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CPT code 64633: Facet ablation, cervical/thoracic, first joint2026 Medicare rate & RVUs in Iowa

Reports radiofrequency lesioning of nerves supplying one cervical or thoracic facet joint to treat pain attributed to that joint.

CMS RVU26DEffective Oct 1, 2026One payment locality111.1K Medicare services in 2024

In Iowa, Medicare pays $423.93 for 64633 in the office and $162.01 when it’s performed in a hospital or facility.

$423.93Office (non-facility)
$162.01Hospital or facility
−7.6%vs the national office rate ($458.93)

Check a contract rate as a % of Medicare · 64633 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 64633 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 64633 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 64633 covers

The physician uses a needle electrode to create a thermal lesion in the nerves supplying a cervical or thoracic facet joint, commonly for persistent axial neck or upper-back pain attributed to facet joints. Pain medicine physicians, anesthesiologists, and other appropriately trained specialists typically perform the procedure in an office procedure room or outpatient facility. Imaging guidance is part of the service, rather than a separately reported guidance service.

Report this code for the first treated cervical or thoracic facet joint; use 64634 for each additional joint in that region. Documentation should identify the treated levels and side, nerves targeted, imaging guidance, and the lesioning performed. The procedure has a 10-day global period, so related postoperative visits during that period are included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment is restricted, and 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 Iowa compares for 64633

Across 109 of 109 payment localities, the office rate for 64633 runs from $406.03 in Arkansas to $616.77 in San Benito County, CA. Iowa pays $423.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

64633 in Iowa vs other payment areas
  1. Iowa · this page$423.93
  2. Los Angeles, CA · California$522.34+$98.41
  3. Washington, DC area · District of Columbia$526.55+$102.62
  4. Miami, FL · Florida$488.22+$64.29
  5. Chicago, IL · Illinois$474.37+$50.44
  6. Manhattan, NY · New York$526.92+$102.99
  7. Alaska · Alaska$530.68+$106.75

Other areas in Iowa first, then benchmark localities. Bars start at $0.

Every other payment area

64633 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$411.99$161.53
ArkansasArkansas$406.03$160.15
ArizonaArizona$446.92$169.55
Bakersfield, CACalifornia$489.77$176.05
Chico, CACalifornia$488.82$175.10
El Centro, CACalifornia$488.87$175.15
Fresno, CACalifornia$488.82$175.10
Hanford, CACalifornia$488.82$175.10

64633 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.

$406.03

$552.80

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

View every state and territory as a table
64633 office rate range by state
State / territoryOffice rate rangeLocalities
AK$530.681
AL$411.991
AR$406.031
AZ$446.921
CA$488.82–$616.7729
CO$479.841
CT$489.431
DC$526.551
DE$454.371
FL$448.98–$488.223
GA$424.06–$466.722
GU$501.381
HI$501.381
IA$423.931
ID$426.391
IL$434.93–$476.624
IN$428.911
KS$421.251
KY$420.261
LA$419.33–$440.192
MA$476.68–$528.362
MD$463.28–$526.553
ME$427.89–$452.162
MI$430.58–$453.882
MN$461.751
MO$411.65–$442.603
MS$408.961
MT$458.911
NC$432.481
ND$452.981
NE$426.461
NH$471.641
NJ$495.57–$520.942
NM$432.671
NV$457.601
NY$438.92–$538.835
OH$429.371
OK$420.241
OR$454.59–$495.912
PA$430.44–$476.782
PR$462.531
RI$471.151
SC$431.531
SD$452.271
TN$423.291
TX$427.55–$477.768
UT$437.461
VA$450.19–$526.552
VI$462.531
VT$450.571
WA$476.00–$539.842
WI$437.691
WV$418.621
WY$456.321

See 64633 in every payment locality

How the 64633 rate is calculated

Each of 64633’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 · 64633

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.24

3.24 RVUs× 1.000 GPCI

Practice expense10.20

10.20 RVUs× 1.000 GPCI

Malpractice0.30

0.30 RVUs× 1.000 GPCI

Adjusted RVUs

13.7400

Conversion factor

$33.4009

Medicare rate

$458.93

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,180

Code
64633
Physician work
3.24
Practice expense
10.20
Malpractice
0.30

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 64633 in Iowa
ComponentRVULocality factorAdjusted
Physician work3.24× 1.0003.2400
Practice expense10.20× 0.9159.3330
Malpractice0.30× 0.3970.1191
Total RVUs12.6921
Conversion factor× 33.4009

Office rate, Iowa$423.93

Office: (3.24 × 1 + 10.2 × 0.915 + 0.3 × 0.397) × $33.4009 = $423.93

Facility: (3.24 × 1 + 1.63 × 0.915 + 0.3 × 0.397) × $33.4009 = $162.01

Open 64633 in the RVU calculator

Payment rules and modifiers for 64633

64633 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64633

Facet ablation, cervical/thoracic, first joint

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 64633

Facet ablation, cervical/thoracic, first joint

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 50 · payment effect

With and without the modifier

64633 without 50 · national office

$458.93

Facet ablation, cervical/thoracic, first joint

64633-50 · Bilateral: 150%

$688.40

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 64633

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

Codes related to 64633
CodeHow it relatesOffice range, Iowa
Add-on codes
64634Facet ablation, each additional facet jointAdd-on code for each additional cervical or thoracic facet joint treated.$245.47
Used instead
64635Facet nerve ablation, first lumbar or sacral jointComparable facet nerve lesioning code for a lumbar or sacral facet joint.$429.60
64636Facet nerve ablation, additional lumbar or sacral jointAdditional-joint code used with lumbar or sacral facet lesioning rather than cervical or thoracic treatment.$231.44

How 64633 has changed in Iowa

64633 · Office / nonfacility

$423.93

Effective 2026-10-01

The base rate is $38.34 higher than on 2025-10-01, moving from $385.59 to $423.93 (9.9%).

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

    $385.59changed to$423.93

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.32 changed to 3.24
    • Practice expense RVU 9.27 changed to 10.20
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $404.41changed to$385.59

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.51 changed to 9.27
    • Malpractice RVU 0.32 changed to 0.30

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $397.81changed to$404.41

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $409.33changed to$397.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.48 changed to 9.51
    • Malpractice RVU 0.30 changed to 0.32
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $421.38changed to$409.33

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.61 changed to 9.48
    • Malpractice RVU 0.33 changed to 0.30
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $403.10changed to$421.38

    • Conversion factor 34.8931 changed to 34.6062
    • Work RVU 3.84 changed to 3.32
    • Practice expense RVU 8.33 changed to 9.61
    • Malpractice RVU 0.37 changed to 0.33

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $397.27changed to$403.10

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.73 changed to 8.33
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $396.12changed to$397.27

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.74 changed to 7.73
    • Malpractice RVU 0.31 changed to 0.37
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $396.84changed to$396.12

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.78 changed to 7.74
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $392.82changed to$396.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.72 changed to 7.78
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $396.72changed to$392.82

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.91 changed to 7.72
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $391.39changed to$396.72

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.70 changed to 7.91

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $389.44changed to$391.39

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $403.11changed to$389.44

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.14 changed to 7.70
    • Malpractice RVU 0.32 changed to 0.31
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $379.31changed to$403.11

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.07 changed to 8.14
    • Malpractice RVU 0.33 changed to 0.32
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $379.31

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$423.93$162.01RVU26D
2026-07-01$423.93$162.01RVU26C
2026-04-01$423.93$162.01RVU26B
2026-01-01$423.93$162.01RVU26A
2025-10-01$385.59$175.32RVU25D
2025-07-01$385.59$175.32RVU25C
2025-04-01$385.59$175.32RVU25B
2025-01-01$385.59$175.32RVU25A
2024-10-01$404.41$179.20RVU24D
2024-07-01$404.41$179.20RVU24C
2024-04-01$404.41$179.20RVU24B
2024-03-09$404.41$179.20RVU24AR
2024-01-01$397.81$176.28RVU24A
2023-10-01$409.33$179.59RVU23D
2023-07-01$409.33$179.59RVU23C
2023-04-01$409.33$179.59RVU23B
2023-01-01$409.33$179.59RVU23A
2022-10-01$421.38$181.58RVU22D
2022-07-01$421.38$181.58RVU22C
2022-04-01$421.38$181.58RVU22B
2022-01-01$421.38$181.58RVU22A
2021-10-01$403.10$213.85RVU21D
2021-07-01$403.10$213.85RVU21C
2021-04-01$403.10$213.85RVU21B
2021-01-01$403.10$213.85RVU21A
2020-10-01$397.27$217.90RVU20D
2020-07-01$397.27$217.90RVU20C
2020-04-01$397.27$217.90RVU20B
2020-01-01$397.27$217.90RVU20A
2019-10-01$396.12$217.64RVU19D
2019-07-01$396.12$217.64RVU19C
2019-04-01$396.12$217.64RVU19B
2019-01-01$396.12$217.64RVU19A
2018-10-01$396.84$218.56RVU18D
2018-07-01$396.84$218.56RVU18C
2018-04-01$396.84$218.56RVU18B
2018-01-01$396.84$218.56RVU18AR1
2017-10-01$392.82$218.01RVU17D
2017-07-01$392.82$218.01RVU17C
2017-04-01$392.82$218.01RVU17B
2017-01-01$392.82$218.01RVU17A
2016-10-01$396.72$219.63RVU16D
2016-07-01$396.72$219.63RVU16C
2016-04-01$396.72$219.63RVU16B
2016-01-01$396.72$219.63RVU16A
2015-10-01$391.39$220.10RVU15D
2015-07-01$391.39$220.10RVU15C
2015-04-01$389.44$219.01RVU15B
2015-01-01$389.44$219.01RVU15A
2014-10-01$403.11$220.33RVU14D
2014-07-01$403.11$220.33RVU14C
2014-04-01$403.11$220.33RVU14B
2014-01-01$403.11$220.33RVU14A
2013-10-01$379.31$206.99RVU13D
2013-07-01$379.31$206.99RVU13C
2013-04-01$379.31$206.99RVU13B
2013-01-01$379.31$206.99RVU13AR

Price 64633 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

64633 billing questions

When should 64634 be reported with 64633?

Use 64633 for the first treated cervical or thoracic facet joint and 64634 for each additional joint in that region. The additional-joint code is not for another nerve or lesion at the same joint.

Does the code include imaging guidance?

Yes. Imaging guidance is included in the facet nerve lesioning service and is not separately reported as guidance for that procedure.

How is bilateral treatment reported?

For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.

Does 64633 describe a diagnostic medial branch block?

No. It describes nerve lesioning. A diagnostic block, such as the cervical or thoracic facet nerve injection reported with 64490, is a different service.

What documentation supports reporting 64633?

Document the cervical or thoracic levels and side treated, the nerves targeted, imaging guidance, and the lesioning performed. Identify the first treated joint separately from any additional joints reported with 64634.

Are postoperative visits included?

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

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 64633PPRRVU2026_Oct_nonQPP.csv, line 7,180 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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