CPT 64636 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 64636 by major payers:
$258.54
$250.00
$295.78
$351.79
| 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 64636 | ||||||
United | 64636 | $555.00 | 1790104248 - METRO SURGERY CENTER, LLC, METRO SURGERY CENTER, LP | 810587498 - (AZ) METRO SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $104.00 | 1821064031 - PIEDMONT DAY SURGERY CENTER INC | 541514162 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $128.00 | 1932782315 - WAKE SPINE AND SPECIALTY SURGERY CENTER LLC, RALEIGH NEUROSURGICAL AND SPINE SURGERY CENTER | 842694789 - (NC) WAKE SPINE & SPECIALTY SURGERY | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $419.00 | 1366799033 - UPSTATE GASTROENTEROLOGY, LLC | 270998899 - (NY) UPSTATE GASTROENTEROLOGY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $118.00 | 1336213099 - SAN GABRIEL AMBULATORY SURGERY CENTER, LP | 510470714 - (CA) SAN GABRIEL AMBULATORY SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $196.00 | 1124526306 - INDIANA PAIN CENTERS-EVANSVILLE LLC | 823643604 - (IN) INDIANA PAIN CENTERSEVANSVILLE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $566.00 | 1801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING | 455364868 - (AZ) SURGCENTER AT PARADISE VALLEY | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $166.00 | 1972568830 - FLORENCE SURGERY CENTER, L.P., FLORENCE SURGERY CENTER | 621551098 - (AL) FLORENCE SURGERY CENTER LP | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $1020.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $1543.00 | 1528479664 - HHC SOUTHINGTON SURGERY CENTER, LLC, CHESHIRE SURGERY CENTER | 465500829 - (CT) HHC SOUTHINGTON SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $127.00 | 1265462881 - WOOSTER OPHTHALMOLOGISTS, INC., EYE SURGERY CENTER OF WOOSTER | 341338984 - (OH) WOOSTER OPHTHALMOLOGISTS, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $600.00 | 1689059222 - GOLDSTEP AMBULATORY SURGERY CENTER, LLC | 465647464 - (NY) GOLDSTEP AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $4613.00 | 1609052679 - BELTWAY SURGERY CENTERS, LLC, BELTWAY SURGERY CENTER SPRINGMILL | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $112.00 | 1124091897 - PADUCAH OPHTHALMOLOGY ASC LLC, THE EYE SURGERY CENTER OF PADUCAH | 943428567 - (KY) PADUCAH OPHTHALMOLOGY ASC LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64636 | $105.00 | 1841325214 - AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERY | 208422547 - (MD) AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERY | MD | 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 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 |
|---|---|---|
| 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 |
| 64636-CPT | Moderate | 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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