CPT code 64633: Facet ablation, cervical/thoracic, first joint2026 Medicare rate & RVUs in Maryland
Reports radiofrequency lesioning of nerves supplying one cervical or thoracic facet joint to treat pain attributed to that joint.
Medicare pays $463.28–$526.55 for 64633 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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.
Where 64633 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$463.28 to $526.55
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $487.90 | $180.76 |
| Rest of Maryland | $463.28 | $173.60 |
| Washington, DC area | $526.55 | $189.35 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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).
64633 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64634Facet ablationEach additional facet joint
- 64633 is for the first cervical or thoracic facet joint treated; 64634 identifies each additional joint in that region.
- 64635Facet nerve ablationFirst lumbar or sacral joint
- Both describe facet nerve lesioning, but 64635 is for lumbar or sacral facet joints; 64633 is for cervical or thoracic joints.
- 64490Facet injectionCervical or thoracic, one level
- 64490 reports a cervical or thoracic facet nerve injection, commonly used as a diagnostic block; 64633 reports nerve lesioning.
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
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