$529.19–$593.57
Use 64600 for neurolysis of peripheral trigeminal branches such as supraorbital, infraorbital, or mental branches. This code is for the second and third trigeminal divisions.
On this page
CMS RVU26D · Effective 2026-10-01
64605 Trigeminal neurolysis Medicare reimbursement rates in Florida
Reports neurolytic treatment directed to the second and third trigeminal nerve divisions for facial pain, with documentation identifying the treated nerve targets and technique. Compare 64605 office and facility rates across CMS payment localities in Florida.
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 64605 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$1103.12–$1254.29
3 of 3 localities have a supported rate.
Facility setting
$455.88–$549.49
3 of 3 localities have a supported rate.
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 64605 pays more and less in Florida
3 payment localities
$1103.12 to $1254.29
Pain management
About 64605: Trigeminal nerve neurolysis, second and third divisions
Reports neurolytic treatment directed to the second and third trigeminal nerve divisions for facial pain, with documentation identifying the treated nerve targets and technique.
This service uses a neurolytic technique to interrupt pain signaling in the second and third divisions of the trigeminal nerve. It may be performed for selected patients with severe, persistent facial neuralgia, including pain in the midface or jaw, after less invasive treatment has not provided adequate relief. Pain-management physicians and other clinicians trained in trigeminal procedures typically perform it in an office-based procedure room or facility setting. The operative record should identify the treated divisions or branches, the side, the neurolytic method, and the clinical indication.
Report the code when the documented service is neurolytic treatment of the specified trigeminal targets, rather than a temporary nerve block or treatment of a different nerve. It has a 10-day global period, which includes related postoperative visits during that period. 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. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 64605
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.51 · 17%
- Practice expense (office) RVU25.12 · 76%
- Malpractice RVU2.33 · 7%
116
Medicare services in 2024 · #4767 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.
64605 compared with similar codes
Office rates for Florida, from the same CMS release.
$872.42–$994.72
Both codes concern trigeminal neurolysis. Choose based on the documented target and the specific service represented by the applicable code descriptor.
$121.46–$136.35
Code 64400 represents an anesthetic trigeminal nerve injection; this code represents neurolytic treatment.
$262.63–$286.80
Code 64640 concerns neurolysis of another peripheral nerve or branch, not the specified trigeminal divisions.
Compare 64605 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
$1174.68
Facility
$488.85
Miami →
Office / nonfacility
$1254.29
Facility
$549.49
Rest Of Florida →
Office / nonfacility
$1103.12
Facility
$455.88
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64605 billing questions
How is this code distinguished from 64600?
This code is for neurolytic treatment involving the second and third trigeminal divisions. Code 64600 describes treatment of peripheral trigeminal branches, such as the supraorbital, infraorbital, or mental branches.
Is a temporary trigeminal nerve block reported with this code?
No. A temporary anesthetic block is a different service; this code represents neurolytic treatment. The record should support the neurolytic method and the trigeminal targets treated.
What documentation supports reporting bilateral treatment?
Document the treated trigeminal targets and side for each side treated. CMS lists bilateral payment with modifier 50 at 150%.
Are related postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure's global package.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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.
7,16364597,,Ins/rplcm prq eltrd ra pn ea,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16464598,,Revj/rmvl nea pn w/int nstim,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16564600,,Injection treatment of nerve,A,,3.40,11.57,,2.48,,0.92,15.89,6.80,0,010,0.10,0.80,0.10,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16664605,,Injection treatment of nerve,A,,5.51,25.12,,4.85,,2.33,32.96,12.69,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16764610,,Injection treatment of nerve,A,,7.02,16.52,,4.23,,2.20,25.74,13.45,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16864611,,Chemodenerv saliv glands,A,,1.00,2.76,,1.85,,0.39,4.15,3.24,0,010,0.10,0.80,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16964612,,Destroy nerve face muscle,A,,1.37,2.58,,1.58,,0.29,4.24,3.24,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00