CPT 64716 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 64716 |
National average reimbursement for CPT 64716 by major payers:
$663.44
$706.13
$743.33
$878.55
| 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 64716 | ||||||
United | 64716 | $2206.00 | 1942715826 - SAFETY HARBOR ASC COMPANY LLC, SAFETY HARBOR SURGERY CENTER | 320547161 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $1380.00 | 1477886406 - BILTMORE SURGICAL PARTNERS, LLC, DEER VALLEY SURGICAL AND ENDOSCOPY CENTER | 264509307 - (AZ) BILTMORE SURGICAL PARTNERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $691.00 | 1407004534 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $1339.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $1050.00 | 1104228931 - GLENNVILLE EYE SURGERY CENTER LLC | 463019697 - (GA) GLENNVILLE EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $1477.00 | 1669021283 - EL DORADO SURGERY CENTER LP, TUCSON ENDOSCOPY CENTER | 850474225 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $2353.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $1834.00 | 1528121316 - SAINT LUKES SOUTH SURGERY CENTER LLC | 201721929 - (KS) SAINT LUKES SOUTH SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $1514.00 | 1467629147 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $2206.00 | 1730713439 - FLORIDA SPRINGS SURGERY CENTER LLC | 832895293 - (FL) FLORIDA SPRINGS SURGERY CENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $2243.00 | 1356572465 - ORCHARD CREEK SURGERY CENTER, ORCHARD CREEK SURGERY CENTER | 770498874 - (CA) ORCHARD CREEK SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $1060.00 | 1841259611 - ALTA-ROSE SURGERY CENTER LLC | 201429557 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $609.00 | 1164697009 - BOX HILL SURGERY CENTER LLC | 262454678 - (MD) BOX HILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $1401.00 | 1689748758 - PARK AVENUE SURGERY CENTER LLC | 721565454 - (CO) PARK AVENUE SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64716 | $2285.00 | 1316462377 - UCSD SURGICAL CENTER OF SAN DIEGO, LLC | 822218664 | CA | 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 64716 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64716 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 64716 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 |
|---|---|---|
| 64708-CPT | Moderate | Neuroplasty Major Peripheral Nerve Arm Or Leg Open Other Than Specified (Revision 2011) |
| 64712-CPT | Moderate | Neuroplasty, Major Peripheral Nerve, Arm Or Leg, Open; Sciatic Nerve (Revision 2011) |
| 64713-CPT | High | Neuroplasty, Major Peripheral Nerve, Arm Or Leg, Open; Brachial Plexus (Revision 2011) |
| 64716-CPT | Moderate | Neuroplasty &/Or Transposition; Cranial |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64716. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64716 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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