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CMS RVU26D · Effective 2026-10-01

64635 in Wyoming**

Office / nonfacility

$462.42

Base rate per service

Facility setting

$170.50

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 64635: Lumbar or sacral facet nerve ablation

Reports image-guided ablation of nerves supplying the first lumbar or sacral facet joint treated during a session for facet-mediated spinal pain.

An interventional pain physician typically uses a radiofrequency probe to create a lesion in nerves supplying a lumbar or sacral facet joint. Fluoroscopy or CT guides probe placement. The procedure is commonly considered for persistent axial low-back pain attributed to facet joints, often after diagnostic medial branch blocks. The target is the nerve supply to the joint, not the joint tissue itself.

Report 64635 for the first lumbar or sacral facet joint treated in the session; report 64636 for each additional joint. Document the spinal levels and sides treated, the image-guided technique, and the ablation performed. Imaging guidance is part of the service. CMS assigns a 10-day global period, so related postoperative visits in that period are included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery is not paid; co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 64635

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 procedure with modifier 50 is paid at 150%.
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 RVU3.24 · 23%
  • Practice expense (office) RVU10.39 · 75%
  • Malpractice RVU0.29 · 2%

381.1K

Medicare services in 2024 · #267 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.

64635 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

64636

Facet nerve ablation

Additional lumbar or sacral joint

$250.55

Use 64635 for the first lumbar or sacral facet joint treated in the session. Use 64636 for each additional joint.

64633

Facet ablation

Cervical/thoracic, first joint

$456.32

64633 applies to the first facet joint treated in the cervical or thoracic region; 64635 is for the lumbar or sacral region.

64625

Radiofrequency ablation

SI-joint innervation

$492.80

64625 targets nerves associated with the sacroiliac joint. Use 64635 when the treated target is a lumbar or sacral facet joint.

64628

Basivertebral ablation

First two lumbar or sacral bodies

No office rate

64628 treats intraosseous basivertebral nerves, not the nerves supplying facet joints targeted by 64635.

The same code, a different location

How does Wyoming** compare?

64635 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $462.42

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

    $529.63

    $67.21 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $533.65

    $71.23 higher than Wyoming**

  4. Miami

    $493.98

    $31.56 higher than Wyoming**

  5. Chicago

    $479.98

    $17.56 higher than Wyoming**

  6. Manhattan

    $533.76

    $71.34 higher than Wyoming**

  7. Alaska*

    $537.26

    $74.84 higher than Wyoming**

Other payment areas listed in Wyoming 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, 64635 ranges from $411.31 in Arkansas to $625.74 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

  • Alabama

    Alabama · 64635

    Office

    $417.36

    Facility

    $161.92

    $45.06 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 64635

    Office

    $411.31

    Facility

    $160.55

    $51.11 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 64635

    Office

    $452.79

    Facility

    $169.91

    $9.63 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 64635

    Office

    $496.52

    Facility

    $176.58

    $34.10 higher than Wyoming** for the office setting.

  • Chico

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • El Centro

    California · 64635

    Office

    $495.65

    Facility

    $175.70

    $33.23 higher than Wyoming** for the office setting.

  • Fresno

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Madera

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Merced

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Modesto

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Napa

    California · 64635

    Office

    $577.35

    Facility

    $192.59

    $114.93 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 64635

    Office

    $527.48

    Facility

    $182.43

    $65.06 higher than Wyoming** for the office setting.

  • Redding

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 64635

    Office

    $498.78

    Facility

    $178.83

    $36.36 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 64635

    Office

    $520.91

    Facility

    $181.40

    $58.49 higher than Wyoming** for the office setting.

  • Salinas

    California · 64635

    Office

    $518.98

    Facility

    $180.64

    $56.56 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 64635

    Office

    $531.77

    Facility

    $182.63

    $69.35 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 64635

    Office

    $612.27

    Facility

    $200.65

    $149.85 higher than Wyoming** for the office setting.

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

    California · 64635

    Office

    $611.94

    Facility

    $200.32

    $149.52 higher than Wyoming** for the office setting.

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

    California · 64635

    Office

    $625.74

    Facility

    $204.79

    $163.32 higher than Wyoming** for the office setting.

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

    California · 64635

    Office

    $624.39

    Facility

    $203.44

    $161.97 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 64635

    Office

    $510.52

    Facility

    $178.02

    $48.10 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 64635

    Office

    $537.33

    Facility

    $182.64

    $74.91 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 64635

    Office

    $521.08

    Facility

    $180.70

    $58.66 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 64635

    Office

    $542.82

    Facility

    $184.33

    $80.40 higher than Wyoming** for the office setting.

  • Stockton

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Vallejo

    California · 64635

    Office

    $576.88

    Facility

    $192.12

    $114.46 higher than Wyoming** for the office setting.

  • Visalia

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Yuba City

    California · 64635

    Office

    $495.60

    Facility

    $175.65

    $33.18 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 64635

    Office

    $486.33

    Facility

    $175.72

    $23.91 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 64635

    Office

    $495.86

    Facility

    $181.46

    $33.44 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 64635

    Office

    $460.34

    Facility

    $171.92

    $2.08 lower than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 64635

    Office

    $477.28

    Facility

    $181.56

    $14.86 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 64635

    Office

    $454.54

    Facility

    $175.46

    $7.88 lower than Wyoming** for the office setting.

  • Atlanta

    Georgia · 64635

    Office

    $472.76

    Facility

    $176.17

    $10.34 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 64635

    Office

    $429.32

    Facility

    $168.92

    $33.10 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 64635

    Office

    $508.41

    Facility

    $176.49

    $45.99 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 64635

    Office

    $429.60

    Facility

    $162.49

    $32.82 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 64635

    Office

    $432.07

    Facility

    $163.50

    $30.35 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 64635

    Office

    $447.00

    Facility

    $178.43

    $15.42 lower than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 64635

    Office

    $440.20

    Facility

    $173.68

    $22.22 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 64635

    Office

    $482.55

    Facility

    $182.74

    $20.13 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 64635

    Office

    $434.63

    Facility

    $164.01

    $27.79 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 64635

    Office

    $426.82

    Facility

    $162.92

    $35.60 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 64635

    Office

    $425.60

    Facility

    $166.08

    $36.82 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 64635

    Office

    $445.78

    Facility

    $171.08

    $16.64 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 64635

    Office

    $424.62

    Facility

    $166.27

    $37.80 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 64635

    Office

    $535.64

    Facility

    $187.08

    $73.22 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 64635

    Office

    $483.10

    Facility

    $175.70

    $20.68 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 64635

    Office

    $494.30

    Facility

    $181.07

    $31.88 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 64635

    Office

    $469.39

    Facility

    $173.97

    $6.97 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 64635

    Office

    $433.52

    Facility

    $164.95

    $28.90 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 64635

    Office

    $458.24

    Facility

    $168.95

    $4.18 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 64635

    Office

    $459.44

    Facility

    $177.73

    $2.98 lower than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 64635

    Office

    $436.00

    Facility

    $169.47

    $26.42 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 64635

    Office

    $468.19

    Facility

    $167.80

    $5.77 higher than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 64635

    Office

    $443.55

    Facility

    $169.43

    $18.87 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 64635

    Office

    $448.30

    Facility

    $170.39

    $14.12 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 64635

    Office

    $416.80

    Facility

    $165.16

    $45.62 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 64635

    Office

    $414.17

    Facility

    $162.83

    $48.25 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 64635

    Office

    $464.92

    Facility

    $173.00

    $2.50 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 64635

    Office

    $438.19

    Facility

    $165.83

    $24.23 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 64635

    Office

    $459.19

    Facility

    $167.26

    $3.23 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 64635

    Office

    $432.19

    Facility

    $162.75

    $30.23 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 64635

    Office

    $477.96

    Facility

    $174.07

    $15.54 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 64635

    Office

    $527.94

    Facility

    $189.31

    $65.52 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 64635

    Office

    $502.14

    Facility

    $183.36

    $39.72 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 64635

    Office

    $438.08

    Facility

    $170.39

    $24.34 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 64635

    Office

    $463.67

    Facility

    $171.45

    $1.25 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 64635

    Office

    $545.76

    Facility

    $198.66

    $83.34 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 64635

    Office

    $504.81

    Facility

    $185.16

    $42.39 higher than Wyoming** for the office setting.

  • Queens

    New York · 64635

    Office

    $539.31

    Facility

    $194.25

    $76.89 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 64635

    Office

    $444.71

    Facility

    $167.38

    $17.71 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 64635

    Office

    $434.83

    Facility

    $168.30

    $27.59 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 64635

    Office

    $425.65

    Facility

    $164.96

    $36.77 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 64635

    Office

    $502.71

    Facility

    $178.39

    $40.29 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 64635

    Office

    $460.68

    Facility

    $169.92

    $1.74 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 64635

    Office

    $482.99

    Facility

    $179.09

    $20.57 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 64635

    Office

    $435.95

    Facility

    $167.96

    $26.47 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 64635

    Office

    $468.61

    Facility

    $173.48

    $6.19 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 64635

    Office

    $477.40

    Facility

    $175.85

    $14.98 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 64635

    Office

    $437.11

    Facility

    $167.38

    $25.31 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 64635

    Office

    $458.51

    Facility

    $166.58

    $3.91 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 64635

    Office

    $428.88

    Facility

    $163.52

    $33.54 lower than Wyoming** for the office setting.

  • Austin

    Texas · 64635

    Office

    $484.18

    Facility

    $175.33

    $21.76 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 64635

    Office

    $433.02

    Facility

    $167.37

    $29.40 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 64635

    Office

    $460.55

    Facility

    $171.26

    $1.87 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 64635

    Office

    $463.15

    Facility

    $172.39

    $0.73 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 64635

    Office

    $459.81

    Facility

    $171.97

    $2.61 lower than Wyoming** for the office setting.

  • Galveston

    Texas · 64635

    Office

    $461.71

    Facility

    $171.83

    $0.71 lower than Wyoming** for the office setting.

  • Houston

    Texas · 64635

    Office

    $467.02

    Facility

    $177.14

    $4.60 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 64635

    Office

    $446.30

    Facility

    $169.27

    $16.12 lower than Wyoming** for the office setting.

  • Utah

    Utah · 64635

    Office

    $443.13

    Facility

    $168.72

    $19.29 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 64635

    Office

    $456.19

    Facility

    $169.23

    $6.23 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 64635

    Office

    $468.61

    Facility

    $173.48

    $6.19 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 64635

    Office

    $456.69

    Facility

    $167.68

    $5.73 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 64635

    Office

    $482.43

    Facility

    $175.03

    $20.01 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 64635

    Office

    $547.36

    Facility

    $189.17

    $84.94 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 64635

    Office

    $443.66

    Facility

    $164.00

    $18.76 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 64635

    Office

    $423.65

    Facility

    $169.97

    $38.77 lower than Wyoming** for the office setting.

See how rates vary across the country

64635 · 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.

$411.31

$560.67

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$537.261
AL$417.361
AR$411.311
AZ$452.791
CA$495.60–$625.7429
CO$486.331
CT$495.861
DC$533.651
DE$460.341
FL$454.54–$493.983
GA$429.32–$472.762
GU$508.411
HI$508.411
IA$429.601
ID$432.071
IL$440.20–$482.554
IN$434.631
KS$426.821
KY$425.601
LA$424.62–$445.782
MA$483.10–$535.642
MD$469.39–$533.653
ME$433.52–$458.242
MI$436.00–$459.442
MN$468.191
MO$416.80–$448.303
MS$414.171
MT$464.921
NC$438.191
ND$459.191
NE$432.191
NH$477.961
NJ$502.14–$527.942
NM$438.081
NV$463.671
NY$444.71–$545.765
OH$434.831
OK$425.651
OR$460.68–$502.712
PA$435.95–$482.992
PR$468.611
RI$477.401
SC$437.111
SD$458.511
TN$428.881
TX$433.02–$484.188
UT$443.131
VA$456.19–$533.652
VI$468.611
VT$456.691
WA$482.43–$547.362
WI$443.661
WV$423.651
WY$462.421

Explore 64635 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 Wyoming →

Why are the office and facility amounts different?

For 64635 in Wyoming**, the physician’s office rate is $462.42 and the facility-setting rate is $170.50: a difference of $291.92.

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 64635 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$508.66

$462.42 × 110% = $508.66

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 64635 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

7,182

Code
64635
Physician work
3.24
Practice expense
10.39
Malpractice
0.29

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 64635 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work3.24× 1.0003.2400
Practice expense10.39× 1.00010.3900
Malpractice0.29× 0.7400.2146
Total RVUs13.8446
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$462.42

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

Open 64635 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.241
Practice expense10.391
Malpractice0.290.74

(3.24 × 1 + 10.39 × 1 + 0.29 × 0.74) × $33.4009 = $462.42

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.241
Practice expense1.651
Malpractice0.290.74

(3.24 × 1 + 1.65 × 1 + 0.29 × 0.74) × $33.4009 = $170.50

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

64635 · Office / nonfacility

$462.42

Effective 2026-10-01

The base rate is $44.36 higher than on 2025-10-01, moving from $418.06 to $462.42 (10.6%).

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

    $418.06changed to$462.42

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.32 changed to 3.24
    • Practice expense RVU 9.39 changed to 10.39
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $418.06

    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$462.42$170.50RVU26D
2026-07-01$462.42$170.50RVU26C
2026-04-01$462.42$170.50RVU26B
2026-01-01$462.42$170.50RVU26A
2025-10-01$418.06$184.19RVU25D
2025-07-01$418.06$184.19RVU25C
2025-04-01$418.06$184.19RVU25B
2025-01-01$418.06$184.19RVU25A

64635 billing questions

When do I report 64635 instead of 64636?

Use 64635 for the first lumbar or sacral facet joint treated in the session. Use 64636 for each additional joint.

Does the code count nerves, lesions, or facet joints?

The reporting unit is the facet joint treated, not each nerve or lesion. Document the treated levels and laterality to support the unit count.

Can fluoroscopy or CT guidance be billed separately?

Imaging guidance is included in the ablation service described by this code. Do not report separate guidance for the same procedure.

How is bilateral treatment reported?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document treatment on both sides.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%. Related postoperative visits are included during the 10-day global period.

Can an assistant or co-surgeon be billed?

CMS does not pay an assistant at surgery for this code. Co-surgeon and team-surgery billing 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.

RVUs for 64635PPRRVU2026_Oct_nonQPP.csv, line 7,182 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet