CPT code 64636: Facet nerve ablation, additional lumbar or sacral joint2026 Medicare rate & RVUs in Ohio
Reports neurolytic treatment of each additional lumbar or sacral facet joint, typically during radiofrequency ablation for facet-mediated low back pain.
In Ohio, Medicare pays $233.26 for 64636 in the office and $49.99 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 64636 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 64636 covers
This add-on code represents neurolytic treatment of another lumbar or sacral facet joint after the first joint is treated. In a common radiofrequency procedure, an interventional pain physician uses imaging to guide treatment of the medial branch nerves that supply the targeted facet joint. The procedure is used for selected patients with chronic axial low back pain attributed to lumbar or sacral facet joints, often after diagnostic medial branch blocks. Imaging guidance is included in the procedure.
Report 64636 for each additional lumbar or sacral facet joint treated, alongside 64635 for the first joint. The procedure note should identify the treated joint levels, laterality, nerves targeted, and imaging guidance. CMS classifies 64636 as an add-on code: it must be billed with its primary procedure and is paid within that procedure's global period. For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.
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 Ohio compares for 64636
Across 109 of 109 payment localities, the office rate for 64636 runs from $220.10 in Arkansas to $346.82 in San Benito County, CA. Ohio pays $233.26. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Ohio · this page$233.26
- Los Angeles, CA · California$290.27+$57.01
- Washington, DC area · District of Columbia$291.36+$58.10
- Miami, FL · Florida$265.74+$32.48
- Chicago, IL · Illinois$257.58+$24.32
- Manhattan, NY · New York$290.11+$56.85
- Alaska · Alaska$282.39+$49.13
Other areas in Ohio first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $223.65 | $48.01 |
| ArkansasArkansas | $220.10 | $47.67 |
| ArizonaArizona | $244.47 | $49.95 |
| Bakersfield, CACalifornia | $270.96 | $50.95 |
| Chico, CACalifornia | $270.61 | $50.60 |
| El Centro, CACalifornia | $270.63 | $50.62 |
| Fresno, CACalifornia | $270.61 | $50.60 |
| Hanford, CACalifornia | $270.61 | $50.60 |
| Madera, CACalifornia | $270.61 | $50.60 |
| Merced, CACalifornia | $270.61 | $50.60 |
| Modesto, CACalifornia | $270.61 | $50.60 |
| Napa, CACalifornia | $318.89 | $54.31 |
| Oxnard, CACalifornia | $289.42 | $52.14 |
| Redding, CACalifornia | $270.61 | $50.60 |
| Rest of CaliforniaCalifornia | $270.61 | $50.60 |
| Riverside, CACalifornia | $271.82 | $51.81 |
| Sacramento, CACalifornia | $285.41 | $51.95 |
| Salinas, CACalifornia | $284.38 | $51.72 |
| San Diego, CACalifornia | $292.14 | $52.05 |
| Marin County, CACalifornia | $339.24 | $56.20 |
| San Francisco, CACalifornia | $339.12 | $56.08 |
| San Benito County, CACalifornia | $346.82 | $57.35 |
| Santa Clara County, CACalifornia | $346.31 | $56.84 |
| San Luis Obispo, CACalifornia | $279.65 | $51.01 |
| Santa Cruz, CACalifornia | $295.77 | $51.87 |
| Santa Maria, CACalifornia | $285.74 | $51.67 |
| Santa Rosa, CACalifornia | $298.84 | $52.33 |
| Stockton, CACalifornia | $270.61 | $50.60 |
| Vallejo, CACalifornia | $318.71 | $54.13 |
| Visalia, CACalifornia | $270.61 | $50.60 |
| Yuba City, CACalifornia | $270.61 | $50.60 |
| ColoradoColorado | $264.60 | $51.02 |
| ConnecticutConnecticut | $269.21 | $53.02 |
| DelawareDelaware | $248.81 | $50.47 |
| Fort Lauderdale, FLFlorida | $257.21 | $53.86 |
| Rest of FloridaFlorida | $244.11 | $52.21 |
| Atlanta, GAGeorgia | $255.72 | $51.77 |
| Rest of GeorgiaGeorgia | $229.52 | $50.46 |
| Hawaii, Guam, HIHawaii | $278.74 | $50.50 |
| IowaIowa | $231.44 | $47.76 |
| IdahoIdaho | $232.77 | $48.08 |
| East St. Louis, ILIllinois | $238.43 | $53.75 |
| Rest of IllinoisIllinois | $235.30 | $52.02 |
| Suburban Chicago, ILIllinois | $260.28 | $54.12 |
| IndianaIndiana | $234.28 | $48.20 |
| KansasKansas | $229.52 | $48.05 |
| KentuckyKentucky | $227.88 | $49.42 |
| New Orleans, LALouisiana | $239.61 | $50.72 |
| Rest of LouisianaLouisiana | $227.19 | $49.54 |
| Metropolitan Boston, MAMassachusetts | $293.41 | $53.73 |
| Rest of MassachusettsMassachusetts | $262.50 | $51.12 |
| Baltimore area, MDMaryland | $268.32 | $52.93 |
| Rest of MarylandMaryland | $254.11 | $50.96 |
| Rest of MaineMaine | $233.31 | $48.63 |
| Southern Maine, MEMaine | $248.26 | $49.33 |
| Detroit, MIMichigan | $246.68 | $52.96 |
| Rest of MichiganMichigan | $233.70 | $50.43 |
| MinnesotaMinnesota | $255.01 | $48.45 |
| Metropolitan Kansas City, MOMissouri | $238.61 | $50.11 |
| Metropolitan St. Louis, MOMissouri | $241.43 | $50.33 |
| Rest of MissouriMissouri | $222.42 | $49.38 |
| MississippiMississippi | $221.35 | $48.51 |
| MontanaMontana | $251.50 | $50.76 |
| North CarolinaNorth Carolina | $236.11 | $48.82 |
| North DakotaNorth Dakota | $249.33 | $48.59 |
| NebraskaNebraska | $233.05 | $47.76 |
| New HampshireNew Hampshire | $259.66 | $50.69 |
| Northern New JerseyNew Jersey | $287.75 | $54.89 |
| Rest of New JerseyNew Jersey | $272.70 | $53.50 |
| New MexicoNew Mexico | $234.81 | $50.73 |
| NevadaNevada | $251.11 | $50.17 |
| NYC suburbs and Long Island, NYNew York | $296.78 | $58.10 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $273.94 | $54.13 |
| Queens, NYNew York | $293.78 | $56.51 |
| Rest of New YorkNew York | $239.91 | $49.21 |
| OklahomaOklahoma | $228.21 | $48.95 |
| Portland, OROregon | $274.49 | $51.47 |
| Rest of OregonOregon | $249.58 | $49.64 |
| Metropolitan Philadelphia, PAPennsylvania | $261.51 | $52.54 |
| Rest of PennsylvaniaPennsylvania | $234.08 | $49.80 |
| Puerto RicoPuerto Rico | $253.76 | $50.82 |
| Rhode IslandRhode Island | $258.76 | $51.40 |
| South CarolinaSouth Carolina | $234.99 | $49.51 |
| South DakotaSouth Dakota | $249.07 | $48.33 |
| TennesseeTennessee | $230.69 | $48.22 |
| Austin, TXTexas | $263.35 | $50.97 |
| Beaumont, TXTexas | $232.34 | $49.67 |
| Brazoria, TXTexas | $249.11 | $50.18 |
| Dallas, TXTexas | $250.49 | $50.55 |
| Fort Worth, TXTexas | $248.43 | $50.50 |
| Galveston, TXTexas | $249.71 | $50.37 |
| Houston, TXTexas | $251.72 | $52.39 |
| Rest of TexasTexas | $240.44 | $49.94 |
| UtahUtah | $238.53 | $49.83 |
| VirginiaVirginia | $246.86 | $49.53 |
| Virgin Islands, VIUnited States Virgin Islands | $253.76 | $50.82 |
| VermontVermont | $247.59 | $48.86 |
| Rest of WashingtonWashington | $262.26 | $50.88 |
| King County, WAWashington | $300.41 | $54.11 |
| WisconsinWisconsin | $240.14 | $47.83 |
| West VirginiaWest Virginia | $225.57 | $51.13 |
| WyomingWyoming | $250.55 | $49.81 |
64636 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$220.10
$308.72
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $282.39 | 1 |
| AL | $223.65 | 1 |
| AR | $220.10 | 1 |
| AZ | $244.47 | 1 |
| CA | $270.61–$346.82 | 29 |
| CO | $264.60 | 1 |
| CT | $269.21 | 1 |
| DC | $291.36 | 1 |
| DE | $248.81 | 1 |
| FL | $244.11–$265.74 | 3 |
| GA | $229.52–$255.72 | 2 |
| GU | $278.74 | 1 |
| HI | $278.74 | 1 |
| IA | $231.44 | 1 |
| ID | $232.77 | 1 |
| IL | $235.30–$260.28 | 4 |
| IN | $234.28 | 1 |
| KS | $229.52 | 1 |
| KY | $227.88 | 1 |
| LA | $227.19–$239.61 | 2 |
| MA | $262.50–$293.41 | 2 |
| MD | $254.11–$291.36 | 3 |
| ME | $233.31–$248.26 | 2 |
| MI | $233.70–$246.68 | 2 |
| MN | $255.01 | 1 |
| MO | $222.42–$241.43 | 3 |
| MS | $221.35 | 1 |
| MT | $251.50 | 1 |
| NC | $236.11 | 1 |
| ND | $249.33 | 1 |
| NE | $233.05 | 1 |
| NH | $259.66 | 1 |
| NJ | $272.70–$287.75 | 2 |
| NM | $234.81 | 1 |
| NV | $251.11 | 1 |
| NY | $239.91–$296.78 | 5 |
| OH | $233.26 | 1 |
| OK | $228.21 | 1 |
| OR | $249.58–$274.49 | 2 |
| PA | $234.08–$261.51 | 2 |
| PR | $253.76 | 1 |
| RI | $258.76 | 1 |
| SC | $234.99 | 1 |
| SD | $249.07 | 1 |
| TN | $230.69 | 1 |
| TX | $232.34–$263.35 | 8 |
| UT | $238.53 | 1 |
| VA | $246.86–$291.36 | 2 |
| VI | $253.76 | 1 |
| VT | $247.59 | 1 |
| WA | $262.26–$300.41 | 2 |
| WI | $240.14 | 1 |
| WV | $225.57 | 1 |
| WY | $250.55 | 1 |
How the 64636 rate is calculated
Each of 64636’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 · 64636
RVUs × geographic indexes × conversion factor
Work1.13
1.13 RVUs× 1.000 GPCI
Practice expense6.29
6.29 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
7.5300
Conversion factor
$33.4009
Medicare rate
$251.51
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Ohio inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,183
- Code
- 64636
- Physician work
- 1.13
- Practice expense
- 6.29
- Malpractice
- 0.11
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.13 | × 1.000 | 1.1300 |
| Practice expense | 6.29 | × 0.913 | 5.7428 |
| Malpractice | 0.11 | × 1.008 | 0.1109 |
| Total RVUs | 6.9836 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Ohio$233.26
Office: (1.13 × 1 + 6.29 × 0.913 + 0.11 × 1.008) × $33.4009 = $233.26
Facility: (1.13 × 1 + 0.28 × 0.913 + 0.11 × 1.008) × $33.4009 = $49.99
Payment rules and modifiers for 64636
The CMS indicators that decide how 64636 is paid alongside other services.
CMS payment indicators · 64636
Facet nerve ablation, additional lumbar or sacral joint
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
64636 without 50 · national office
$251.51
Facet nerve ablation, additional lumbar or sacral joint
64636-50 · Bilateral: 150%
$377.27
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).
How 64636 has changed in Ohio
64636 · Office / nonfacility
$233.26
Effective 2026-10-01
The base rate is $23.17 higher than on 2025-10-01, moving from $210.09 to $233.26 (11.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$210.09changed to$233.26
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.16 changed to 1.13
- Practice expense RVU 5.72 changed to 6.29
- Malpractice RVU 0.12 changed to 0.11
- Practice expense GPCI 0.911 changed to 0.913
- Malpractice GPCI 1.033 changed to 1.008
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$222.22changed to$210.09
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 5.93 changed to 5.72
- Malpractice RVU 0.11 changed to 0.12
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$218.60changed to$222.22
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$228.08changed to$218.60
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.98 changed to 5.93
- Practice expense GPCI 0.912 changed to 0.911
- Malpractice GPCI 1.063 changed to 1.033
January 1, 2023
RVU23A
$238.30changed to$228.08
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 6.14 changed to 5.98
- Practice expense GPCI 0.913 changed to 0.912
- Malpractice GPCI 1.094 changed to 1.063
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$168.60changed to$238.30
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.89 changed to 6.14
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$164.91changed to$168.60
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.60 changed to 3.89
- Practice expense GPCI 0.915 changed to 0.913
- Malpractice GPCI 1.049 changed to 1.094
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$164.04changed to$164.91
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.09 changed to 0.11
- Practice expense GPCI 0.917 changed to 0.915
- Malpractice GPCI 1.005 changed to 1.049
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$164.52changed to$164.04
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.62 changed to 3.60
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$163.13changed to$164.52
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.59 changed to 3.62
- Practice expense GPCI 0.918 changed to 0.917
- Malpractice GPCI 0.999 changed to 1.005
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$165.69changed to$163.13
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 3.68 changed to 3.59
- Malpractice GPCI 0.993 changed to 0.999
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$163.32changed to$165.69
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 3.59 changed to 3.68
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$162.50changed to$163.32
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$170.47changed to$162.50
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 3.79 changed to 3.59
- Practice expense GPCI 0.923 changed to 0.918
- Malpractice GPCI 1.117 changed to 0.993
Held through RVU15B.
January 1, 2014
RVU14A
$161.22changed to$170.47
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.74 changed to 3.79
- Practice expense GPCI 0.927 changed to 0.923
- Malpractice GPCI 1.240 changed to 1.117
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $161.22
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $233.26 | $49.99 | RVU26D |
| 2026-07-01 | $233.26 | $49.99 | RVU26C |
| 2026-04-01 | $233.26 | $49.99 | RVU26B |
| 2026-01-01 | $233.26 | $49.99 | RVU26A |
| 2025-10-01 | $210.09 | $55.68 | RVU25D |
| 2025-07-01 | $210.09 | $55.68 | RVU25C |
| 2025-04-01 | $210.09 | $55.68 | RVU25B |
| 2025-01-01 | $210.09 | $55.68 | RVU25A |
| 2024-10-01 | $222.22 | $56.65 | RVU24D |
| 2024-07-01 | $222.22 | $56.65 | RVU24C |
| 2024-04-01 | $222.22 | $56.65 | RVU24B |
| 2024-03-09 | $222.22 | $56.65 | RVU24AR |
| 2024-01-01 | $218.60 | $55.72 | RVU24A |
| 2023-10-01 | $228.08 | $57.80 | RVU23D |
| 2023-07-01 | $228.08 | $57.80 | RVU23C |
| 2023-04-01 | $228.08 | $57.80 | RVU23B |
| 2023-01-01 | $228.08 | $57.80 | RVU23A |
| 2022-10-01 | $238.30 | $58.84 | RVU22D |
| 2022-07-01 | $238.30 | $58.84 | RVU22C |
| 2022-04-01 | $238.30 | $58.84 | RVU22B |
| 2022-01-01 | $238.30 | $58.84 | RVU22A |
| 2021-10-01 | $168.60 | $59.65 | RVU21D |
| 2021-07-01 | $168.60 | $59.65 | RVU21C |
| 2021-04-01 | $168.60 | $59.65 | RVU21B |
| 2021-01-01 | $168.60 | $59.65 | RVU21A |
| 2020-10-01 | $164.91 | $60.89 | RVU20D |
| 2020-07-01 | $164.91 | $60.89 | RVU20C |
| 2020-04-01 | $164.91 | $60.89 | RVU20B |
| 2020-01-01 | $164.91 | $60.89 | RVU20A |
| 2019-10-01 | $164.04 | $60.27 | RVU19D |
| 2019-07-01 | $164.04 | $60.27 | RVU19C |
| 2019-04-01 | $164.04 | $60.27 | RVU19B |
| 2019-01-01 | $164.04 | $60.27 | RVU19A |
| 2018-10-01 | $164.52 | $60.20 | RVU18D |
| 2018-07-01 | $164.52 | $60.20 | RVU18C |
| 2018-04-01 | $164.52 | $60.20 | RVU18B |
| 2018-01-01 | $164.52 | $60.20 | RVU18AR1 |
| 2017-10-01 | $163.13 | $60.01 | RVU17D |
| 2017-07-01 | $163.13 | $60.01 | RVU17C |
| 2017-04-01 | $163.13 | $60.01 | RVU17B |
| 2017-01-01 | $163.13 | $60.01 | RVU17A |
| 2016-10-01 | $165.69 | $60.51 | RVU16D |
| 2016-07-01 | $165.69 | $60.51 | RVU16C |
| 2016-04-01 | $165.69 | $60.51 | RVU16B |
| 2016-01-01 | $165.69 | $60.51 | RVU16A |
| 2015-10-01 | $163.32 | $60.73 | RVU15D |
| 2015-07-01 | $163.32 | $60.73 | RVU15C |
| 2015-04-01 | $162.50 | $60.43 | RVU15B |
| 2015-01-01 | $162.50 | $60.43 | RVU15A |
| 2014-10-01 | $170.47 | $61.36 | RVU14D |
| 2014-07-01 | $170.47 | $61.36 | RVU14C |
| 2014-04-01 | $170.47 | $61.36 | RVU14B |
| 2014-01-01 | $170.47 | $61.36 | RVU14A |
| 2013-10-01 | $161.22 | $58.09 | RVU13D |
| 2013-07-01 | $161.22 | $58.09 | RVU13C |
| 2013-04-01 | $161.22 | $58.09 | RVU13B |
| 2013-01-01 | $161.22 | $58.09 | RVU13AR |
Where the Ohio rate applies
Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Ada
- Adamsville
- Addyston
- Adelphi
- Adena
- Ai
- Akron
64636 billing questions
When should 64636 be reported instead of 64635?
Use 64635 for the first lumbar or sacral facet joint treated. Report 64636 for each additional joint treated in the same procedure.
Is 64636 reported per nerve or per facet joint?
It is reported for each additional facet joint, not for each individual medial branch nerve treated to reach that joint.
Can 64636 be billed by itself?
No. It is an add-on code and must be billed with the primary procedure, 64635, for the first lumbar or sacral facet joint.
Can imaging guidance be billed separately?
Imaging guidance for the facet nerve destruction procedure is included in the code. The documentation should identify the guidance used.
How is bilateral treatment reported?
For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.
What documentation supports multiple units of 64636?
Document each additional lumbar or sacral facet joint treated, its laterality, the nerves targeted, and the imaging guidance used.
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
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