No office rate
64628 covers the first one or two lumbar or sacral vertebral bodies. 64629 is reported for each additional vertebral body treated.
On this page
CMS RVU26D · Effective 2026-10-01
64628 Basivertebral ablation Medicare reimbursement rates in Colorado
Reports image-guided thermal destruction of the intraosseous basivertebral nerve in up to the first two lumbar or sacral vertebral bodies. Compare 64628 office and facility rates across CMS payment localities in Colorado.
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 64628 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$369.17
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Pain management
About 64628: Lumbar or sacral basivertebral nerve ablation
Reports image-guided thermal destruction of the intraosseous basivertebral nerve in up to the first two lumbar or sacral vertebral bodies.
This service uses a needle-based approach to thermally ablate the basivertebral nerve within lumbar or sacral vertebral bodies. It is generally performed by an interventional pain physician or spine specialist for selected patients with vertebrogenic axial low back pain associated with vertebral endplate changes. Imaging guidance is part of the service. Procedures are commonly performed in a hospital or ambulatory surgery center.
Report 64628 for treatment of the first one or two lumbar or sacral vertebral bodies; report 64629 for each additional body treated. The operative record should identify the treated vertebral levels and support the intraosseous target and thermal ablation. Guidance is included, so it is not separately reported as imaging for this procedure. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 64628
- 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 RVU6.97 · 64%
- Practice expense (office) RVU3.23 · 30%
- Malpractice RVU0.72 · 7%
13.2K
Medicare services in 2024 · #1332 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.
64628 compared with similar codes
Office rates for Colorado, from the same CMS release.
$486.33
64635 is lumbar or sacral facet-joint nerve destruction. Choose 64628 when the ablation target is the intraosseous basivertebral nerve within vertebral bodies.
$518.52
64625 addresses nerves supplying the sacroiliac joint; 64628 targets the basivertebral nerve inside lumbar or sacral vertebral bodies.
Compare 64628 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$369.17
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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 64628 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
7,176
- Code
- 64628
- Physician work
- 6.97
- Practice expense
- 3.23
- Malpractice
- 0.72
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.97 | × 1.012 | 7.0536 |
| Practice expense | 3.23 | × 1.064 | 3.4367 |
| Malpractice | 0.72 | × 0.781 | 0.5623 |
| Total RVUs | 11.0527 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$369.17
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.97 | 1.012 |
| Practice expense | 3.23 | 1.064 |
| Malpractice | 0.72 | 0.781 |
(6.97 × 1.012 + 3.23 × 1.064 + 0.72 × 0.781) × $33.4009 = $369.17
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.
64628 billing questions
When is 64628 reported instead of 64629?
64628 covers treatment of the first one or two lumbar or sacral vertebral bodies. Use 64629 for each additional vertebral body treated beyond those first two.
Can imaging guidance be billed separately?
No. Imaging guidance is included in 64628; it is not separately reported as guidance for this ablation.
What documentation supports the number of units?
Document the vertebral levels treated and the intraosseous basivertebral nerve ablation performed at each level. The additional-body code is reported per vertebral body beyond the first two.
Does modifier 50 apply when treatment is on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.
Are related postoperative visits separately payable?
Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is statutorily restricted for this code. 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 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.
7,17364620,,Injection treatment of nerve,A,,2.82,3.58,,1.83,,0.36,6.76,5.01,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17464624,,Dstrj nulyt agt gnclr nrv,A,,2.44,9.65,,1.33,,0.22,12.31,3.99,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17564625,,Rf abltj nrv nrvtg si jt,A,,3.31,11.20,,1.65,,0.33,14.84,5.29,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17664628,,Trml dstrj ios bvn 1st 2 l/s,A,,6.97,3.23,NA,3.23,,0.72,10.92,10.92,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17764629,,Trml dstrj ios bvn ea addl,A,,3.68,0.94,NA,0.94,,0.39,5.01,5.01,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17864630,,Injection treatment of nerve,A,,2.97,4.69,,1.98,,0.55,8.21,5.50,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17964632,,N block inj common digit,A,,1.20,1.41,,0.56,,0.09,2.70,1.85,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899