CPT 64653 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 PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 64653 |
National average reimbursement for CPT 64653 by major payers:
$109.60
$128.01
$147.03
$102.39
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 64653 | $150.00 | 1700282852 - LAKE JACKSON ENDOSCOPY CENTER, LP. | 800513571 - (TX) LAKE JACKSON ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $121.00 | 1760773949 - PIEDMONT OUTPATIENT SURGERY CENTER, LLC | 273982668 - (NC) PIEDMONT OUTPATIENT SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $490.00 | 1932530284 - VP SURGERY CENTER OF AUBURN LLC | 371668651 - (WA) VP SURGERY CENTER OF AUBURN LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $200.00 | 1881845907 - NORTH PACIFIC DERMATOLOGY PS | 204269950 - (WA) NORTH PACIFIC DERMATOLOGY PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $500.00 | 1669621496 - CPM SURGERY CENTER 3, LLC | 263297851 - (GA) CPM SURGERY CENTER 3 LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $110.00 | 1205800752 - MEDICAL EYE ASSOCIATES, INC. | 581606296 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $207.00 | 1336635747 - ROCKVILLE SURGICAL SUITES, LLC | 825263227 - (MD) ROCKVILLE SURGICAL SUITES LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $574.00 | 1194723981 - GREENWOOD ASC LLC, GREENWOOD AMBULATORY SURGERY CENTER | 331021175 - (CO) GREENWOOD ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $250.00 | 1174503080 - THE SURGICAL CENTER FOR EXCELLENCE, LLLP | 743107832 - (FL) SURGICAL CENTER FOR EXCELLENCE, LLLP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $506.00 | 1467796730 - WINDSOR MILL SURGERY CENTER, LLC | 461412275 - (MD) WINDSOR MILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $970.00 | 1235715996 - CENTRAL UTAH SURGICENTER, LLC | 862348485 - (UT) CENTRAL UTAH SURGICENTER LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $566.00 | 1881697522 - RIVERSIDE PARK SURGICENTER LLC | 593106055 - (FL) RIVERSIDE PARK SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $150.00 | 1710924899 - DMG SURGICAL CENTER LLC, SURGICAL CENTER OF DUPAGE MEDICAL GROUP | 371474161 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $566.00 | 1154387710 - WARNER PARK SURGERY CENTER LLC, CENTER FOR ADVANCED SURGERY | 752824260 - (AZ) WARNER PARK SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64653 | $328.00 | 1609887041 - ZITELLI & BRODLAND PC, ZITELLI & BRODLAND ASF CENTRAL | 251549973 - JOHN A. ZITELLI, MD, PC | PA | 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 64653 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64653 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 64653 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 | Muscle Injection For Spasm, An Injection Into A Muscle In Order To Weaken Or Temporarily Paralyze It. The Treatment Typically Is Given To Relieve Muscle Spasms Associated With Various Conditions. |
| 64643-CPT | Low | Muscle Injection For Spasm, An Injection Into A Muscle In Order To Weaken Or Temporarily Paralyze It. The Treatment Typically Is Given To Relieve Muscle Spasms Associated With Various Conditions. |
| 64644-CPT | Moderate | Muscle Injection For Spasm, An Injection Into A Muscle In Order To Weaken Or Temporarily Paralyze It. The Treatment Typically Is Given To Relieve Muscle Spasms Associated With Various Conditions. |
| 64653-CPT | Low | Treatment Of Sweat Glands, An Injection Of Botulinum Toxin Or A Similar Medicine Into A Sweat Gland. The Chemical Partially Disables The Sweating Reflex To Relieve Excessive Perspiration. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64653. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64653 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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