CPT 64726 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 64726 |
National average reimbursement for CPT 64726 by major payers:
$368.33
$374.19
$371.31
$463.30
| 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 64726 | ||||||
United | 64726 | $1050.00 | 1316499452 - COLONIE ASC LLC, SPECIALTY EYE SURGERY & LASER CENTER OF THE CAPITAL REGION | 811964670 - (NY) COLONIE ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $700.00 | 1083654636 - PLASTIC SURGERY SPECIALISTS, PC, NORTH ARUNDEL PLASTIC SURGERY SPECIALISTS | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1350.00 | 1245806876 - WICHITA UROLOGY SURGERY CENTER,LLC | 834482229 - (KS) WICHITA UROLOGY SURGERY CENTERLLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $4014.00 | 1285202077 - SURGCENTER OF PINE RIDGE LLC | 853561528 - (FL) SURGCENTER OF PINE RIDGE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $3553.00 | 1679943989 - LIVINGSTON ASC LLC | 474735737 - (NJ) LIVINGSTON ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1399.00 | 1417987595 - ENDOSCOPY CENTER OF NORTH BALTIMORE | 412081861 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1884.00 | 1346969789 - ADVENTHEALTH SURGERY CENTER INNOVATION TOWER, LLC | 882744377 - (FL) ADVENTHEALTH SURGERY CENTER INNOVATION TOWER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $2900.00 | 1477695336 - SOMERSET OUTPATIENT SURGERY, LLC, RARITAN VALLEY SURGERY CENTER | 208433398 - (NJ) SOMERSET OUTPATIENT SURGERY, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $509.00 | 1023055001 - ZION AMBULATORY CENTER LLC | 203243084 - (MD) ZION AMBULATORY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1550.00 | 1750844049 - FORT WORTH SURGICAL CENTER LP | 832752727 - (TX) FORT WORTH SURGICAL CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $5841.00 | 1053391870 - NORTHWEST SURGERY CENTER, LTD, NORTHWEST SURGERY CENTER RED OAK | 760452319 - (TX) NORTHWEST SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $2101.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1648.00 | 1104087089 - CONGRESS MEDICAL SURGERY CENTER LLC | 262785454 - (CA) CONGRESS MEDICAL SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $2244.00 | 1528027026 - VIRGINIA BEACH AMBULATORY SURGERY CENTER | 541448218 - (VA) VIRGINIA BEACH AMBULATORY SURGERY CENTER | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1014.00 | 1972556942 - CHERRY HILL WOMEN'S CENTER, INC. | 232068660 - (NJ) CHERRY HILL WOMENS CENTER INC | NJ | 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 64726 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64726 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 64726 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 |
|---|---|---|
| 64726-CPT | Moderate | Decompress Plantar Digital Nerve |
| 64727-CPT | Moderate | Internal Neurolysis, Requiring Use Of Operating Microscope (List Separately In Addition To Code For Neuroplasty) (Neuroplasty Includes External Neurolysis) |
| 64774-CPT | Moderate | Excis.Neuroma; Cutan.Nerve,Surg.Id |
| 64778-CPT | Moderate | Exc Neuroma;Dig.Nrv,Ea Added Digit |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64726. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64726 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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