Billing code 64610: Nerve treatmentMedicare rate & RVUs in Virginia
Report this procedure for neurolytic treatment of trigeminal nerve branches, such as when treating selected cases of severe facial neuralgia.
Medicare pays $828.76–$978.92 for 64610 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 64610 covers
This service uses a neurolytic technique, such as chemical treatment or radiofrequency, to injure a targeted portion of the trigeminal nerve and reduce pain signaling. It is performed percutaneously by a clinician experienced in facial pain procedures, commonly in a procedural or facility setting. The target is selected from the patient's pain distribution and clinical findings; treatment may involve branches serving the midface or lower face.
Choose the code that matches the specific trigeminal target and procedure documented, rather than coding only from the diagnosis of facial pain or trigeminal neuralgia. The record should identify the treated nerve or branch, side, technique, and clinical rationale. The procedure has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this procedure; 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.
Where 64610 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $978.92 | $495.36 |
| Virginia | $828.76 | $425.24 |
How the 64610 rate is calculated
Each of 64610’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 · 64610
RVUs × geographic indexes × conversion factor
Work7.02
7.02 RVUs× 1.000 GPCI
Practice expense16.52
16.52 RVUs× 1.000 GPCI
Malpractice2.20
2.20 RVUs× 1.000 GPCI
Adjusted RVUs
25.7400
Conversion factor
$33.4009
Medicare rate
$859.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64610
64610 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64610
Nerve treatment
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 64610
Nerve treatment
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 50 · payment effect
With and without the modifier
64610 without 50 · national office
$859.74
Nerve treatment
64610-50 · Bilateral: 150%
$1,289.61
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).
64610 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64600Nerve destruction
- Both address trigeminal nerve neurolytic treatment. Use the code whose descriptor matches the particular branch or target treated, not simply the diagnosis.
- 64605Trigeminal neurolysis
- This is a related trigeminal nerve procedure. Compare the specific target and procedural language in the full descriptors before selecting between the codes.
- 64640Nerve treatment
- 64640 describes neurolytic treatment of a peripheral nerve; use the trigeminal-specific code when the treated target is a trigeminal branch covered by its descriptor.
64610 billing questions
How do I distinguish this code from 64600 or 64605?
These codes address trigeminal nerve neurolytic treatment, but the applicable code depends on the specific target and procedure described by its full billing code descriptor. Document the branch or division treated and match it to the descriptor.
Does the 10-day global period include follow-up visits?
Related postoperative visits during the 10-day period are included in the global service.
How should bilateral treatment be reported?
Report bilateral treatment with modifier 50. CMS pays this bilateral procedure at 150%.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, while other procedures performed in the same session are subject to the standard multiple procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery for this procedure, 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 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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