FeeBase
Log inGet started
Menu

CPT code 64620: Nerve neurolysis, intercostal nerve2026 Medicare rate & RVUs in Washington, DC area

Reports neurolytic treatment of an intercostal nerve, commonly for persistent nerve-related chest wall pain when a temporary block is not the treatment performed.

CMS RVU26DEffective Oct 1, 2026One payment locality3.3K Medicare services in 2024

In Washington, DC area, Medicare pays $253.52 for 64620 in the office and $184.66 when it’s performed in a hospital or facility.

$253.52Office (non-facility)
$184.66Hospital or facility
+12.3%vs the national office rate ($225.79)

Check a contract rate as a % of Medicare · 64620 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 64620 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 64620 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 64620 covers

This service uses a neurolytic agent to intentionally disrupt an intercostal nerve’s ability to transmit pain signals. Pain medicine physicians and anesthesiologists commonly perform it for persistent intercostal neuralgia, including selected cases of post-thoracotomy or postherpetic pain, in an outpatient procedure setting. The target is an intercostal nerve along the chest wall; this is not a routine temporary anesthetic block or a muscle chemodenervation service.

Report the code when the documented procedure supports neurolytic treatment of an intercostal nerve, rather than temporary pain relief from an anesthetic injection. The record should identify the treated nerve and support the neurolytic intervention. Related postoperative visits are included in the 10-day global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. CMS indicates modifier 50 is inappropriate. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 64620

Across 109 of 109 payment localities, the office rate for 64620 runs from $203.10 in Arkansas to $283.42 in San Benito County, CA. Washington, DC area pays $253.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

64620 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$253.52
  2. Los Angeles, CA · California$247.49−$6.03
  3. Miami, FL · Florida$249.08−$4.44
  4. Chicago, IL · Illinois$242.62−$10.90
  5. Manhattan, NY · New York$258.24+$4.72
  6. Alaska · Alaska$275.26+$21.74
  7. Alabama · Alabama$205.62−$47.90

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

64620 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$203.10$152.89
ArizonaArizona$220.35$163.71
Bakersfield, CACalifornia$234.36$170.29
Chico, CACalifornia$233.29$169.23
El Centro, CACalifornia$233.35$169.29
Fresno, CACalifornia$233.29$169.23
Hanford, CACalifornia$233.29$169.23
Madera, CACalifornia$233.29$169.23

64620 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$203.10

$275.26

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
64620 office rate range by state
State / territoryOffice rate rangeLocalities
AK$275.261
AL$205.621
AR$203.101
AZ$220.351
CA$233.29–$283.4229
CO$231.941
CT$239.411
DC$253.521
DE$223.611
FL$226.58–$249.083
GA$215.18–$230.402
GU$237.111
HI$237.111
IA$208.381
ID$209.891
IL$222.16–$242.624
IN$210.881
KS$208.351
KY$211.501
LA$211.53–$220.372
MA$231.19–$251.532
MD$227.18–$253.523
ME$211.68–$220.282
MI$216.94–$229.852
MN$220.791
MO$208.98–$220.073
MS$206.031
MT$225.771
NC$213.441
ND$218.651
NE$209.101
NH$229.191
NJ$241.72–$251.672
NM$218.281
NV$223.901
NY$216.24–$264.725
OH$215.481
OK$210.311
OR$221.74–$237.492
PA$215.32–$234.712
PR$226.931
RI$230.231
SC$214.901
SD$217.811
TN$209.341
TX$214.17–$231.548
UT$217.391
VA$220.22–$253.522
VI$226.931
VT$218.651
WA$230.48–$255.442
WI$212.451
WV$215.311
WY$222.661

See 64620 in every payment locality

How the 64620 rate is calculated

Each of 64620’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 64620

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.82

2.82 RVUs× 1.000 GPCI

Practice expense3.58

3.58 RVUs× 1.000 GPCI

Malpractice0.36

0.36 RVUs× 1.000 GPCI

Adjusted RVUs

6.7600

Conversion factor

$33.4009

Medicare rate

$225.79

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,173

Code
64620
Physician work
2.82
Practice expense
3.58
Malpractice
0.36

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 64620 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work2.82× 1.0542.9723
Practice expense3.58× 1.1784.2172
Malpractice0.36× 1.1130.4007
Total RVUs7.5902
Conversion factor× 33.4009

Office rate, Washington, DC area$253.52

Office: (2.82 × 1.054 + 3.58 × 1.178 + 0.36 × 1.113) × $33.4009 = $253.52

Facility: (2.82 × 1.054 + 1.83 × 1.178 + 0.36 × 1.113) × $33.4009 = $184.66

Open 64620 in the RVU calculator

Payment rules and modifiers for 64620

64620 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64620

Nerve neurolysis, intercostal nerve

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 64620

Nerve neurolysis, intercostal nerve

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

64620 without 51 · national office

$225.79

Nerve neurolysis, intercostal nerve

64620-51 · Second procedure: 50%

$112.90

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 64620

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 64620
CodeHow it relatesOffice range, Washington, DC area
Used instead
64420Intercostal block, single nerveAnesthetic intercostal nerve injection is a temporary block, not neurolytic treatment.$120.18
Same family
64630Nerve neurolysis, pudendal nerveNeurolytic treatment directed to the pudendal nerve rather than an intercostal nerve.$309.54
64640Nerve treatment, other peripheral nerve or branchNeurolytic treatment for another peripheral nerve or branch when a more specific site code does not apply.$306.69

How 64620 has changed in Washington, DC area

64620 · Office / nonfacility

$253.52

Effective 2026-10-01

The base rate is $20.80 higher than on 2025-10-01, moving from $232.72 to $253.52 (8.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $232.72changed to$253.52

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.89 changed to 2.82
    • Practice expense RVU 3.13 changed to 3.58
    • Malpractice RVU 0.35 changed to 0.36
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $237.51changed to$232.72

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.09 changed to 3.13
    • Malpractice RVU 0.34 changed to 0.35

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $233.63changed to$237.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $241.02changed to$233.63

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.00 changed to 3.09
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $247.65changed to$241.02

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.98 changed to 3.00
    • Malpractice RVU 0.33 changed to 0.34
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $248.78changed to$247.65

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.99 changed to 2.98
    • Malpractice RVU 0.30 changed to 0.33

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $245.26changed to$248.78

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.79 changed to 2.99
    • Malpractice RVU 0.28 changed to 0.30
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $240.49changed to$245.26

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.77 changed to 2.79
    • Malpractice RVU 0.25 changed to 0.28
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $237.17changed to$240.49

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.71 changed to 2.77
    • Malpractice RVU 0.24 changed to 0.25

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $235.11changed to$237.17

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.67 changed to 2.71
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $235.81changed to$235.11

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.69 changed to 2.67
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $238.82changed to$235.81

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.74 changed to 2.69

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $237.64changed to$238.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $236.62changed to$237.64

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.69 changed to 2.74
    • Malpractice RVU 0.28 changed to 0.24
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $239.83changed to$236.62

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.08 changed to 2.69
    • Malpractice RVU 0.29 changed to 0.28
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $239.83

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$253.52$184.66RVU26D
2026-07-01$253.52$184.66RVU26C
2026-04-01$253.52$184.66RVU26B
2026-01-01$253.52$184.66RVU26A
2025-10-01$232.72$194.55RVU25D
2025-07-01$232.72$194.55RVU25C
2025-04-01$232.72$194.55RVU25B
2025-01-01$232.72$194.55RVU25A
2024-10-01$237.51$197.83RVU24D
2024-07-01$237.51$197.83RVU24C
2024-04-01$237.51$197.83RVU24B
2024-03-09$237.51$197.83RVU24AR
2024-01-01$233.63$194.60RVU24A
2023-10-01$241.02$201.11RVU23D
2023-07-01$241.02$201.11RVU23C
2023-04-01$241.02$201.11RVU23B
2023-01-01$241.02$201.11RVU23A
2022-10-01$247.65$204.88RVU22D
2022-07-01$247.65$204.88RVU22C
2022-04-01$247.65$204.88RVU22B
2022-01-01$247.65$204.88RVU22A
2021-10-01$248.78$204.79RVU21D
2021-07-01$248.78$204.79RVU21C
2021-04-01$248.78$204.79RVU21B
2021-01-01$248.78$204.79RVU21A
2020-10-01$245.26$204.28RVU20D
2020-07-01$245.26$204.28RVU20C
2020-04-01$245.26$204.28RVU20B
2020-01-01$245.26$204.28RVU20A
2019-10-01$240.49$200.98RVU19D
2019-07-01$240.49$200.98RVU19C
2019-04-01$240.49$200.98RVU19B
2019-01-01$240.49$200.98RVU19A
2018-10-01$237.17$198.13RVU18D
2018-07-01$237.17$198.13RVU18C
2018-04-01$237.17$198.13RVU18B
2018-01-01$237.17$198.13RVU18AR1
2017-10-01$235.11$196.62RVU17D
2017-07-01$235.11$196.62RVU17C
2017-04-01$235.11$196.62RVU17B
2017-01-01$235.11$196.62RVU17A
2016-10-01$235.81$197.41RVU16D
2016-07-01$235.81$197.41RVU16C
2016-04-01$235.81$197.41RVU16B
2016-01-01$235.81$197.41RVU16A
2015-10-01$238.82$199.42RVU15D
2015-07-01$238.82$199.42RVU15C
2015-04-01$237.64$198.43RVU15B
2015-01-01$237.64$198.43RVU15A
2014-10-01$236.62$198.30RVU14D
2014-07-01$236.62$198.30RVU14C
2014-04-01$236.62$198.30RVU14B
2014-01-01$236.62$198.30RVU14A
2013-10-01$239.83$197.85RVU13D
2013-07-01$239.83$197.85RVU13C
2013-04-01$239.83$197.85RVU13B
2013-01-01$239.83$197.85RVU13AR

Price 64620 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

64620 billing questions

How is this different from an intercostal nerve block?

This code describes neurolytic treatment intended to disrupt nerve signaling. CPT 64420 describes an anesthetic injection for an intercostal nerve block, a different method and purpose.

Should modifier 50 be used for treatment on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.

What documentation supports reporting this service?

Document the intercostal nerve targeted and the neurolytic treatment performed. The record should distinguish the procedure from a temporary anesthetic nerve block.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure's global payment.

Can an assistant or co-surgeon be reported?

CMS does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 64620PPRRVU2026_Oct_nonQPP.csv, line 7,173 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 64620 pays in Washington, DC area?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 64620 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist