imaging Guidance Fluoroscopy Or Ct Cervical Or Thoracic Single Facet Joint
64634-CPT	Moderate	Destroy C Th Facet Jnt Addl, Destruction By Neurolytic Agent Paravertebral Facet Joint Nerve S With Imaging Guidance Fluoroscopy Or Ct Cervical Or Thoracic Each Additional Facet Joint List Separately In Addition To Code For Primary Procedure
64635-CPT	Moderate	Destruction By Neurolytic Agen, Destruction By Neurolytic Agent Paravertebral Facet Joint Nerve(S) With Imaging Guidance (Fluoroscopy Or Ct) Lumbar Or Sacral Single Facet Joint
64636-CPT	Moderate	Destroy L S Facet Jnt Addl, Destruction By Neurolytic Agent Paravertebral Facet Joint Nerve S With Imaging Guidance Fluoroscopy Or Ct Lumbar Or Sacral Each Additional Facet Joint List Separately In Addition To Code For Primary Procedure

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64636. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 64636 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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CPT 64636 Fee Schedule

Centennial Asc, LLC, Baylor Surgicare At Centennial

Winter Haven Ambulatory Surgical Center LLC

Mercy South Asc LLC, Mercy Outpatient Surgery Center - West Bend

Texas Midwest Endoscopy Center, LLC

Boston Eye Surgery & Laser Center Trust, Boston Eye Surgery & Laser Center