64451 reports injection of anesthetic or steroid around nerves innervating the SI joint; 64625 reports radiofrequency ablation of those nerves.
On this page
CMS RVU26D · Effective 2026-10-01
64625 Radiofrequency ablation Medicare reimbursement rates in Rhode Island
Reports image-guided radiofrequency ablation of nerves supplying the sacroiliac joint to treat pain attributed to that joint’s innervation. Compare 64625 office and facility rates across CMS payment localities in Rhode Island.
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 64625 in Rhode Island?
Rhode Island 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
$508.92
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$179.42
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Pain management
About 64625: Sacroiliac joint nerve radiofrequency ablation
Reports image-guided radiofrequency ablation of nerves supplying the sacroiliac joint to treat pain attributed to that joint’s innervation.
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.
CMS billing rules for 64625
- 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
- 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 RVU3.31 · 22%
- Practice expense (office) RVU11.20 · 75%
- Malpractice RVU0.33 · 2%
11.5K
Medicare services in 2024 · #1404 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.
64625 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
64635 addresses lumbar or sacral facet-joint nerves. Use 64625 when the ablated targets innervate the SI joint.
64628 ablates the intraosseous basivertebral nerve for a different spinal pain target; 64625 treats nerves supplying the SI joint.
Compare 64625 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
Rhode Island →
Office / nonfacility
$508.92
Facility
$179.42
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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 64625 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,175
- Code
- 64625
- Physician work
- 3.31
- Practice expense
- 11.20
- Malpractice
- 0.33
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.31 | × 1.019 | 3.3729 |
| Practice expense | 11.20 | × 1.033 | 11.5696 |
| Malpractice | 0.33 | × 0.892 | 0.2944 |
| Total RVUs | 15.2368 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$508.92
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.31 | 1.019 |
| Practice expense | 11.2 | 1.033 |
| Malpractice | 0.33 | 0.892 |
(3.31 × 1.019 + 11.2 × 1.033 + 0.33 × 0.892) × $33.4009 = $508.92
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.31 | 1.019 |
| Practice expense | 1.65 | 1.033 |
| Malpractice | 0.33 | 0.892 |
(3.31 × 1.019 + 1.65 × 1.033 + 0.33 × 0.892) × $33.4009 = $179.42
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.
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 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.
