CPT 64891 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 64891 by major payers:
$1,436.93
$1,545.27
$1,581.83
$1,905.44
| 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 64891 | ||||||
United | 64891 | $3348.00 | 1215978945 - SAPLING GROVE AMBULATORY SURGERY CENTER, LLC | 204450153 - (TN) SAPLING GROVE AMBULATORY SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $1050.00 | 1285333914 - ARIZONA SURGICAL SPECIALISTS CENTER, LLC, ARIZONA SURGICAL SPECIALISTS CENTER, LLC - SCOTTSDALE | 760737449 - (AZ) ARIZONA SURGICAL SPECIALISTS CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $8825.00 | 1407165772 - MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY, LLC, MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY | 273520409 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $4070.00 | 1962920751 - WEST END SURGICAL, LLC, OREGON SURGICAL INSTITUTE | 812758812 - (OR) WEST END SURGICAL LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $2790.00 | 1215455217 - DAKOTA GASTROENTEROLOGY, LTD | 383908818 - (ND) DAKOTA GASTROENTEROLOGY LTD. | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $863.00 | 1326563537 - OPTUMCARE COLORADO ASC, LLC | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $2300.00 | 1811095136 - GROSSMONT OUTPATIENT SURGICAL CENTER | 953337109 - (CA) GROSSMONT OUTPATIENT SURGICAL CE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $1638.00 | 1770551517 - SOUTHERN MARYLAND ENDOSCOPY CENTER | 522315798 - (MD) SOUTHERN MARYLAND ENDOSCOPY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $4132.00 | 1427422799 - WEBSTER AMBULATORY SUGERY CENTER LP, SUNSET HILLS SURGERY CENTER | 205953387 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $6506.00 | 1811994080 - PACIFIC ENDO-SURGICAL CENTER, LP, PACIFIC ENDO-SURGICAL CENTER | 562387275 - (CA) PACIFIC ENDOSURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $5002.00 | 1396011615 - MEC ENDOSCOPY LLC | 900768532 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $1919.00 | 1336605351 - KURESMART PAIN MANAGEMENT SURGERY CENTER, CLEARWAY SURGERY CENTER OF DUNDALK | 832407319 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $5433.00 | 1538390539 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $2785.00 | 1871538140 - INLAND EYE SPECIALISTS A MEDICAL CORP, INLAND EYE SPECIALISTS | 330585144 - (CA) INLAND EYE SPECIALISTS, A MEDICAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64891 | $7012.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | 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 64891 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64891 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 64891 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 64891. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64891 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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