Billing code 64680: Celiac neurolysisMedicare rate & RVUs in Texas
Reports chemical destruction of the celiac plexus, commonly performed to relieve severe upper abdominal visceral pain such as pain from pancreatic cancer.
Medicare pays $323.48–$360.45 for 64680 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 64680 covers
This service destroys the celiac plexus with a neurolytic agent to reduce severe visceral pain from upper abdominal disease, often pancreatic cancer. Interventional pain physicians, anesthesiologists, and radiologists may perform it in an outpatient procedure suite or hospital setting. The needle is commonly positioned with fluoroscopic or CT monitoring; the code includes the service whether or not radiologic monitoring is used.
Report the code when the documented target is the celiac plexus and the treatment is neurolysis, rather than a temporary anesthetic block. The procedure note should identify the indication, target, neurolytic agent, and technique. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When this and other multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is not appropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery reporting 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.
Where 64680 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$323.48 to $360.45
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $360.45 | $148.78 |
| Beaumont | $323.48 | $141.41 |
| Brazoria | $343.22 | $144.95 |
| Dallas | $345.25 | $145.97 |
| Fort Worth | $342.85 | $145.58 |
| Galveston | $344.14 | $145.47 |
| Houston | $348.90 | $150.23 |
| Rest Of Texas | $333.05 | $143.18 |
How the 64680 rate is calculated
Each of 64680’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 · 64680
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.60Practice expense 7.52Malpractice 0.26
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64680
64680 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64680
Celiac neurolysis
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 64680
Celiac neurolysis
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
64680 without 51 · national office
$346.70
Celiac neurolysis
64680-51 · Second procedure: 50%
$173.35
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
64680 compared with similar codes
Compare codes
64680 vs 64530 vs 64681 vs 64640: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64530Celiac plexus block
- Choose 64530 for an anesthetic injection or block of the celiac plexus. Choose 64680 when a neurolytic agent is used to destroy the plexus.
- 64681Plexus neurolysis
- 64681 targets the superior hypogastric plexus. 64680 targets the celiac plexus, typically for upper abdominal visceral pain.
- 64640Nerve treatment
- 64640 covers neurolytic treatment of another peripheral nerve or branch. Use 64680 when the documented target is specifically the celiac plexus.
64680 billing questions
How is this different from a celiac plexus block?
64680 is for neurolytic treatment intended to destroy the celiac plexus. A celiac plexus injection with an anesthetic agent, such as 64530, is a block rather than neurolysis.
Does radiologic monitoring change the code?
No. The service is reported whether or not radiologic monitoring is used; document the technique and target in the procedure note.
Can modifier 50 be used for bilateral treatment?
No. Modifier 50 is inappropriate for this celiac plexus service.
Are related postoperative visits included?
Yes. The 10-day global period includes related postoperative visits during that period.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this procedure. Co-surgeon and team-surgery reporting 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 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
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