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 |
| Medicare Fee Schedule | View Medicare rates for 64866 |
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 | $1016.00 | 1528261195 - ORCHARD CREEK SURGERY CENTER | 770498874 - (CA) ORCHARD CREEK SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $421.00 | 1730112178 - SAN JOAQUIN LASER SURGERY CENTER | 943308994 - (CA) SAN JOAQUIN LASER SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $510.00 | 1770724122 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA | 264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $435.00 | 1972179208 - IDAHO OTOLOGIC SURGERY CENTER, LLC, SYRINGA OUTPATIENT SURGERY CENTER | 852522925 - (ID) IDAHO OTOLOGIC SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $743.00 | 1962772871 - SURGERY CENTER OF NORTHEAST TEXAS LLC, SURGERY CENTER OF NORTHEAST TEXAS | 454184639 - (TX) SCNETX, LLCDBA SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $1367.00 | 1356965750 - PROLIANCE SURGERY CENTER AT VALLEY, LLC | 842108616 - (WA) PROLIANCE SURGERY CENTER AT VALLEY LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $103.00 | 1205821097 - ADOBE SURGERY CENTER, PC | 860835901 - (AZ) ADOBE SURGERY CENTER PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $2785.00 | 1821249616 - LINCOLN SURGERY CENTER LLC | 261790900 - (CO) LINCOLN SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $1095.00 | 1760457204 - ORTHOPAEDIC SURGERY CENTER OF ILLINOIS, LLC | 371366377 - (IL) ORTHOPAEDIC SURGERY CENTER OF ILLINOIS LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $890.00 | 1669720397 - PLEASANT VIEW SURGERY CENTER, LLC | 455254219 - (ID) PLEASANT VIEW SURGERY CENTER, LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $983.00 | 1841395894 - FRANKLIN ENDOSCOPY CENTER, LLC, FRANKLIN ENDOSCOPY CENTER | 383730672 - (TN) FRANKLIN ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $394.00 | 1477917151 - WHITE OAK SURGERY CENTER | 273885555 - (GA) WHITE OAK SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64866 | $654.00 | 1952518029 - RALEIGH NC ENDOSCOPY ASC LLC, RALEIGH ENDOSCOPY CENTER - CARY | 200864597 - (NC) RALEIGH NC ENDOSCOPY ASC LLC | NC | 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 | $850.00 | 1720227945 - WESTERN CONNECTICUT ORTHOPEDIC SURGICAL CENTER LLC, THE HAND CENTER OF WESTERN CONNECTICUT LLC | 61521999 - (CT) THE HAND CENTER OF WESTERN CONNECTICUT, L.L.C. | CT | 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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