CPT 64858 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 64858 |
National average reimbursement for CPT 64858 by major payers:

$1,576.08

$1,608.35

$1,622.25

$1,966.97
| 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 64858 | ||||||
United | 64858 | $3570.00 | 1275545279 - SURGERY CENTER OF COLUMBIA LP | 205227138 - (MO) SURGERY CENTER OF COLUMBIA LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $3000.00 | 1003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $1650.00 | 1194966051 - FIRST STREET SURGERY CENTER INC. | 263375664 - (CA) FIRST STREET SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $550.00 | 1639105455 - ENDOSURG OUTPATIENT CENTER LLC | 593678998 - (FL) ENDOSURG OUTPATIENT CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $1070.00 | 1871811257 - HILLSIDE ENDOSCOPY CENTER, LLC | 263741464 - (PA) HILLSIDE ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $1635.00 | 1407335458 - MERRITT ISLAND OUTPATIENT SURGERY CENTER, LLC | 821391712 - (FL) MERRITT ISLAND OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $3570.00 | 1053764779 - SURGCENTER OF ST. LUCIE, LLC | 475425011 - (FL) SURGCENTER OF ST. LUCIE, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $2549.00 | 1326557653 - SJ EAST CAMPUS ASC, LLC, DENVER SURGERY CENTER | 821485491 - (CO) SJ EAST CAMPUS ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $1685.00 | 1720514359 - JOHNS HOPKINS SURGERY CENTERS SERIES, KNOLL NORTH SURGERY CENTER | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $1350.00 | 1972030161 - ADVANCED VISION SURGERY CENTER LLC | 820697854 - (CO) ADVANCED VISION SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $1420.00 | 1205317054 - SKYLINE SURGERY CENTER, LLC, SKYLINE EYE SURGERY CENTER | 824134934 - (CO) SKYLINE SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $2307.00 | 1477594422 - SURGERY CENTER OF AVENTURA LTD | 113765789 - (FL) SURGERY CENTER OF AVENTURA LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $4600.00 | 1295702942 - GRAPEVINE SURGICARE PARTNERS LTD, BAYLOR SCOTT & WHITE SURGICARE - SOUTHLAKE | 752854711 - (TX) GRAPEVINE SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $3653.00 | 1417287137 - EAST PORTLAND SURGERY CENTER LLC | 271402985 - (OR) EAST PORTLAND SURGERY CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64858 | $1730.00 | 1265401202 - NORTHWEST ORTHOPAEDIC SPECIALISTS, P.S., THE ORTHOPAEDIC SURGERY CENTER | 911502837 - NORTHWEST ORTHOPAEDIC SPECIALISTS, P.S. | WA | 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 64858 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64858 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 64858 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 64858. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64858 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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