Choose 64530 for an anesthetic injection or block of the celiac plexus. Choose 64680 when a neurolytic agent is used to destroy the plexus.
On this page
CMS RVU26D · Effective 2026-10-01
64680 in Chico
Office / nonfacility
$368.26
Base rate per service
Facility setting
$148.98
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Pain management
About 64680: Celiac plexus neurolysis by injection
Reports chemical destruction of the celiac plexus, commonly performed to relieve severe upper abdominal visceral pain such as pain from pancreatic cancer.
This service destroys the celiac plexus with a neurolytic agent to reduce severe visceral pain from upper abdominal disease, often pancreatic cancer. Interventional pain physicians, anesthesiologists, and radiologists may perform it in an outpatient procedure suite or hospital setting. The needle is commonly positioned with fluoroscopic or CT monitoring; the code includes the service whether or not radiologic monitoring is used.
Report the code when the documented target is the celiac plexus and the treatment is neurolysis, rather than a temporary anesthetic block. The procedure note should identify the indication, target, neurolytic agent, and technique. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When this and other multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is not appropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 64680
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.60 · 25%
- Practice expense (office) RVU7.52 · 72%
- Malpractice RVU0.26 · 3%
856
Medicare services in 2024 · #3089 by national volume
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.
64680 compared with similar codes
Office rates for Chico, from the same CMS release.
64681 targets the superior hypogastric plexus. 64680 targets the celiac plexus, typically for upper abdominal visceral pain.
64640 covers neurolytic treatment of another peripheral nerve or branch. Use 64680 when the documented target is specifically the celiac plexus.
The same code, a different location
How does Chico compare?
In Bakersfield, the office rate for 64680 is $369.07—$0.81 higher than the $368.26 rate in Chico. Both use the same code, release and participation basis.
64680 across payment areas
Same release and payment basis · bars start at $0
Chico · This locality
$368.26
$369.07
$0.81 higher than Chico
$368.30
$0.04 higher than Chico
$368.26
The same base rate than Chico
$368.26
The same base rate than Chico
$25.05 higher than Chico
$368.26
The same base rate than Chico
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
Across 109 of 109 CMS payment localities with a supported office rate, 64680 ranges from $307.07 in Arkansas to $463.24 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 64680
Office
$368.26
Facility
$148.98
The same base rate than Chico for the office setting.
Modesto
California · 64680
Office
$368.26
Facility
$148.98
The same base rate than Chico for the office setting.
Napa
California · 64680
Office
$427.77
Facility
$164.08
$59.51 higher than Chico for the office setting.
Oxnard-Thousand Oaks-Ventura
California · 64680
Office
$391.57
Facility
$155.09
$23.31 higher than Chico for the office setting.
Redding
California · 64680
Office
$368.26
Facility
$148.98
The same base rate than Chico for the office setting.
Rest Of California
California · 64680
Office
$368.26
Facility
$148.98
The same base rate than Chico for the office setting.
Riverside-San Bernardino-Ontario
California · 64680
Office
$371.10
Facility
$151.82
$2.84 higher than Chico for the office setting.
Sacramento-Roseville-Folsom
California · 64680
Office
$386.74
Facility
$154.06
$18.48 higher than Chico for the office setting.
Salinas
California · 64680
Office
$385.30
Facility
$153.42
$17.04 higher than Chico for the office setting.
San Diego-Chula Vista-Carlsbad
California · 64680
Office
$394.56
Facility
$155.27
$26.30 higher than Chico for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 64680
Office
$453.23
Facility
$171.13
$84.97 higher than Chico for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 64680
Office
$452.94
Facility
$170.84
$84.68 higher than Chico for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 64680
Office
$463.24
Facility
$174.74
$94.98 higher than Chico for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 64680
Office
$462.04
Facility
$173.53
$93.78 higher than Chico for the office setting.
San Luis Obispo-Paso Robles
California · 64680
Office
$379.06
Facility
$151.18
$10.80 higher than Chico for the office setting.
Santa Cruz-Watsonville
California · 64680
Office
$398.50
Facility
$155.41
$30.24 higher than Chico for the office setting.
Santa Maria-Santa Barbara
California · 64680
Office
$386.80
Facility
$153.52
$18.54 higher than Chico for the office setting.
Santa Rosa-Petaluma
California · 64680
Office
$402.54
Facility
$156.86
$34.28 higher than Chico for the office setting.
Stockton
California · 64680
Office
$368.26
Facility
$148.98
The same base rate than Chico for the office setting.
Vallejo
California · 64680
Office
$427.35
Facility
$163.65
$59.09 higher than Chico for the office setting.
Visalia
California · 64680
Office
$368.26
Facility
$148.98
The same base rate than Chico for the office setting.
Yuba City
California · 64680
Office
$368.26
Facility
$148.98
The same base rate than Chico for the office setting.
Dc + Md/Va Suburbs
District of Columbia · 64680
Office
$397.08
Facility
$161.40
$28.82 higher than Chico for the office setting.
Miami
Florida · 64680
Office
$370.28
Facility
$162.00
$2.02 higher than Chico for the office setting.
Chicago
Illinois · 64680
Office
$359.81
Facility
$158.74
$8.45 lower than Chico for the office setting.
Manhattan
New York · 64680
Office
$398.04
Facility
$165.56
$29.78 higher than Chico for the office setting.
Alaska*
Alaska · 64680
Office
$402.55
Facility
$189.47
$34.29 higher than Chico for the office setting.
Alabama
Alabama · 64680
Office
$311.54
Facility
$136.47
$56.72 lower than Chico for the office setting.
Arkansas
Arkansas · 64680
Office
$307.07
Facility
$135.21
$61.19 lower than Chico for the office setting.
Arizona
Arizona · 64680
Office
$337.66
Facility
$143.80
$30.60 lower than Chico for the office setting.
Colorado
Colorado · 64680
Office
$361.92
Facility
$149.04
$6.34 lower than Chico for the office setting.
Connecticut
Connecticut · 64680
Office
$369.60
Facility
$154.13
$1.34 higher than Chico for the office setting.
Delaware
Delaware · 64680
Office
$343.24
Facility
$145.57
$25.02 lower than Chico for the office setting.
Fort Lauderdale
Florida · 64680
Office
$356.98
Facility
$154.31
$11.28 lower than Chico for the office setting.
Rest Of Florida
Florida · 64680
Office
$340.02
Facility
$148.75
$28.24 lower than Chico for the office setting.
Atlanta
Georgia · 64680
Office
$352.73
Facility
$149.45
$15.53 lower than Chico for the office setting.
Rest Of Georgia
Georgia · 64680
Office
$321.24
Facility
$142.78
$47.02 lower than Chico for the office setting.
Hawaii, Guam
Hawaii · 64680
Office
$377.46
Facility
$149.98
$9.20 higher than Chico for the office setting.
Iowa
Iowa · 64680
Office
$320.11
Facility
$137.05
$48.15 lower than Chico for the office setting.
Idaho
Idaho · 64680
Office
$322.03
Facility
$137.97
$46.23 lower than Chico for the office setting.
East St. Louis
Illinois · 64680
Office
$335.41
Facility
$151.35
$32.85 lower than Chico for the office setting.
Rest Of Illinois
Illinois · 64680
Office
$329.74
Facility
$147.07
$38.52 lower than Chico for the office setting.
Suburban Chicago
Illinois · 64680
Office
$360.80
Facility
$155.32
$7.46 lower than Chico for the office setting.
Indiana
Indiana · 64680
Office
$323.90
Facility
$138.44
$44.36 lower than Chico for the office setting.
Kansas
Kansas · 64680
Office
$318.28
Facility
$137.42
$49.98 lower than Chico for the office setting.
Kentucky
Kentucky · 64680
Office
$318.08
Facility
$140.22
$50.18 lower than Chico for the office setting.
New Orleans
Louisiana · 64680
Office
$333.06
Facility
$144.80
$35.20 lower than Chico for the office setting.
Rest Of Louisiana
Louisiana · 64680
Office
$317.45
Facility
$140.39
$50.81 lower than Chico for the office setting.
Metropolitan Boston
Massachusetts · 64680
Office
$398.03
Facility
$159.15
$29.77 higher than Chico for the office setting.
Rest Of Massachusetts
Massachusetts · 64680
Office
$359.64
Facility
$148.97
$8.62 lower than Chico for the office setting.
Baltimore/Surr. Cntys
Maryland · 64680
Office
$368.48
Facility
$153.81
$0.22 higher than Chico for the office setting.
Rest Of Maryland
Maryland · 64680
Office
$349.87
Facility
$147.40
$18.39 lower than Chico for the office setting.
Rest Of Maine
Maine · 64680
Office
$323.32
Facility
$139.26
$44.94 lower than Chico for the office setting.
Southern Maine
Maine · 64680
Office
$341.24
Facility
$142.97
$27.02 lower than Chico for the office setting.
Detroit
Michigan · 64680
Office
$343.87
Facility
$150.80
$24.39 lower than Chico for the office setting.
Rest Of Michigan
Michigan · 64680
Office
$325.97
Facility
$143.30
$42.29 lower than Chico for the office setting.
Minnesota
Minnesota · 64680
Office
$347.87
Facility
$142.00
$20.39 lower than Chico for the office setting.
Metropolitan Kansas City
Missouri · 64680
Office
$331.18
Facility
$143.31
$37.08 lower than Chico for the office setting.
Metropolitan St. Louis
Missouri · 64680
Office
$334.66
Facility
$144.19
$33.60 lower than Chico for the office setting.
Rest Of Missouri
Missouri · 64680
Office
$311.81
Facility
$139.35
$56.45 lower than Chico for the office setting.
Mississippi
Mississippi · 64680
Office
$309.52
Facility
$137.26
$58.74 lower than Chico for the office setting.
Montana**
Montana · 64680
Office
$346.68
Facility
$146.61
$21.58 lower than Chico for the office setting.
North Carolina
North Carolina · 64680
Office
$326.74
Facility
$140.07
$41.52 lower than Chico for the office setting.
North Dakota**
North Dakota · 64680
Office
$341.54
Facility
$141.47
$26.72 lower than Chico for the office setting.
Nebraska
Nebraska · 64680
Office
$321.96
Facility
$137.29
$46.30 lower than Chico for the office setting.
New Hampshire
New Hampshire · 64680
Office
$355.91
Facility
$147.64
$12.35 lower than Chico for the office setting.
Northern Nj
New Jersey · 64680
Office
$392.95
Facility
$160.87
$24.69 higher than Chico for the office setting.
Rest Of New Jersey
New Jersey · 64680
Office
$374.13
Facility
$155.65
$5.87 higher than Chico for the office setting.
New Mexico
New Mexico · 64680
Office
$327.60
Facility
$144.13
$40.66 lower than Chico for the office setting.
Nevada**
Nevada · 64680
Office
$345.50
Facility
$145.23
$22.76 lower than Chico for the office setting.
Nyc Suburbs/Long Island
New York · 64680
Office
$407.17
Facility
$169.29
$38.91 higher than Chico for the office setting.
Poughkpsie/N Nyc Suburbs
New York · 64680
Office
$376.29
Facility
$157.22
$8.03 higher than Chico for the office setting.
Queens
New York · 64680
Office
$401.81
Facility
$165.33
$33.55 higher than Chico for the office setting.
Rest Of New York
New York · 64680
Office
$331.56
Facility
$141.50
$36.70 lower than Chico for the office setting.
Ohio
Ohio · 64680
Office
$324.92
Facility
$142.25
$43.34 lower than Chico for the office setting.
Oklahoma
Oklahoma · 64680
Office
$317.89
Facility
$139.23
$50.37 lower than Chico for the office setting.
Portland
Oregon · 64680
Office
$373.75
Facility
$151.47
$5.49 higher than Chico for the office setting.
Rest Of Oregon
Oregon · 64680
Office
$343.12
Facility
$143.85
$25.14 lower than Chico for the office setting.
Metropolitan Philadelphia
Pennsylvania · 64680
Office
$360.24
Facility
$151.96
$8.02 lower than Chico for the office setting.
Rest Of Pennsylvania
Pennsylvania · 64680
Office
$325.63
Facility
$141.96
$42.63 lower than Chico for the office setting.
Puerto Rico
Puerto Rico · 64680
Office
$349.33
Facility
$147.06
$18.93 lower than Chico for the office setting.
Rhode Island
Rhode Island · 64680
Office
$355.70
Facility
$149.03
$12.56 lower than Chico for the office setting.
South Carolina
South Carolina · 64680
Office
$326.31
Facility
$141.44
$41.95 lower than Chico for the office setting.
South Dakota**
South Dakota · 64680
Office
$340.94
Facility
$140.86
$27.32 lower than Chico for the office setting.
Tennessee
Tennessee · 64680
Office
$319.82
Facility
$137.96
$48.44 lower than Chico for the office setting.
Austin
Texas · 64680
Office
$360.45
Facility
$148.78
$7.81 lower than Chico for the office setting.
Beaumont
Texas · 64680
Office
$323.48
Facility
$141.41
$44.78 lower than Chico for the office setting.
Brazoria
Texas · 64680
Office
$343.22
Facility
$144.95
$25.04 lower than Chico for the office setting.
Dallas
Texas · 64680
Office
$345.25
Facility
$145.97
$23.01 lower than Chico for the office setting.
Fort Worth
Texas · 64680
Office
$342.85
Facility
$145.58
$25.41 lower than Chico for the office setting.
Galveston
Texas · 64680
Office
$344.14
Facility
$145.47
$24.12 lower than Chico for the office setting.
Houston
Texas · 64680
Office
$348.90
Facility
$150.23
$19.36 lower than Chico for the office setting.
Rest Of Texas
Texas · 64680
Office
$333.05
Facility
$143.18
$35.21 lower than Chico for the office setting.
Utah
Utah · 64680
Office
$330.75
Facility
$142.68
$37.51 lower than Chico for the office setting.
Virginia
Virginia · 64680
Office
$339.88
Facility
$143.21
$28.38 lower than Chico for the office setting.
Virgin Islands
United States Virgin Islands · 64680
Office
$349.33
Facility
$147.06
$18.93 lower than Chico for the office setting.
Vermont
Vermont · 64680
Office
$339.90
Facility
$141.83
$28.36 lower than Chico for the office setting.
Rest Of Washington
Washington · 64680
Office
$359.07
Facility
$148.39
$9.19 lower than Chico for the office setting.
Seattle (King Cnty)
Washington · 64680
Office
$406.47
Facility
$160.98
$38.21 higher than Chico for the office setting.
Wisconsin
Wisconsin · 64680
Office
$330.14
Facility
$138.47
$38.12 lower than Chico for the office setting.
West Virginia
West Virginia · 64680
Office
$317.54
Facility
$143.68
$50.72 lower than Chico for the office setting.
Wyoming**
Wyoming · 64680
Office
$344.44
Facility
$144.37
$23.82 lower than Chico for the office setting.
See how rates vary across the country
64680 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$307.07
$415.75
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $402.55 | 1 |
| AL | $311.54 | 1 |
| AR | $307.07 | 1 |
| AZ | $337.66 | 1 |
| CA | $368.26–$463.24 | 29 |
| CO | $361.92 | 1 |
| CT | $369.60 | 1 |
| DC | $397.08 | 1 |
| DE | $343.24 | 1 |
| FL | $340.02–$370.28 | 3 |
| GA | $321.24–$352.73 | 2 |
| GU | $377.46 | 1 |
| HI | $377.46 | 1 |
| IA | $320.11 | 1 |
| ID | $322.03 | 1 |
| IL | $329.74–$360.80 | 4 |
| IN | $323.90 | 1 |
| KS | $318.28 | 1 |
| KY | $318.08 | 1 |
| LA | $317.45–$333.06 | 2 |
| MA | $359.64–$398.03 | 2 |
| MD | $349.87–$397.08 | 3 |
| ME | $323.32–$341.24 | 2 |
| MI | $325.97–$343.87 | 2 |
| MN | $347.87 | 1 |
| MO | $311.81–$334.66 | 3 |
| MS | $309.52 | 1 |
| MT | $346.68 | 1 |
| NC | $326.74 | 1 |
| ND | $341.54 | 1 |
| NE | $321.96 | 1 |
| NH | $355.91 | 1 |
| NJ | $374.13–$392.95 | 2 |
| NM | $327.60 | 1 |
| NV | $345.50 | 1 |
| NY | $331.56–$407.17 | 5 |
| OH | $324.92 | 1 |
| OK | $317.89 | 1 |
| OR | $343.12–$373.75 | 2 |
| PA | $325.63–$360.24 | 2 |
| PR | $349.33 | 1 |
| RI | $355.70 | 1 |
| SC | $326.31 | 1 |
| SD | $340.94 | 1 |
| TN | $319.82 | 1 |
| TX | $323.48–$360.45 | 8 |
| UT | $330.75 | 1 |
| VA | $339.88–$397.08 | 2 |
| VI | $349.33 | 1 |
| VT | $339.90 | 1 |
| WA | $359.07–$406.47 | 2 |
| WI | $330.14 | 1 |
| WV | $317.54 | 1 |
| WY | $344.44 | 1 |
Where does this rate apply?
Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Why are the office and facility amounts different?
For 64680 in Chico, the physician’s office rate is $368.26 and the facility-setting rate is $148.98: a difference of $219.28.
The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 64680 in Chico. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$405.09
$368.26 × 110% = $405.09
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64680 in Chico.
PPRRVU2026_Oct_nonQPP.csv
7,199
- Code
- 64680
- Physician work
- 2.60
- Practice expense
- 7.52
- Malpractice
- 0.26
GPCI2026.csv
9
- Locality
- Chico
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.60 | × 1.017 | 2.6442 |
| Practice expense | 7.52 | × 1.096 | 8.2419 |
| Malpractice | 0.26 | × 0.536 | 0.1394 |
| Total RVUs | 11.0255 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Chico$368.26
Open 64680 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.6 | 1.017 |
| Practice expense | 7.52 | 1.096 |
| Malpractice | 0.26 | 0.536 |
(2.6 × 1.017 + 7.52 × 1.096 + 0.26 × 0.536) × $33.4009 = $368.26
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.6 | 1.017 |
| Practice expense | 1.53 | 1.096 |
| Malpractice | 0.26 | 0.536 |
(2.6 × 1.017 + 1.53 × 1.096 + 0.26 × 0.536) × $33.4009 = $148.98
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
64680 · Office / nonfacility
$368.26
Effective 2026-10-01
The base rate is $24.07 higher than on 2025-10-01, moving from $344.19 to $368.26 (7.0%).
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
$344.19changed to$368.26
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.67 changed to 2.60
- Practice expense RVU 7.12 changed to 7.52
- Malpractice RVU 0.27 changed to 0.26
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $344.19
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
64680 billing questions
How is this different from a celiac plexus block?
64680 is for neurolytic treatment intended to destroy the celiac plexus. A celiac plexus injection with an anesthetic agent, such as 64530, is a block rather than neurolysis.
Does radiologic monitoring change the code?
No. The service is reported whether or not radiologic monitoring is used; document the technique and target in the procedure note.
Can modifier 50 be used for bilateral treatment?
No. Modifier 50 is inappropriate for this celiac plexus service.
Are related postoperative visits included?
Yes. The 10-day global period includes related postoperative visits during that period.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this procedure. Co-surgeon and team-surgery reporting 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
