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CMS RVU26D · Effective 2026-10-01

64681 in Merced

Office / nonfacility

$491.30

Base rate per service

Facility setting

$196.24

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 64681: Superior hypogastric plexus neurolysis

Reports neurolytic injection of the superior hypogastric plexus to interrupt visceral pain signaling, commonly for persistent pelvic or lower abdominal pain.

This service uses a neurolytic agent to interrupt pain signaling through the superior hypogastric plexus, a target associated with pelvic and lower abdominal visceral pain. Interventional pain physicians, anesthesiologists, and other clinicians who perform image-guided pain procedures may provide it, often for persistent pain related to pelvic malignancy. Radiologic monitoring may be used during the procedure.

Select this code when the treated target is the superior hypogastric plexus and the purpose is neurolysis, rather than a temporary anesthetic block or treatment of a different nerve. The procedure note should identify the target, neurolytic treatment, and any imaging used. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this target. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

CMS billing rules for 64681

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 RVU3.69 · 27%
  • Practice expense (office) RVU9.85 · 71%
  • Malpractice RVU0.30 · 2%

106

Medicare services in 2024 · #4837 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.

64681 compared with similar codes

Office rates for Merced, from the same CMS release.

64680

Celiac neurolysis

Neurolytic agent injection

$368.26

64680 treats the celiac plexus; 64681 applies to neurolytic treatment of the superior hypogastric plexus.

64517

Plexus block

Hypogastric plexus

$212.79

64517 describes an anesthetic injection of the superior hypogastric plexus for a block. Choose 64681 for neurolytic treatment.

64640

Nerve treatment

Other peripheral nerve or branch

$284.02

64640 is for neurolytic treatment of another peripheral nerve or branch. Use 64681 when the treated structure is the superior hypogastric plexus.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 64681 is $492.28—$0.98 higher than the $491.30 rate in Merced. Both use the same code, release and participation basis.

64681 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $491.30

  2. Bakersfield

    $492.28

    $0.98 higher than Merced

  3. Chico

    $491.30

    The same base rate than Merced

  4. El Centro

    $491.35

    $0.05 higher than Merced

  5. Fresno

    $491.30

    The same base rate than Merced

  6. Hanford-Corcoran

    $491.30

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $524.16

    $32.86 higher than Merced

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, 64681 ranges from $411.02 in Arkansas to $616.59 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

  • Madera

    California · 64681

    Office

    $491.30

    Facility

    $196.24

    The same base rate than Merced for the office setting.

  • Modesto

    California · 64681

    Office

    $491.30

    Facility

    $196.24

    The same base rate than Merced for the office setting.

  • Napa

    California · 64681

    Office

    $569.72

    Facility

    $214.90

    $78.42 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 64681

    Office

    $521.82

    Facility

    $203.61

    $30.52 higher than Merced for the office setting.

  • Redding

    California · 64681

    Office

    $491.30

    Facility

    $196.24

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 64681

    Office

    $491.30

    Facility

    $196.24

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 64681

    Office

    $494.60

    Facility

    $199.54

    $3.30 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 64681

    Office

    $515.68

    Facility

    $202.59

    $24.38 higher than Merced for the office setting.

  • Salinas

    California · 64681

    Office

    $513.75

    Facility

    $201.73

    $22.45 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 64681

    Office

    $525.86

    Facility

    $203.88

    $34.56 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 64681

    Office

    $603.45

    Facility

    $223.86

    $112.15 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 64681

    Office

    $603.11

    Facility

    $223.52

    $111.81 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 64681

    Office

    $616.59

    Facility

    $228.39

    $125.29 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 64681

    Office

    $615.20

    Facility

    $227.00

    $123.90 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 64681

    Office

    $505.45

    Facility

    $198.81

    $14.15 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 64681

    Office

    $530.94

    Facility

    $203.85

    $39.64 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 64681

    Office

    $515.68

    Facility

    $201.78

    $24.38 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 64681

    Office

    $536.33

    Facility

    $205.74

    $45.03 higher than Merced for the office setting.

  • Stockton

    California · 64681

    Office

    $491.30

    Facility

    $196.24

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 64681

    Office

    $569.23

    Facility

    $214.41

    $77.93 higher than Merced for the office setting.

  • Visalia

    California · 64681

    Office

    $491.30

    Facility

    $196.24

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 64681

    Office

    $491.30

    Facility

    $196.24

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 64681

    Office

    $528.62

    Facility

    $211.49

    $37.32 higher than Merced for the office setting.

  • Miami

    Florida · 64681

    Office

    $491.08

    Facility

    $210.83

    $0.22 lower than Merced for the office setting.

  • Chicago

    Illinois · 64681

    Office

    $477.75

    Facility

    $207.20

    $13.55 lower than Merced for the office setting.

  • Manhattan

    New York · 64681

    Office

    $529.33

    Facility

    $216.50

    $38.03 higher than Merced for the office setting.

  • Alaska*

    Alaska · 64681

    Office

    $540.78

    Facility

    $254.07

    $49.48 higher than Merced for the office setting.

  • Alabama

    Alabama · 64681

    Office

    $416.79

    Facility

    $181.23

    $74.51 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 64681

    Office

    $411.02

    Facility

    $179.77

    $80.28 lower than Merced for the office setting.

  • Arizona

    Arizona · 64681

    Office

    $450.63

    Facility

    $189.76

    $40.67 lower than Merced for the office setting.

  • Colorado

    Colorado · 64681

    Office

    $482.61

    Facility

    $196.17

    $8.69 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 64681

    Office

    $492.17

    Facility

    $202.23

    $0.87 higher than Merced for the office setting.

  • Delaware

    Delaware · 64681

    Office

    $457.92

    Facility

    $191.94

    $33.38 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 64681

    Office

    $474.64

    Facility

    $201.93

    $16.66 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 64681

    Office

    $452.83

    Facility

    $195.47

    $38.47 lower than Merced for the office setting.

  • Atlanta

    Georgia · 64681

    Office

    $469.92

    Facility

    $196.40

    $21.38 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 64681

    Office

    $428.66

    Facility

    $188.52

    $62.64 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 64681

    Office

    $503.12

    Facility

    $197.03

    $11.82 higher than Merced for the office setting.

  • Iowa

    Iowa · 64681

    Office

    $428.26

    Facility

    $181.93

    $63.04 lower than Merced for the office setting.

  • Idaho

    Idaho · 64681

    Office

    $430.67

    Facility

    $182.99

    $60.63 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 64681

    Office

    $446.11

    Facility

    $198.43

    $45.19 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 64681

    Office

    $439.29

    Facility

    $193.50

    $52.01 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 64681

    Office

    $479.75

    Facility

    $203.27

    $11.55 lower than Merced for the office setting.

  • Indiana

    Indiana · 64681

    Office

    $433.10

    Facility

    $183.54

    $58.20 lower than Merced for the office setting.

  • Kansas

    Kansas · 64681

    Office

    $425.71

    Facility

    $182.35

    $65.59 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 64681

    Office

    $424.90

    Facility

    $185.57

    $66.40 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 64681

    Office

    $444.22

    Facility

    $190.89

    $47.08 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 64681

    Office

    $424.01

    Facility

    $185.76

    $67.29 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 64681

    Office

    $530.05

    Facility

    $208.61

    $38.75 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 64681

    Office

    $479.64

    Facility

    $196.16

    $11.66 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 64681

    Office

    $490.63

    Facility

    $201.77

    $0.67 lower than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 64681

    Office

    $466.63

    Facility

    $194.19

    $24.67 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 64681

    Office

    $432.16

    Facility

    $184.49

    $59.14 lower than Merced for the office setting.

  • Southern Maine

    Maine · 64681

    Office

    $455.61

    Facility

    $188.82

    $35.69 lower than Merced for the office setting.

  • Detroit

    Michigan · 64681

    Office

    $457.63

    Facility

    $197.84

    $33.67 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 64681

    Office

    $434.94

    Facility

    $189.15

    $56.36 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 64681

    Office

    $464.76

    Facility

    $187.74

    $26.54 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 64681

    Office

    $441.97

    Facility

    $189.18

    $49.33 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 64681

    Office

    $446.50

    Facility

    $190.21

    $44.80 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 64681

    Office

    $416.61

    Facility

    $184.55

    $74.69 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 64681

    Office

    $413.92

    Facility

    $182.13

    $77.38 lower than Merced for the office setting.

  • Montana**

    Montana · 64681

    Office

    $462.25

    Facility

    $193.04

    $29.05 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 64681

    Office

    $436.61

    Facility

    $185.43

    $54.69 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 64681

    Office

    $456.32

    Facility

    $187.11

    $34.98 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 64681

    Office

    $430.70

    Facility

    $182.22

    $60.60 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 64681

    Office

    $474.50

    Facility

    $194.26

    $16.80 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 64681

    Office

    $523.35

    Facility

    $211.07

    $32.05 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 64681

    Office

    $498.44

    Facility

    $204.46

    $7.14 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 64681

    Office

    $436.98

    Facility

    $190.11

    $54.32 lower than Merced for the office setting.

  • Nevada**

    Nevada · 64681

    Office

    $460.92

    Facility

    $191.44

    $30.38 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 64681

    Office

    $540.92

    Facility

    $220.83

    $49.62 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 64681

    Office

    $501.17

    Facility

    $206.39

    $9.87 higher than Merced for the office setting.

  • Queens

    New York · 64681

    Office

    $534.46

    Facility

    $216.26

    $43.16 higher than Merced for the office setting.

  • Rest Of New York

    New York · 64681

    Office

    $442.84

    Facility

    $187.09

    $48.46 lower than Merced for the office setting.

  • Ohio

    Ohio · 64681

    Office

    $433.73

    Facility

    $187.94

    $57.57 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 64681

    Office

    $424.83

    Facility

    $184.43

    $66.47 lower than Merced for the office setting.

  • Portland

    Oregon · 64681

    Office

    $498.19

    Facility

    $199.10

    $6.89 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 64681

    Office

    $457.98

    Facility

    $189.84

    $33.32 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 64681

    Office

    $479.91

    Facility

    $199.66

    $11.39 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 64681

    Office

    $434.74

    Facility

    $187.60

    $56.56 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 64681

    Office

    $465.74

    Facility

    $193.56

    $25.56 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 64681

    Office

    $474.38

    Facility

    $196.29

    $16.92 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 64681

    Office

    $435.76

    Facility

    $187.01

    $55.54 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 64681

    Office

    $455.61

    Facility

    $186.40

    $35.69 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 64681

    Office

    $427.69

    Facility

    $182.98

    $63.61 lower than Merced for the office setting.

  • Austin

    Texas · 64681

    Office

    $480.45

    Facility

    $195.63

    $10.85 lower than Merced for the office setting.

  • Beaumont

    Texas · 64681

    Office

    $431.95

    Facility

    $186.96

    $59.35 lower than Merced for the office setting.

  • Brazoria

    Texas · 64681

    Office

    $458.09

    Facility

    $191.30

    $33.21 lower than Merced for the office setting.

  • Dallas

    Texas · 64681

    Office

    $460.64

    Facility

    $192.50

    $30.66 lower than Merced for the office setting.

  • Fort Worth

    Texas · 64681

    Office

    $457.48

    Facility

    $192.04

    $33.82 lower than Merced for the office setting.

  • Galveston

    Texas · 64681

    Office

    $459.23

    Facility

    $191.90

    $32.07 lower than Merced for the office setting.

  • Houston

    Texas · 64681

    Office

    $464.72

    Facility

    $197.39

    $26.58 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 64681

    Office

    $444.52

    Facility

    $189.04

    $46.78 lower than Merced for the office setting.

  • Utah

    Utah · 64681

    Office

    $441.51

    Facility

    $188.45

    $49.79 lower than Merced for the office setting.

  • Virginia

    Virginia · 64681

    Office

    $453.73

    Facility

    $189.09

    $37.57 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 64681

    Office

    $465.74

    Facility

    $193.56

    $25.56 lower than Merced for the office setting.

  • Vermont

    Vermont · 64681

    Office

    $454.03

    Facility

    $187.51

    $37.27 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 64681

    Office

    $478.91

    Facility

    $195.43

    $12.39 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 64681

    Office

    $541.28

    Facility

    $210.96

    $49.98 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 64681

    Office

    $441.52

    Facility

    $183.61

    $49.78 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 64681

    Office

    $423.49

    Facility

    $189.54

    $67.81 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 64681

    Office

    $459.66

    Facility

    $190.45

    $31.64 lower than Merced for the office setting.

See how rates vary across the country

64681 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$411.02

$553.95

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$540.781
AL$416.791
AR$411.021
AZ$450.631
CA$491.30–$616.5929
CO$482.611
CT$492.171
DC$528.621
DE$457.921
FL$452.83–$491.083
GA$428.66–$469.922
GU$503.121
HI$503.121
IA$428.261
ID$430.671
IL$439.29–$479.754
IN$433.101
KS$425.711
KY$424.901
LA$424.01–$444.222
MA$479.64–$530.052
MD$466.63–$528.623
ME$432.16–$455.612
MI$434.94–$457.632
MN$464.761
MO$416.61–$446.503
MS$413.921
MT$462.251
NC$436.611
ND$456.321
NE$430.701
NH$474.501
NJ$498.44–$523.352
NM$436.981
NV$460.921
NY$442.84–$540.925
OH$433.731
OK$424.831
OR$457.98–$498.192
PA$434.74–$479.912
PR$465.741
RI$474.381
SC$435.761
SD$455.611
TN$427.691
TX$431.95–$480.458
UT$441.511
VA$453.73–$528.622
VI$465.741
VT$454.031
WA$478.91–$541.282
WI$441.521
WV$423.491
WY$459.661

Explore 64681 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 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.

Browse all communities in California →

Why are the office and facility amounts different?

For 64681 in Merced, the physician’s office rate is $491.30 and the facility-setting rate is $196.24: a difference of $295.06.

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.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 64681 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$540.43

$491.30 × 110% = $540.43

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.

Compare your contract offer →

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 64681 in Merced.

PPRRVU2026_Oct_nonQPP.csv

7,200

Code
64681
Physician work
3.69
Practice expense
9.85
Malpractice
0.30

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 64681 in Merced
ComponentRVULocality factorAdjusted
Physician work3.69× 1.0173.7527
Practice expense9.85× 1.09610.7956
Malpractice0.30× 0.5360.1608
Total RVUs14.7091
Conversion factor× 33.4009

Office / nonfacility rate, Merced$491.30

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 64681 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.691.017
Practice expense9.851.096
Malpractice0.30.536

(3.69 × 1.017 + 9.85 × 1.096 + 0.3 × 0.536) × $33.4009 = $491.30

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.691.017
Practice expense1.791.096
Malpractice0.30.536

(3.69 × 1.017 + 1.79 × 1.096 + 0.3 × 0.536) × $33.4009 = $196.24

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

64681 · Office / nonfacility

$491.30

Effective 2026-10-01

The base rate is $28.98 higher than on 2025-10-01, moving from $462.32 to $491.30 (6.3%).

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

    $462.32changed to$491.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.78 changed to 3.69
    • Practice expense RVU 9.37 changed to 9.85
    • Malpractice RVU 0.39 changed to 0.30
    • 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.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $462.32

    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
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$491.30$196.24RVU26D
2026-07-01$491.30$196.24RVU26C
2026-04-01$491.30$196.24RVU26B
2026-01-01$491.30$196.24RVU26A
2025-10-01$462.32$218.73RVU25D
2025-07-01$462.32$218.73RVU25C
2025-04-01$462.32$218.73RVU25B
2025-01-01$462.32$218.73RVU25A

64681 billing questions

How is this different from a superior hypogastric plexus block?

This code is for neurolytic treatment intended to interrupt plexus signaling. A temporary anesthetic injection for a block is reported with 64517.

When should 64680 be used instead?

64680 is for neurolytic treatment of the celiac plexus. Use 64681 when the treated target is the superior hypogastric plexus.

Is radiologic monitoring included in the service?

The code covers the neurolytic treatment with or without radiologic monitoring. Document the target and treatment, including imaging used.

Should modifier 50 be reported for treatment on both sides?

No. Modifier 50 is inappropriate for this plexus target.

Are related postoperative visits separately reported during the global period?

Related postoperative visits for 10 days are included in the procedure's global period.

How does Medicare handle another procedure performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.

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.

RVUs for 64681PPRRVU2026_Oct_nonQPP.csv, line 7,200 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet