CPT 64901 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • XS - Separate Structure • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 64901 by major payers:
$771.09
$828.34
$822.79
$994.09
| 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 64901 | ||||||
United | 64901 | $285.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $191.00 | 1831217231 - THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | 205430025 - (OH) THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $1187.00 | 1750415220 - TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE | 751977850 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL CLEBURNE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $219.00 | 1073794855 - SURGICARE OF LA VETA INC., BARRANCA SURGERY CENTER | 752507129 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $1129.00 | 1073009304 - SUSITNA SURGERY CENTER LLC | 472934701 - (AK) SUSITNA SURGERY CENTER LLC | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $555.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $2079.00 | 1083644124 - MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP, MEMORIAL HERMANN SURGERY CENTER SOUTHWEST | 202866884 - (TX) MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $125.00 | 1518450790 - VIRGINIA ENT SURGERY CENTER INC | 541052755 - (VA) VIRGINIA EAR, NOSE & THROAT ASSOCIATES, P.C. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $375.00 | 1326097981 - FREDERICKSBURG AMBULATORY SURGERY CENTER, LLC | 562322548 - (VA) FREDERICKSBURG AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $71.00 | 1013999580 - INTEG HEALTH SYSTEM, P.C., BLOOMINGTON SURGERY CENTER | 352045236 - (IN) INTEG HEALTH SYSTEM PC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $261.00 | 1619149960 - THE VANCOUVER CLINIC INC PS, THE VANCOUVER CLINIC, AMBULATORY SURGERY CENTER | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $76.00 | 1619244175 - BARRINGTON PAIN AND SPINE INSTITUTE, LLC, BARRINGTON AMBULATORY SURGERY CENTER | 273091392 - (IL) BARRINGTON PAIN AND SPINE INSTITUTE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $92.00 | 1598809758 - CALIFORNIA EYE CLINIC | 680024090 - (CA) CALIFORNIA EYE CLINIC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $200.00 | 1760794218 - NSC MANAGEMENT COMPANY, INC., ENDEAVOR SURGICAL CENTER | 954683164 - (CA) NORTHRIDGE SURGERY AND PAIN MANAGEMENT CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64901 | $814.00 | 1922301712 - THE SURGERY CENTER AT WILLIAMSON LLC | 270929515 - (TX) THE SURGERY CENTER AT WILLIAMSON 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 64901 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64901 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 64901 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 64901. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64901 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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