$355.70
64680 treats the celiac plexus; 64681 applies to neurolytic treatment of the superior hypogastric plexus.
On this page
CMS RVU26D · Effective 2026-10-01
64681 Plexus neurolysis Medicare reimbursement rates in Rhode Island
Reports neurolytic injection of the superior hypogastric plexus to interrupt visceral pain signaling, commonly for persistent pelvic or lower abdominal pain. Compare 64681 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 64681 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
$474.38
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$196.29
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 64681: Superior hypogastric plexus neurolysis
Reports neurolytic injection of the superior hypogastric plexus to interrupt visceral pain signaling, commonly for persistent pelvic or lower abdominal pain.
This service uses a neurolytic agent to interrupt pain signaling through the superior hypogastric plexus, a target associated with pelvic and lower abdominal visceral pain. Interventional pain physicians, anesthesiologists, and other clinicians who perform image-guided pain procedures may provide it, often for persistent pain related to pelvic malignancy. Radiologic monitoring may be used during the procedure.
Select this code when the treated target is the superior hypogastric plexus and the purpose is neurolysis, rather than a temporary anesthetic block or treatment of a different nerve. The procedure note should identify the target, neurolytic treatment, and any imaging used. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this target. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 64681
- 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 RVU3.69 · 27%
- Practice expense (office) RVU9.85 · 71%
- Malpractice RVU0.30 · 2%
106
Medicare services in 2024 · #4837 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.
64681 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$207.49
64517 describes an anesthetic injection of the superior hypogastric plexus for a block. Choose 64681 for neurolytic treatment.
$274.43
64640 is for neurolytic treatment of another peripheral nerve or branch. Use 64681 when the treated structure is the superior hypogastric plexus.
Compare 64681 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
$474.38
Facility
$196.29
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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 64681 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,200
- Code
- 64681
- Physician work
- 3.69
- Practice expense
- 9.85
- Malpractice
- 0.30
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.69 | × 1.019 | 3.7601 |
| Practice expense | 9.85 | × 1.033 | 10.1750 |
| Malpractice | 0.30 | × 0.892 | 0.2676 |
| Total RVUs | 14.2028 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$474.38
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.69 | 1.019 |
| Practice expense | 9.85 | 1.033 |
| Malpractice | 0.3 | 0.892 |
(3.69 × 1.019 + 9.85 × 1.033 + 0.3 × 0.892) × $33.4009 = $474.38
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.69 | 1.019 |
| Practice expense | 1.79 | 1.033 |
| Malpractice | 0.3 | 0.892 |
(3.69 × 1.019 + 1.79 × 1.033 + 0.3 × 0.892) × $33.4009 = $196.29
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.
64681 billing questions
How is this different from a superior hypogastric plexus block?
This code is for neurolytic treatment intended to interrupt plexus signaling. A temporary anesthetic injection for a block is reported with 64517.
When should 64680 be used instead?
64680 is for neurolytic treatment of the celiac plexus. Use 64681 when the treated target is the superior hypogastric plexus.
Is radiologic monitoring included in the service?
The code covers the neurolytic treatment with or without radiologic monitoring. Document the target and treatment, including imaging used.
Should modifier 50 be reported for treatment on both sides?
No. Modifier 50 is inappropriate for this plexus target.
Are related postoperative visits separately reported during the global period?
Related postoperative visits for 10 days are included in the procedure's global period.
How does Medicare handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
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.
7,19764658,,Rmvl bat modul sys lead only,A,,8.95,3.03,NA,3.03,,2.27,14.25,14.25,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19864659,,Rmvl bat modulj sys pg only,A,,8.23,2.90,NA,2.90,,2.09,13.22,13.22,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19964680,,Injection treatment of nerve,A,,2.60,7.52,,1.53,,0.26,10.38,4.39,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20064681,,Injection treatment of nerve,A,,3.69,9.85,,1.79,,0.30,13.84,5.78,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20164702,,Revise finger/toe nerve,A,,6.10,7.44,NA,7.44,,1.09,14.63,14.63,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20264704,,Revise hand/foot nerve,A,,4.57,4.10,NA,4.10,,0.56,9.23,9.23,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20364708,,Revise arm/leg nerve,A,,6.20,6.85,NA,6.85,,0.85,13.90,13.90,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537