CPT 64831 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 • F1 - Left hand, second digit • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 64831 |
National average reimbursement for CPT 64831 by major payers:
$894.01
$938.79
$982.27
$1,165.79
| 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 64831 | ||||||
United | 64831 | $840.00 | 1528024114 - AMBULATORY CARE CENTER PA | 223479837 - (NJ) AMBULATORY CARE CENTER PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $3623.00 | 1194239483 - ATLANTIC COAST SURGICAL SUITES, LLC | 822449256 - (NH) ATLANTIC COAST SURGICAL SUITES LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $1307.00 | 1447271713 - COLUMBUS ORTHOPEDIC OUTPATIENT | 900069344 - (MS) COLUMBUS ORTHOPEDIC OUTPATIENT | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $1773.00 | 1033102140 - SSC HOLDINGS LLC, SEDONA SURGERY CENTER | 470887316 - (CA) SSC HOLDINGS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $5000.00 | 1811220429 - SURGICARE OF MANHATTAN, LLC | 205679305 - (NY) SURGICARE OF MANHATTAN LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $2060.00 | 1215126438 - THE ARCADIA CA ENDOSCOPY ASC LP, VALLEY DIGESTIVE HEALTH CENTER | 204484163 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $3623.00 | 1275292229 - SCOTTSDALE ENDOSCOPY ASC LLC | 873952617 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $1602.00 | 1083674196 - VISION CARE CENTER OF IDAHO LLC | 820516189 - (ID) VISION CARE CENTER OF IDAHO LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $626.00 | 1225070527 - LIBERTY CATARACT CENTER LLC | 743099283 - (MO) LIBERTY CATARACT CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $552.72 | 1013392620 - ANGELA SAMS | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 64831 | $1203.00 | 1710036892 - MARCUS OBEIUS | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 64831 | $1155.00 | 1205899705 - EL PASO SURGERY CENTERS LP | 621846494 - (TX) EL PASO SURGERY CENTERS LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $6342.00 | 1851650428 - TEXAS HEALTH OUTPATIENT SURGERY CENTER ALLIANCE | 822296081 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $3100.00 | 1649463605 - PRINCETON ORTHOPAEDIC ASSOCIATES II PA | 223471829 - (NJ) PRINCETON ORTHOPAEDIC ASSOCIATES II, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64831 | $3188.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | 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 64831 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64831 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 64831 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 |
|---|---|---|
| 64823-CPT | High | Sympathectomy; Superficial Palmar Arch |
| 64831-CPT | Moderate | Suture-Digital Nerve,Hand/Ft; 1 Nrv |
| 64832-CPT | Moderate | Suture Of Digital Nerve, Hand Or Foot; Each Additional Digital Nerve (List Separately In Addition To Code For Primary Procedure) |
| 64834-CPT | Moderate | Suture-1 Nrv,Hand/Ft;Common Sensory |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64831. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64831 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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