$1,132.51–$1,262.65
Use 64605 for percutaneous neurolytic treatment of proximal second- and third-division trigeminal branches at the foramen ovale or rotundum; use 64600 for its specified peripheral branches.
On this page
CMS RVU26D · Effective 2026-10-01
64600 Nerve destruction Medicare reimbursement rates in Massachusetts
Reports neurolytic treatment of selected trigeminal nerve branches, such as supraorbital or infraorbital branches, for persistent facial pain or neuralgia. Compare 64600 office and facility rates across CMS payment localities in Massachusetts.
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 64600 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$546.80–$606.99
2 of 2 localities have a supported rate.
Facility setting
$227.10–$244.47
2 of 2 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.
Pain management
About 64600: Trigeminal branch neurolysis
Reports neurolytic treatment of selected trigeminal nerve branches, such as supraorbital or infraorbital branches, for persistent facial pain or neuralgia.
This service uses an injected neurolytic agent to intentionally disrupt a selected trigeminal nerve branch, including the supraorbital, infraorbital, mental, or inferior alveolar branch. It may be performed for persistent facial pain or trigeminal neuralgia when treatment is directed to one of these branches. Pain physicians and other qualified physicians may provide it in an office or facility setting.
Select the code based on the nerve branch treated; document the indication, specific branch and side, neurolytic agent, and procedure performed. CMS assigns this code a 10-day global period, so related postoperative visits during that 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. CMS prices this code as bilateral; modifier 50 does not increase payment. Assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 64600
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- 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 RVU3.40 · 21%
- Practice expense (office) RVU11.57 · 73%
- Malpractice RVU0.92 · 6%
494
Medicare services in 2024 · #3578 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.
64600 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$877.82–$968.32
Use 64610 for the proximal second- and third-division procedure when performed with imaging guidance. This code covers the listed peripheral trigeminal branches.
$125.68–$139.70
64400 describes an anesthetic trigeminal nerve injection or block. This code describes treatment with a neurolytic agent to disrupt a branch.
$277.45–$307.35
64640 is for neurolytic treatment of other peripheral nerves or branches. Use this code when the treated site is one of its specifically named trigeminal branches.
Compare 64600 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$606.99
Facility
$244.47
Rest Of Massachusetts →
Office / nonfacility
$546.80
Facility
$227.10
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64600 billing questions
Which trigeminal branches fit this code?
It covers neurolytic treatment of the supraorbital, infraorbital, mental, or inferior alveolar branch. Choose based on the branch actually treated.
How does this differ from 64605 or 64610?
Those codes address percutaneous neurolytic treatment of the second and third trigeminal divisions at the foramen ovale or rotundum. This code is for the listed peripheral branches.
Can a nerve block be reported instead?
Code 64400 describes injection of an anesthetic agent for a trigeminal nerve block. This code is for neurolytic treatment intended to disrupt the targeted branch.
Should modifier 50 be appended for bilateral treatment?
CMS prices this code as bilateral, and modifier 50 does not increase payment. Document the branches and sides treated.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
What documentation supports code selection?
Record the facial pain indication, the specific trigeminal branch and side, the neurolytic agent, and the treatment performed.
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.
7,16264596,,Ins/rplcmt prq eltrd ra pn 1,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
7,16364597,,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