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 |
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 | $1014.00 | 1972556942 - CHERRY HILL WOMEN'S CENTER, INC. | 232068660 - (NJ) CHERRY HILL WOMENS CENTER INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1352.00 | 1346237237 - LUFKIN ENDOSCOPY CENTER LTD | 204411582 - (TX) LUFKIN ENDOSCOPY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $965.52 | 1255070116 - MERCY SOUTH ASC LLC, MERCY OUTPATIENT SURGERY CENTER - WEST BEND | 882512783 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $2307.00 | 1396211264 - PALM BEACH SURGICAL SUITES LLC | 830558319 - (FL) PALM BEACH SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1045.00 | 1548223654 - SPARTAN HEALTH SURGICENTER LLC | 251898641 - (PA) SPARTAN HEALTH SURGICENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1923.00 | 1528335148 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN - ERIE AMBULATORY SURGERY CENTER | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $4014.00 | 1497705883 - MISSION AMBULATORY SURGICENTER LTD., MISSION SURGERY CENTER | 330355575 - (CA) MISSION AMBULATORY SURGICENTER LTD | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $5379.00 | 1770252868 - STONESPRINGS SURGICENTER, LLC | 812929320 - (VA) STONESPRINGS SURGICENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $565.00 | 1639282932 - ATLANTA ENDOSCOPY CENTER | 582007241 - (GA) ATLANTA ENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1597.00 | 1477586063 - ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER, LLC | 203378059 - (GA) ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $1670.00 | 1548842180 - DIGESTIVE HEALTH CENTER LLC | 853810510 - (IA) DIGESTIVE HEALTH CENTER LLC | IA | 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 | $2121.00 | 1710945787 - UPLAND OUTPATIENT SURGERY CENTER LP, ONTARIO ADVANCED SURGERY CENTER | 330812827 - (CA) UPLAND OUTPATIENT SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $3150.00 | 1639146541 - CENTENNIAL ASC, LLC, BAYLOR SURGICARE AT CENTENNIAL | 352199232 - (TX) CENTENNIAL ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64726 | $2353.00 | 1316947609 - AMARILLO ENDOSCOPY CENTER, LP | 752893120 - (TX) AMARILLO ENDOSCOPY CENTER LP | TX | 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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