Billing code 64625: Radiofrequency ablationMedicare rate & RVUs in Ohio

Reports image-guided radiofrequency ablation of nerves supplying the sacroiliac joint to treat pain attributed to that joint’s innervation.

CMS RVU26DEffective Oct 1, 20261 payment locality11.5K Medicare services in 2024

Medicare pays $463.21 for 64625 in the office in Ohio (Ohio). Which amount applies depends on the service address.

$463.21Office (non-facility)
$171.98Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 64625 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 64625 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 64625 covers

This procedure uses radiofrequency energy to create lesions in nerves that carry pain signals from the sacroiliac joint. Pain medicine physicians, anesthesiologists, and other clinicians who perform image-guided interventions may use it for persistent SI-joint-related pain after evaluation, often including diagnostic nerve blocks. Fluoroscopy or CT guidance is part of the service; the code covers placement of needles at multiple target nerves, including sacral lateral branches.

Report the service for ablation of nerves innervating the SI joint, not for an SI-joint injection or ablation of lumbar facet nerves. The procedure note should identify the treated side and targets, describe the ablation and imaging guidance, and support the relationship of the treated nerves to the patient’s SI-joint pain. Related postoperative visits are included in the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 reports a bilateral procedure and is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

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.

64625 in Ohio

64625 office and facility rates by payment locality
Payment localityOfficeFacility
Ohio$463.21$171.98

How the 64625 rate is calculated

Each of 64625’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 64625

RVUs × geographic indexes × conversion factor

Work3.31

3.31 RVUs× 1.000 GPCI

Practice expense11.20

11.20 RVUs× 1.000 GPCI

Malpractice0.33

0.33 RVUs× 1.000 GPCI

Adjusted RVUs

14.8400

Conversion factor

$33.4009

Medicare rate

$495.67

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 64625

64625 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64625

Radiofrequency ablation

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 64625

Radiofrequency ablation

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

64625 without 50 · national office

$495.67

Radiofrequency ablation

64625-50 · Bilateral: 150%

$743.51

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

64625 compared with similar codes

Compare codes · National

4 codes, side by side

  • 64625

    Radiofrequency ablation3.31 wRVU

    $495.67

  • 64451

    SI nerve block1.48 wRVU

    $241.49−$254.18

  • 64635

    Facet nerve ablation3.24 wRVU

    $464.94−$30.73

  • 64628

    Basivertebral ablation6.97 wRVU

    Not priced

How to choose

64451SI nerve block
64451 reports injection of anesthetic or steroid around nerves innervating the SI joint; 64625 reports radiofrequency ablation of those nerves.
64635Facet nerve ablation
64635 addresses lumbar or sacral facet-joint nerves. Use 64625 when the ablated targets innervate the SI joint.
64628Basivertebral ablation
64628 ablates the intraosseous basivertebral nerve for a different spinal pain target; 64625 treats nerves supplying the SI joint.

64625 billing questions

How is 64625 different from 64635?

64625 targets nerves innervating the sacroiliac joint. 64635 targets nerves supplying a lumbar or sacral facet joint, so select according to the joint and nerves treated.

Can imaging guidance be billed separately?

No. Imaging guidance, including fluoroscopy or CT, is included in 64625.

How should a bilateral procedure be reported?

Use modifier 50 for a bilateral procedure. CMS pays the bilateral procedure at 150% under the supplied fee schedule rule.

What documentation supports reporting 64625?

Document the SI-joint-related pain indication, treated side and nerve targets, ablation performed, and imaging guidance. The note should distinguish the SI-joint innervation from lumbar facet targets.

Are related postoperative visits separately payable?

Related postoperative visits during the 10-day global period are included in the procedure payment.

How does the multiple-procedure rule affect 64625?

When 64625 is performed with other procedures in the same session, CMS pays the highest-valued procedure in full and the others at 50%.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 64625PPRRVU2026_Oct_nonQPP.csv, line 7,175 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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