$251.58–$318.42
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 Celiac neurolysis Medicare reimbursement rates in California
Reports chemical destruction of the celiac plexus, commonly performed to relieve severe upper abdominal visceral pain such as pain from pancreatic cancer. Compare 64680 office and facility rates across CMS payment localities in California.
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.
What does Medicare pay for 64680 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$368.26–$463.24
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $94.98 per service.
Facility setting
$148.98–$174.74
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $25.76 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 64680 pays more and less in California
29 payment localities
$368.26 to $463.24
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 California, from the same CMS release.
$491.30–$616.59
64681 targets the superior hypogastric plexus. 64680 targets the celiac plexus, typically for upper abdominal visceral pain.
$284.02–$357.73
64640 covers neurolytic treatment of another peripheral nerve or branch. Use 64680 when the documented target is specifically the celiac plexus.
Compare 64680 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $369.07 | Facility $149.79 |
| Chico | Office $368.26 | Facility $148.98 |
| El Centro | Office $368.30 | Facility $149.03 |
| Fresno | Office $368.26 | Facility $148.98 |
| Hanford-Corcoran | Office $368.26 | Facility $148.98 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $393.31 | Facility $156.62 |
| Madera | Office $368.26 | Facility $148.98 |
| Merced | Office $368.26 | Facility $148.98 |
| Modesto | Office $368.26 | Facility $148.98 |
| Napa | Office $427.77 | Facility $164.08 |
| Oxnard-Thousand Oaks-Ventura | Office $391.57 | Facility $155.09 |
| Redding | Office $368.26 | Facility $148.98 |
| Rest Of California | Office $368.26 | Facility $148.98 |
| Riverside-San Bernardino-Ontario | Office $371.10 | Facility $151.82 |
| Sacramento-Roseville-Folsom | Office $386.74 | Facility $154.06 |
| Salinas | Office $385.30 | Facility $153.42 |
| San Diego-Chula Vista-Carlsbad | Office $394.56 | Facility $155.27 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $453.23 | Facility $171.13 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $452.94 | Facility $170.84 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $463.24 | Facility $174.74 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $462.04 | Facility $173.53 |
| San Luis Obispo-Paso Robles | Office $379.06 | Facility $151.18 |
| Santa Cruz-Watsonville | Office $398.50 | Facility $155.41 |
| Santa Maria-Santa Barbara | Office $386.80 | Facility $153.52 |
| Santa Rosa-Petaluma | Office $402.54 | Facility $156.86 |
| Stockton | Office $368.26 | Facility $148.98 |
| Vallejo | Office $427.35 | Facility $163.65 |
| Visalia | Office $368.26 | Facility $148.98 |
| Yuba City | Office $368.26 | Facility $148.98 |
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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.
7,19664657,,Rmvl bat modulj sys tot sys,A,,12.13,3.76,NA,3.76,,3.04,18.93,18.93,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19764658,,Rmvl bat modul sys lead only,A,,8.95,3.03,NA,3.03,,2.27,14.25,14.25,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19864659,,Rmvl bat modulj sys pg only,A,,8.23,2.90,NA,2.90,,2.09,13.22,13.22,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19964680,,Injection treatment of nerve,A,,2.60,7.52,,1.53,,0.26,10.38,4.39,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20064681,,Injection treatment of nerve,A,,3.69,9.85,,1.79,,0.30,13.84,5.78,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20164702,,Revise finger/toe nerve,A,,6.10,7.44,NA,7.44,,1.09,14.63,14.63,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20264704,,Revise hand/foot nerve,A,,4.57,4.10,NA,4.10,,0.56,9.23,9.23,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00