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CMS RVU26D · Effective 2026-10-01

64746 Phrenic neurotomy Medicare reimbursement rates in Colorado

Reports surgical incision of the phrenic nerve, which supplies the diaphragm, including selected operations to interrupt nerve signaling for refractory hiccups. Compare 64746 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 64746 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

$435.22

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.

Find 64746 in your payment locality →

Peripheral nerve surgery

About 64746: Phrenic nerve neurotomy

Reports surgical incision of the phrenic nerve, which supplies the diaphragm, including selected operations to interrupt nerve signaling for refractory hiccups.

This operation incises the phrenic nerve, the nerve that drives the diaphragm. A surgeon may perform it in an operating room to interrupt phrenic signaling in a selected case, such as intractable hiccups. The operative report should identify the phrenic nerve and side treated, describe the nerve procedure, and document the clinical reason for interrupting its function.

Report the code for the phrenic nerve procedure, not for work on a different nerve such as the vagus or a spinal nerve. The service has a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. When other 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. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted.

CMS billing rules for 64746

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU6.40 · 49%
  • Practice expense (office) RVU4.97 · 38%
  • Malpractice RVU1.62 · 12%

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.

64746 compared with similar codes

Office rates for Colorado, from the same CMS release.

64760

Vagus nerve surgery

Vagus nerve

No office rate

Choose 64746 for the phrenic nerve supplying the diaphragm; 64760 targets the vagus nerve.

64772

Spinal nerve surgery

Extradural nerve interruption

No office rate

Code 64746 identifies the phrenic nerve, while 64772 identifies a spinal nerve as the operative target.

64771

Cranial nerve transection

Other nerve, intracranial

No office rate

64746 concerns the phrenic nerve. Code 64771 describes severing a cranial nerve, a different nerve target and procedure.

Compare 64746 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

Office and facility base rates · shared scale starting at $0

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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 64746 in Colorado.

PPRRVU2026_Oct_nonQPP.csv

7,222

Code
64746
Physician work
6.40
Practice expense
4.97
Malpractice
1.62

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Facility calculation for 64746 in Colorado
ComponentRVULocality factorAdjusted
Physician work6.40× 1.0126.4768
Practice expense4.97× 1.0645.2881
Malpractice1.62× 0.7811.2652
Total RVUs13.0301
Conversion factor× 33.4009

Facility rate, Colorado$435.22

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work6.41.012
Practice expense4.971.064
Malpractice1.620.781

(6.4 × 1.012 + 4.97 × 1.064 + 1.62 × 0.781) × $33.4009 = $435.22

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.

64746 billing questions

What documentation supports reporting this code?

Document the phrenic nerve as the operative target, the side treated, the incision or neurotomy performed, and the clinical indication. The operative note should distinguish this work from a procedure on another nerve.

How does this differ from 64760?

64746 is for the phrenic nerve, which supplies the diaphragm. Code 64760 is for incision of the vagus nerve.

How is bilateral surgery reported?

For bilateral phrenic nerve surgery, report modifier 50; CMS pays the bilateral procedure at 150%.

Are related postoperative visits separately included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, while team-surgery billing is not permitted.

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

CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures.

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 64746PPRRVU2026_Oct_nonQPP.csv, line 7,222 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet