Billing code 64620: Nerve neurolysisMedicare rate & RVUs
Reports neurolytic treatment of an intercostal nerve, commonly for persistent nerve-related chest wall pain when a temporary block is not the treatment performed.
Medicare pays $225.79 for 64620 nationally in the office and $167.34 in a hospital or facility. Local office rates run $203.10–$283.42.
Medicare rate · 64620
Nerve neurolysis
Swap in your local Medicare rate.
- Work RVUs
- 2.82
- Total RVUs
- 6.76
- Global days
- 010
National rate · 2026
$225.79
Office setting, before claim adjustments.
See every locality for 64620 → · Billed by an NP, PA or therapist? →
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 10 sections
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.
Where 64620 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$203.10 to $283.42
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $205.62 | $154.48 |
| Alaska* | $275.26 | $213.01 |
| Arizona | $220.35 | $163.71 |
| Arkansas | $203.10 | $152.89 |
| Atlanta | $230.40 | $171.02 |
| Austin | $231.54 | $169.70 |
| Bakersfield | $234.36 | $170.29 |
| Baltimore/Surr. Cntys | $238.88 | $176.16 |
| Beaumont | $214.17 | $160.98 |
| Brazoria | $222.82 | $164.90 |
| Chicago | $242.62 | $183.87 |
| Chico | $233.29 | $169.23 |
| Colorado | $231.94 | $169.75 |
| Connecticut | $239.41 | $176.45 |
| Dallas | $224.45 | $166.23 |
| Dc + Md/Va Suburbs | $253.52 | $184.66 |
| Delaware | $223.61 | $165.86 |
| Detroit | $229.85 | $173.45 |
| East St. Louis | $228.42 | $174.64 |
| El Centro | $233.35 | $169.29 |
| Fort Lauderdale | $237.06 | $177.85 |
| Fort Worth | $223.41 | $165.78 |
| Fresno | $233.29 | $169.23 |
| Galveston | $223.64 | $165.60 |
| Hanford-Corcoran | $233.29 | $169.23 |
| Hawaii, Guam | $237.11 | $170.65 |
| Houston | $230.23 | $172.19 |
| Idaho | $209.89 | $156.11 |
| Indiana | $210.88 | $156.70 |
| Iowa | $208.38 | $154.89 |
| Kansas | $208.35 | $155.51 |
| Kentucky | $211.50 | $159.53 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $247.49 | $178.35 |
| Madera | $233.29 | $169.23 |
| Manhattan | $258.24 | $190.31 |
| Merced | $233.29 | $169.23 |
| Metropolitan Boston | $251.53 | $181.74 |
| Metropolitan Kansas City | $218.22 | $163.33 |
| Metropolitan Philadelphia | $234.71 | $173.86 |
| Metropolitan St. Louis | $220.07 | $164.43 |
| Miami | $249.08 | $188.23 |
| Minnesota | $220.79 | $160.65 |
| Mississippi | $206.03 | $155.70 |
| Modesto | $233.29 | $169.23 |
| Montana** | $225.77 | $167.31 |
| Napa | $263.83 | $186.79 |
| Nebraska | $209.10 | $155.15 |
| Nevada** | $223.90 | $165.39 |
| New Hampshire | $229.19 | $168.34 |
| New Mexico | $218.28 | $164.68 |
| New Orleans | $220.37 | $165.37 |
| North Carolina | $213.44 | $158.90 |
| North Dakota** | $218.65 | $160.20 |
| Northern Nj | $251.67 | $183.87 |
| Nyc Suburbs/Long Island | $264.72 | $195.22 |
| Ohio | $215.48 | $162.12 |
| Oklahoma | $210.31 | $158.12 |
| Oxnard-Thousand Oaks-Ventura | $245.66 | $176.57 |
| Portland | $237.49 | $172.55 |
| Poughkpsie/N Nyc Suburbs | $243.91 | $179.91 |
| Puerto Rico | $226.93 | $167.83 |
| Queens | $258.90 | $189.81 |
| Redding | $233.29 | $169.23 |
| Rest Of California | $233.29 | $169.23 |
| Rest Of Florida | $226.58 | $170.70 |
| Rest Of Georgia | $215.18 | $163.05 |
| Rest Of Illinois | $222.16 | $168.79 |
| Rest Of Louisiana | $211.53 | $159.80 |
| Rest Of Maine | $211.68 | $157.90 |
| Rest Of Maryland | $227.18 | $168.03 |
| Rest Of Massachusetts | $231.19 | $169.64 |
| Rest Of Michigan | $216.94 | $163.57 |
| Rest Of Missouri | $208.98 | $158.59 |
| Rest Of New Jersey | $241.72 | $177.90 |
| Rest Of New York | $216.24 | $160.71 |
| Rest Of Oregon | $221.74 | $163.52 |
| Rest Of Pennsylvania | $215.32 | $161.67 |
| Rest Of Texas | $218.53 | $163.05 |
| Rest Of Washington | $230.48 | $168.93 |
| Rhode Island | $230.23 | $169.85 |
| Riverside-San Bernardino-Ontario | $237.20 | $173.13 |
| Sacramento-Roseville-Folsom | $243.09 | $175.11 |
| Salinas | $242.14 | $174.40 |
| San Diego-Chula Vista-Carlsbad | $246.55 | $176.64 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $277.26 | $194.84 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $276.85 | $194.43 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $283.42 | $199.14 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $281.75 | $197.47 |
| San Luis Obispo-Paso Robles | $238.43 | $171.86 |
| Santa Cruz-Watsonville | $247.90 | $176.88 |
| Santa Maria-Santa Barbara | $242.70 | $174.54 |
| Santa Rosa-Petaluma | $250.30 | $178.52 |
| Seattle (King Cnty) | $255.44 | $183.72 |
| South Carolina | $214.90 | $160.89 |
| South Dakota** | $217.81 | $159.35 |
| Southern Maine | $220.28 | $162.35 |
| Stockton | $233.29 | $169.23 |
| Suburban Chicago | $238.96 | $178.93 |
| Tennessee | $209.34 | $156.21 |
| Utah | $217.39 | $162.44 |
| Vallejo | $263.24 | $186.20 |
| Vermont | $218.65 | $160.79 |
| Virgin Islands | $226.93 | $167.83 |
| Virginia | $220.22 | $162.76 |
| Visalia | $233.29 | $169.23 |
| West Virginia | $215.31 | $164.51 |
| Wisconsin | $212.45 | $156.45 |
| Wyoming** | $222.66 | $164.21 |
| Yuba City | $233.29 | $169.23 |
64620 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.
$203.10
$275.26
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 | $275.26 | 1 |
| AL | $205.62 | 1 |
| AR | $203.10 | 1 |
| AZ | $220.35 | 1 |
| CA | $233.29–$283.42 | 29 |
| CO | $231.94 | 1 |
| CT | $239.41 | 1 |
| DC | $253.52 | 1 |
| DE | $223.61 | 1 |
| FL | $226.58–$249.08 | 3 |
| GA | $215.18–$230.40 | 2 |
| GU | $237.11 | 1 |
| HI | $237.11 | 1 |
| IA | $208.38 | 1 |
| ID | $209.89 | 1 |
| IL | $222.16–$242.62 | 4 |
| IN | $210.88 | 1 |
| KS | $208.35 | 1 |
| KY | $211.50 | 1 |
| LA | $211.53–$220.37 | 2 |
| MA | $231.19–$251.53 | 2 |
| MD | $227.18–$253.52 | 3 |
| ME | $211.68–$220.28 | 2 |
| MI | $216.94–$229.85 | 2 |
| MN | $220.79 | 1 |
| MO | $208.98–$220.07 | 3 |
| MS | $206.03 | 1 |
| MT | $225.77 | 1 |
| NC | $213.44 | 1 |
| ND | $218.65 | 1 |
| NE | $209.10 | 1 |
| NH | $229.19 | 1 |
| NJ | $241.72–$251.67 | 2 |
| NM | $218.28 | 1 |
| NV | $223.90 | 1 |
| NY | $216.24–$264.72 | 5 |
| OH | $215.48 | 1 |
| OK | $210.31 | 1 |
| OR | $221.74–$237.49 | 2 |
| PA | $215.32–$234.71 | 2 |
| PR | $226.93 | 1 |
| RI | $230.23 | 1 |
| SC | $214.90 | 1 |
| SD | $217.81 | 1 |
| TN | $209.34 | 1 |
| TX | $214.17–$231.54 | 8 |
| UT | $217.39 | 1 |
| VA | $220.22–$253.52 | 2 |
| VI | $226.93 | 1 |
| VT | $218.65 | 1 |
| WA | $230.48–$255.44 | 2 |
| WI | $212.45 | 1 |
| WV | $215.31 | 1 |
| WY | $222.66 | 1 |
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
Swap in your local Medicare rate.
Work 2.82Practice expense 3.58Malpractice 0.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
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
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 64620
Nerve neurolysis
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 51 · payment effect
With and without the modifier
64620 without 51 · national office
$225.79
Nerve neurolysis
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%).
64620 compared with similar codes
Compare codes
64620 vs 64420 vs 64630 vs 64640: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64420Intercostal block
- Choose 64420 for an anesthetic intercostal nerve block. Choose 64620 when the documented procedure uses a neurolytic agent to disrupt the nerve.
- 64630Nerve neurolysis
- 64630 is the site-specific neurolytic procedure for the pudendal nerve; 64620 is for an intercostal nerve.
- 64640Nerve treatment
- 64640 covers neurolytic treatment of another peripheral nerve or branch. Use 64620 for an intercostal nerve, the specifically identified site.
64620 billing questions
How is this different from an intercostal nerve block?
This code describes neurolytic treatment intended to disrupt nerve signaling. billing code 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
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