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CPT code 64640: Nerve treatment, other peripheral nerve or branch2026 Medicare rate & RVUs in Delaware

Reports neurolytic treatment directed at a peripheral nerve or branch when the target is not covered by a more specifically named nerve code.

CMS RVU26DEffective Oct 1, 2026One payment locality102.8K Medicare services in 2024

In Delaware, Medicare pays $264.77 for 64640 in the office and $110.66 when it’s performed in a hospital or facility.

$264.77Office (non-facility)
$110.66Hospital or facility
−1.0%vs the national office rate ($267.54)

Check a contract rate as a % of Medicare · 64640 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 64640 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 64640 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 64640 covers

This service involves intentionally disabling a targeted peripheral nerve or branch to reduce pain, commonly by injecting a neurolytic agent. Interventional pain physicians and other qualified clinicians may perform it for selected cases of persistent neuralgia or nerve pain, including pain associated with an injured nerve or neuroma. The specific nerve and treatment approach distinguish this service from codes assigned to particular nerves or nerve groups.

Select the code based on the nerve treated and the documented procedure, not simply the presence of an injection or nerve block. The record should identify the target nerve or branch, the condition treated, and the neurolytic method. Related postoperative visits are included in the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 Delaware compares for 64640

Across 109 of 109 payment localities, the office rate for 64640 runs from $236.38 in Arkansas to $357.73 in San Benito County, CA. Delaware pays $264.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

64640 in Delaware vs other payment areas
  1. Delaware · this page$264.77
  2. Los Angeles, CA · California$303.53+$38.76
  3. Washington, DC area · District of Columbia$306.69+$41.92
  4. Miami, FL · Florida$286.80+$22.03
  5. Chicago, IL · Illinois$278.49+$13.72
  6. Manhattan, NY · New York$307.68+$42.91
  7. Alaska · Alaska$309.20+$44.43

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

Every other payment area

64640 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$239.89$103.40
ArkansasArkansas$236.38$102.39
ArizonaArizona$260.42$109.27
Bakersfield, CACalifornia$284.68$113.73
Chico, CACalifornia$284.02$113.06
El Centro, CACalifornia$284.05$113.10
Fresno, CACalifornia$284.02$113.06
Hanford, CACalifornia$284.02$113.06

64640 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.

$236.38

$320.88

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

View every state and territory as a table
64640 office rate range by state
State / territoryOffice rate rangeLocalities
AK$309.201
AL$239.891
AR$236.381
AZ$260.421
CA$284.02–$357.7329
CO$279.231
CT$285.441
DC$306.691
DE$264.771
FL$262.63–$286.803
GA$247.81–$272.342
GU$291.261
HI$291.261
IA$246.471
ID$248.011
IL$254.65–$278.954
IN$249.481
KS$245.111
KY$245.191
LA$244.72–$256.992
MA$277.45–$307.352
MD$269.93–$306.693
ME$249.11–$263.072
MI$251.46–$265.732
MN$268.041
MO$240.34–$258.163
MS$238.421
MT$267.531
NC$251.771
ND$263.181
NE$247.901
NH$274.651
NJ$288.84–$303.422
NM$252.771
NV$266.511
NY$255.57–$314.965
OH$250.571
OK$244.961
OR$264.58–$288.422
PA$251.09–$278.142
PR$269.581
RI$274.431
SC$251.561
SD$262.661
TN$246.331
TX$249.40–$278.188
UT$255.051
VA$262.05–$306.692
VI$269.581
VT$261.951
WA$277.00–$313.852
WI$254.241
WV$245.071
WY$265.631

See 64640 in every payment locality

How the 64640 rate is calculated

Each of 64640’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 · 64640

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.93

1.93 RVUs× 1.000 GPCI

Practice expense5.86

5.86 RVUs× 1.000 GPCI

Malpractice0.22

0.22 RVUs× 1.000 GPCI

Adjusted RVUs

8.0100

Conversion factor

$33.4009

Medicare rate

$267.54

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,184

Code
64640
Physician work
1.93
Practice expense
5.86
Malpractice
0.22

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 64640 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.93× 1.0051.9396
Practice expense5.86× 0.9885.7897
Malpractice0.22× 0.8990.1978
Total RVUs7.9271
Conversion factor× 33.4009

Office rate, Delaware$264.77

Office: (1.93 × 1.005 + 5.86 × 0.988 + 0.22 × 0.899) × $33.4009 = $264.77

Facility: (1.93 × 1.005 + 1.19 × 0.988 + 0.22 × 0.899) × $33.4009 = $110.66

Open 64640 in the RVU calculator

Payment rules and modifiers for 64640

64640 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64640

Nerve treatment, other peripheral nerve or branch

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 · 64640

Nerve treatment, other peripheral nerve or branch

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

64640 without 50 · national office

$267.54

Nerve treatment, other peripheral nerve or branch

64640-50 · Bilateral: 150%

$401.31

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 64640

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

Codes related to 64640
CodeHow it relatesOffice range, Delaware
Used instead
64630Nerve neurolysis, pudendal nerveUse the pudendal nerve code when that specifically named nerve is treated.$270.98
64632Nerve destruction, plantar common digital nerveSpecifically describes neurolytic treatment of a common digital nerve.$89.51
64620Nerve neurolysis, intercostal nerveUsed for neurolytic treatment of an intercostal nerve.$223.61
64624Genicular nerve ablation, three or more branchesA site-specific code for neurolytic treatment of genicular nerve branches.$406.96

How 64640 has changed in Delaware

64640 · Office / nonfacility

$264.77

Effective 2026-10-01

The base rate is $24.92 higher than on 2025-10-01, moving from $239.85 to $264.77 (10.4%).

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

    $239.85changed to$264.77

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.98 changed to 1.93
    • Practice expense RVU 5.26 changed to 5.86
    • Malpractice RVU 0.21 changed to 0.22
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $247.16changed to$239.85

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.27 changed to 5.26

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $243.12changed to$247.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $251.05changed to$243.12

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.20 changed to 5.27
    • Malpractice RVU 0.19 changed to 0.21
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $260.96changed to$251.05

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.25 changed to 5.20
    • Malpractice RVU 0.20 changed to 0.19
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $266.01changed to$260.96

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.34 changed to 5.25
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $258.72changed to$266.01

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.89 changed to 5.34
    • Malpractice RVU 0.18 changed to 0.19
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $141.58changed to$258.72

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.23 changed to 1.98
    • Practice expense RVU 2.53 changed to 4.89
    • Malpractice RVU 0.10 changed to 0.18
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $138.13changed to$141.58

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.44 changed to 2.53

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $137.56changed to$138.13

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.42 changed to 2.44
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $139.25changed to$137.56

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.46 changed to 2.42
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $139.76changed to$139.25

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $139.06changed to$139.76

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $138.78changed to$139.06

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.44 changed to 2.46
    • Malpractice RVU 0.11 changed to 0.10
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $141.84changed to$138.78

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.73 changed to 2.44
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $141.84

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$264.77$110.66RVU26D
2026-07-01$264.77$110.66RVU26C
2026-04-01$264.77$110.66RVU26B
2026-01-01$264.77$110.66RVU26A
2025-10-01$239.85$116.95RVU25D
2025-07-01$239.85$116.95RVU25C
2025-04-01$239.85$116.95RVU25B
2025-01-01$239.85$116.95RVU25A
2024-10-01$247.16$118.38RVU24D
2024-07-01$247.16$118.38RVU24C
2024-04-01$247.16$118.38RVU24B
2024-03-09$247.16$118.38RVU24AR
2024-01-01$243.12$116.44RVU24A
2023-10-01$251.05$118.99RVU23D
2023-07-01$251.05$118.99RVU23C
2023-04-01$251.05$118.99RVU23B
2023-01-01$251.05$118.99RVU23A
2022-10-01$260.96$121.26RVU22D
2022-07-01$260.96$121.26RVU22C
2022-04-01$260.96$121.26RVU22B
2022-01-01$260.96$121.26RVU22A
2021-10-01$266.01$121.58RVU21D
2021-07-01$266.01$121.58RVU21C
2021-04-01$266.01$121.58RVU21B
2021-01-01$266.01$121.58RVU21A
2020-10-01$258.72$123.49RVU20D
2020-07-01$258.72$123.49RVU20C
2020-04-01$258.72$123.49RVU20B
2020-01-01$258.72$123.49RVU20A
2019-10-01$141.58$98.62RVU19D
2019-07-01$141.58$98.62RVU19C
2019-04-01$141.58$98.62RVU19B
2019-01-01$141.58$98.62RVU19A
2018-10-01$138.13$97.77RVU18D
2018-07-01$138.13$97.77RVU18C
2018-04-01$138.13$97.77RVU18B
2018-01-01$138.13$97.77RVU18AR1
2017-10-01$137.56$97.46RVU17D
2017-07-01$137.56$97.46RVU17C
2017-04-01$137.56$97.46RVU17B
2017-01-01$137.56$97.46RVU17A
2016-10-01$139.25$97.91RVU16D
2016-07-01$139.25$97.91RVU16C
2016-04-01$139.25$97.91RVU16B
2016-01-01$139.25$97.91RVU16A
2015-10-01$139.76$98.26RVU15D
2015-07-01$139.76$98.26RVU15C
2015-04-01$139.06$97.77RVU15B
2015-01-01$139.06$97.77RVU15A
2014-10-01$138.78$97.88RVU14D
2014-07-01$138.78$97.88RVU14C
2014-04-01$138.78$97.88RVU14B
2014-01-01$138.78$97.88RVU14A
2013-10-01$141.84$97.44RVU13D
2013-07-01$141.84$97.44RVU13C
2013-04-01$141.84$97.44RVU13B
2013-01-01$141.84$97.44RVU13AR

Price 64640 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

64640 billing questions

When should 64640 be selected instead of a nerve-specific code?

Use 64640 for neurolytic treatment of another peripheral nerve or branch. Use a more specific code when the treated nerve is named in a separate code, such as the pudendal or common digital nerve.

Does an ordinary nerve block support 64640?

A diagnostic or therapeutic nerve block alone is not the neurolytic treatment reported by this code. The documentation should support intentional neurolytic treatment of the identified nerve or branch.

What should the procedure note identify?

Document the nerve or branch treated, the clinical condition, and the neurolytic method. The note should distinguish the treatment from a temporary anesthetic block.

How is bilateral treatment reported?

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

How are multiple procedures in one session paid?

CMS pays the highest-valued procedure in full and the other procedures at 50% when performed in the same session.

Are related postoperative visits separately included?

Related postoperative visits during the 10-day global period are included in this procedure's 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 64640PPRRVU2026_Oct_nonQPP.csv, line 7,184 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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