$96.45–$102.63
Choose 64420 for an anesthetic intercostal nerve block. Choose 64620 when the documented procedure uses a neurolytic agent to disrupt the nerve.
On this page
CMS RVU26D · Effective 2026-10-01
64620 Nerve neurolysis Medicare reimbursement rates in Missouri
Reports neurolytic treatment of an intercostal nerve, commonly for persistent nerve-related chest wall pain when a temporary block is not the treatment performed. Compare 64620 office and facility rates across CMS payment localities in Missouri.
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 64620 in Missouri?
Missouri 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
$208.98–$220.07
3 of 3 localities have a supported rate.
Facility setting
$158.59–$164.43
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 64620 pays more and less in Missouri
3 payment localities
$208.98 to $220.07
Pain management
About 64620: Intercostal nerve neurolysis
Reports neurolytic treatment of an intercostal nerve, commonly for persistent nerve-related chest wall pain when a temporary block is not the treatment performed.
This service uses a neurolytic agent to intentionally disrupt an intercostal nerve’s ability to transmit pain signals. Pain medicine physicians and anesthesiologists commonly perform it for persistent intercostal neuralgia, including selected cases of post-thoracotomy or postherpetic pain, in an outpatient procedure setting. The target is an intercostal nerve along the chest wall; this is not a routine temporary anesthetic block or a muscle chemodenervation service.
Report the code when the documented procedure supports neurolytic treatment of an intercostal nerve, rather than temporary pain relief from an anesthetic injection. The record should identify the treated nerve and support the neurolytic intervention. Related postoperative visits are included in the 10-day global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. CMS indicates modifier 50 is inappropriate. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 64620
- 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 RVU2.82 · 42%
- Practice expense (office) RVU3.58 · 53%
- Malpractice RVU0.36 · 5%
3.3K
Medicare services in 2024 · #2108 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.
64620 compared with similar codes
Office rates for Missouri, from the same CMS release.
$252.13–$266.74
64630 is the site-specific neurolytic procedure for the pudendal nerve; 64620 is for an intercostal nerve.
$240.34–$258.16
64640 covers neurolytic treatment of another peripheral nerve or branch. Use 64620 for an intercostal nerve, the specifically identified site.
Compare 64620 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
Metropolitan Kansas City →
Office / nonfacility
$218.22
Facility
$163.33
Metropolitan St. Louis →
Office / nonfacility
$220.07
Facility
$164.43
Rest Of Missouri →
Office / nonfacility
$208.98
Facility
$158.59
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64620 billing questions
How is this different from an intercostal nerve block?
This code describes neurolytic treatment intended to disrupt nerve signaling. CPT 64420 describes an anesthetic injection for an intercostal nerve block, a different method and purpose.
Should modifier 50 be used for treatment on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.
What documentation supports reporting this service?
Document the intercostal nerve targeted and the neurolytic treatment performed. The record should distinguish the procedure from a temporary anesthetic nerve block.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure's global payment.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code, and 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.
7,17064615,,Chemodenerv musc migraine,A,,1.80,2.28,,0.85,,0.62,4.70,3.27,0,010,0.10,0.80,0.10,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17164616,,Chemodenerv musc neck dyston,A,,1.49,2.31,,0.99,,0.50,4.30,2.98,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17264617,,Chemodener muscle larynx emg,A,,1.85,2.65,,0.64,,0.26,4.76,2.75,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17364620,,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