CPT 64643 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 • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments • LT - Left side of body |
| Complexity Level | Low |
National average reimbursement for CPT 64643 by major payers:
$126.64
$128.02
$134.06
$168.26
| 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 64643 | ||||||
United | 64643 | $113.00 | 1053985721 - ENDO SURGICAL CENTER OF KISSIMMEE, PLLC | 844377406 - (FL) ENDO SURGICAL CENTER OF KISSIMMEE PLLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $963.00 | 1568776615 - CEDAR PARK SURGERY CENTER, LLC | 272533497 - (TX) CEDAR PARK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $108.00 | 1134135213 - MORGANTON EYE PHYSICIANS, P.A., SURGERY CENTER OF MORGANTON EYE PHYSICIANS | 561109834 - (NC) MORGANTON EYE PHYSICIANS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $103.00 | 1093214819 - PREMIER SURGICAL CENTER, LLC | 823438730 - (MS) PREMIER SURGICAL CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $125.00 | 1699445981 - ELKO COMMUNITY HEALTH CENTER, LLC | 851569152 - (NV) ELKO COMMUNITY HEALTH CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $546.00 | 1093960700 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE HIGHLANDS SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $688.00 | 1801983556 - TRESANTI SURGICAL CENTER LLC, TRESANTI MEDICAL CORPORATION | 710905694 - (CA) TRESANTI SURGICAL CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $566.00 | 1174802045 - LEONARDTOWN SURGERY CENTER LLC | 452019132 - (MD) LEONARDTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $222.00 | 1649218009 - RIVER DRIVE SURGERY CENTER, LLC, RIVER DRIVE SURGERY AND LASER CENTER | 223672648 - (NJ) RIVER DRIVE SURGERY CENTER L L | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $1344.00 | 1144291261 - OCEAN SURGICAL PAVILION, PC, OCEAN SURGICAL PAVILION | 223182653 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $55.00 | 1043396245 - WEST FLORIDA MEDICAL CENTER CLINIC PA, MEDICAL CENTER CLINIC AMBULATORY SURGICAL CENTER | 592193856 - (FL) WEST FLORIDA MEDICAL CENTER CLINIC, P.A. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $521.00 | 1154460525 - VIRGINIA MASON MEDICAL CENTER, VIRGINIA MASON LYNNWOOD ASC | 910565539 - (WA) VIRGINIA MASON MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $115.00 | 1538124490 - CITRUS REGIONAL SURGERY CENTER LP | 621510209 - (FL) CITRUS REGIONAL SURGERY CENTER LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $137.00 | 1447685458 - CHECKERSPOT SURGERY CENTERS, LLC | 463181931 - (MD) CHECKERSPOT SURGERY CENTERS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64643 | $80.00 | 1255446910 - DOWNTOWN BALTIMORE SURGERY CENTER, LLC | 522219532 - (MD) DOWNTOWN BALTIMORE SURGERY CENTER LLC | 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 64643 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64643 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 64643 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 |
|---|---|---|
| 64642-CPT | Low | Injection Of Chemical For Paralysis Of Nerve Muscles On Arm Or Leg, 1-4 Muscles, First Extremity |
| 64643-CPT | Low | Chemodenervation Of One Extremity; Each Additionalextremity 1-4 Muscle(S) (List Separately In Addition To Code For Primary Procedure) |
| 64644-CPT | Moderate | Injection Of Chemical For Paralysis Of Nerve Muscles On Arm Or Leg, 5 Or More Muscles, First Extremity |
| 64645-CPT | Low | Chemodenervation Of One Extremity; Each Additional Extremity, 5 Or More Muscles (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 64643. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64643 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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