CPT 64738 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 64738 by major payers:

$609.58

$624.81

$629.92

$773.48
| 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 64738 | ||||||
United | 64738 | $794.00 | 1063459451 - CARROLL COUNTY AMBULATORY SURGICAL CENTER | 522165022 - (MD) CARROLL COUNTY AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $1886.00 | 1447364682 - RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $840.00 | 1437102241 - SURGERY CENTER OF FREMONT, LLC | 203639614 - (NE) SURGERY CENTER OF FREMONT LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $544.00 | 1588644520 - WESTGLEN ENDOSCOPY CENTER LLC, WESTGLEN ENDOSCOPY CENTER | 621707329 - WESTGLEN ENDOSCOPY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $1628.00 | 1801944343 - HUDSON VALLEY AMBULATORY SURGERY, LLC | 510451539 - (NY) HUDSON VALLEY AMBULATORY | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $875.00 | 1235466863 - AESTHETIC ASSOCIATES INC., P.S, SEATTLE FACIAL PLASTIC SURGERY CENTER | 911650765 - (WA) AESTHETIC ASSOCIATES INC PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $1368.00 | 1194788182 - SURGICAL PARK CENTER LTD | 592827368 - (FL) SURGICAL PARK CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $925.00 | 1952852345 - HUEBNER AMBULATORY SURGERY CENTER, LLC | 813360799 - (TX) HUEBNER AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $758.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $4044.00 | 1679998025 - SURGERY CENTER OF KENAI | 462556456 - (AK) SURGERY CENTER OF KENAI | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $539.00 | 1245343912 - WICHITA ENDOSCOPY CENTER LLC | 202572299 - (KS) WICHITA ENDOSCOPY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $397.00 | 1205303930 - LASER SURGERY HOLDING COMPANY, LTD | 550882748 - (AZ) LASER SURGERY HOLDING COMPANY LT | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $1438.00 | 1770513855 - CAPITAL ENDOSCOPY LLC | 134244093 - (MD) CAPITAL ENDOSCOPY & SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $1278.00 | 1437202249 - PACMED CLINICS | 562290878 - (WA) PACMED CLINICS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64738 | $1275.00 | 1255728499 - SUMMIT ATLANTIC SURGERY CENTER LLC | 473235212 - (NJ) SUMMIT ATLANTIC SURGERY CENTER LLC | 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 64738 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64738 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 64738 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64738. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64738 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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Medicare Reimbursement Lookup Tool
Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)
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| Year | Billing Code | Locality | Non-Facility Fee | Facility Fee |
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