CPT 64866 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 • 59 - Distinct Procedural Service • 80 - Assistant surgeon • GC - Service performed by resident under supervision • 51 - Multiple procedures |
| Complexity Level | High |
National average reimbursement for CPT 64866 by major payers:
$1,751.76
$1,674.28
$1,689.91
$2,063.82
| 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 64866 | ||||||
United | 64866 | $1367.00 | 1093960700 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE HIGHLANDS SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $200.00 | 1275519373 - PROGRESSIVE LASER SURGICAL INSTITUTE LTD | 200172711 - (PA) PROGRESSIVE LASER SURGICAL INSTITUTE LTD | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $2401.66 | 1437114378 - EMERALD COAST SURGERY CENTER, LP, EMERALD COAST SURGERY CENTER | 621502718 - (FL) EMERALD COAST SURGERY CENTER LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $2517.00 | 1578566758 - ADVANCED AMBULATORY SURGICAL CARE, LP, ADVANCED SURGICAL CARE | 203833272 - (MO) ADVANCED AMBULATORY SURGICAL CARE LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $715.00 | 1629713730 - PG COUNTY ENDOSCOPY CENTER LLC | 881766792 - (MD) PG COUNTY ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $973.00 | 1619469244 - RUSH OAK BROOK SURGERY CENTER, LLC | 371832312 - (IL) RUSH OAK BROOK SURGERY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $525.00 | 1053985721 - ENDO SURGICAL CENTER OF KISSIMMEE, PLLC | 844377406 - (FL) ENDO SURGICAL CENTER OF KISSIMMEE PLLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $983.00 | 1104485440 - SURGCENTER OF GREATER JACKSONVILLE, LLC | 832504492 - (FL) SURGCENTER OF GREATER JACKSONVILLE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $1295.00 | 1639694797 - UCSD CENTER FOR SURGERY OF ENCINITAS, L.P. | 822326631 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $2101.00 | 1740231489 - STONEGATE SURGERY CENTER LP | 201211544 - (TX) STONEGATE SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $109.00 | 1972578771 - SUN CITY AZ ENDOSCOPY ASC LLC, SUN CITY ENDOSCOPY CENTER | 201519369 - (AZ) SUN CITY AZ ENDOSCOPY ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $349.00 | 1902802036 - CATARACT & SURGICAL CENTER OF LUBBOCK LLC | 522344594 - (TX) CATARACT SURGICAL CENTER OF LUBBOCK LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $950.00 | 1457087926 - SPOKANE UROLOGY, PLLC, UROLOGY SURGERY CENTER NORTHWEST | 911043589 - (WA) SPOKANE UROLOGY, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $978.00 | 1689059222 - GOLDSTEP AMBULATORY SURGERY CENTER, LLC | 465647464 - (NY) GOLDSTEP AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $1913.00 | 1437552643 - BEAR CREEK SURGERY CENTER, LLC | 465530768 - (TX) BEAR CREEK SURGERY CENTER, LLC | 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 64866 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64866 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 64866 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 64866. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64866 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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