CPT 64628

Destruction by Neurolytic Agent - Back

Current code29 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for CPT 64628 by hospital
Hospital	Medicare Advantage rates (lowest – highest)	Cash price	List price (before discounts)
EvergreenHealth Medical CenterKirkland	$14,681 – $14,9665 plans	$34,326	$42,907
Harborview Medical CenterSeattleFile dated 2026-04-01	—	$936	$1,338
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01	—	$37,250	$53,214
Providence Holy Family HospitalSpokaneFile dated 2026-04-01	—	$32,573	$46,533
University of Washington Medical CtrSeattleFile dated 2026-04-01	—	$713	$1,018
Virginia Mason Medical CenterSeattle	—	$7,162	$14,043

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County): $396 in a hospital or surgery center
Doctor's fee, rest of Washington: $368 in a hospital or surgery center
Hospital outpatient payment (national): $13,117 (APC 5115)
Surgery center payment (national): $9,891