How much does Medicare pay for CPT 64999?

Medicare allowed an average of $53.63 per service and paid $42.73 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1164.44, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64999?

Other procedure on nervous system. It was billed 44,814 times to 41,706 Medicare beneficiaries by 1,612 providers in 2024.

Does 64999 pay differently in an office than a hospital?

Yes. The allowed amount averaged $225.10 in an office setting and $45.88 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 64999 most?

Anesthesiology, with 38,973 services from 1,398 clinicians. Next are Certified Registered Nurse Anesthetist (CRNA), Nurse Practitioner, Family Practice.

CPT 64999

Other procedure on nervous system

$53.63Medicare-allowed amount per service, averaged across 44,814 services

Providers submitted

$1164.44

Asking price, not received

Medicare allowed

$53.63

The fee schedule figure

Medicare paid

$42.73

Balance is patient coinsurance

Providers submitted an average of $1164.44 for this code and Medicare allowed $53.63 — 21.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $42.73 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $225.10
Hospital / facility: $45.88

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,938 services were billed in an office setting and 42,876 in a facility.

Services: 44,814
Beneficiaries: 41,706
Providers billing it: 1,612
Total allowed: $2,403,375

What Medicare pays for CPT 64999

Across 44,814 services billed by 1,612 providers to 41,706 beneficiaries, Medicare allowed an average of $53.63 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 64999

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	38,973	37,588	$37.97	1,398
Certified Registered Nurse Anesthetist (CRNA)	3,015	2,829	$32.39	149
Nurse Practitioner	1,210	253	$293.54	11
Family Practice	384	132	$50.14	3
Thoracic Surgery	240	108	$98.14	6
Pain Management	191	185	$59.16	11
Neurosurgery	150	108	$1180.04	8
Infectious Disease	104	56	$223.91	1
Physical Medicine and Rehabilitation	91	74	$187.87	4
Orthopedic Surgery	90	69	$118.26	3
Neurology	76	53	$117.33	3
Interventional Pain Management	74	63	$180.69	5
Podiatry	41	17	$224.34	1
Critical Care (Intensivists)	38	38	$59.98	2
Hospitalist	38	38	$35.90	1

64999 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	8,160	$50.13	$40.24	339
New York	5,268	$38.74	$30.68	126
Ohio	4,305	$28.28	$22.56	138
Florida	3,219	$52.92	$42.04	101
Tennessee	2,136	$37.99	$30.18	59
Pennsylvania	1,680	$163.55	$129.89	69
Missouri	1,425	$30.85	$24.60	49
New Jersey	1,378	$51.66	$40.74	48
Virginia	1,283	$55.20	$43.97	49
South Carolina	1,196	$287.99	$229.44	17
Maryland	1,173	$54.30	$43.31	50
Connecticut	1,170	$27.20	$21.58	38
Illinois	1,012	$39.65	$31.56	52
Nebraska	969	$29.90	$23.76	31
Kentucky	963	$27.34	$21.64	34
California	942	$62.25	$49.58	30
Massachusetts	850	$39.58	$31.47	31
Colorado	848	$49.56	$39.59	41
Kansas	670	$34.50	$27.61	27
Mississippi	626	$35.40	$28.17	26
Michigan	618	$34.45	$27.46	27
Oklahoma	612	$46.68	$37.30	34
North Carolina	600	$55.72	$44.54	23
Wisconsin	597	$32.55	$25.99	32
Minnesota	438	$30.04	$24.06	19
Arkansas	420	$33.13	$26.41	20
Louisiana	368	$46.42	$36.98	13
Georgia	343	$50.48	$40.46	16
Washington	247	$47.55	$37.92	9
New Mexico	216	$53.92	$41.89	13
Rhode Island	152	$24.02	$19.14	7
Alabama	148	$39.82	$31.79	7
Indiana	99	$27.64	$22.09	5
Hawaii	99	$91.30	$72.74	1
Delaware	95	$123.45	$95.63	3
Arizona	92	$37.63	$29.98	4
Iowa	85	$27.14	$21.64	6
District of Columbia	76	$32.07	$25.45	5
Oregon	44	$40.63	$32.73	2
AP	42	$22.13	$17.63	1
Utah	32	$46.07	$36.70	2
New Hampshire	30	$142.07	$111.68	2
Maine	24	$27.79	$21.57	2
Vermont	24	$31.93	$25.45	1
West Virginia	24	$64.15	$49.39	2
Nevada	16	$65.52	$52.21	1

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.