CPT code 64744: Occipital neurectomy2026 Medicare rate & RVUs in Virginia
Surgical transection or avulsion of the greater occipital nerve, generally reported for operative treatment of persistent occipital neuralgia.
CMS doesn’t publish an office rate for 64744 in Virginia.
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 64744 covers
This operation intentionally interrupts or removes the greater occipital nerve in the posterior scalp and occipital region, usually to treat persistent occipital neuralgia when surgical neurectomy is selected. The surgeon identifies the targeted nerve and divides or avulses it. This is a destructive nerve procedure, rather than decompression, and is generally performed in an operating room.
Report 64744 for operative treatment of the greater occipital nerve. The operative report should identify the nerve, side, indication, and transection or avulsion performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 64744 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $610.38 |
| Virginia | Unavailable | $514.31 |
How the 64744 rate is calculated
Each of 64744’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 · 64744
RVUs × geographic indexes × conversion factor
Work5.58
5.58 RVUs× 1.000 GPCI
Practice expense8.30
8.30 RVUs× 1.000 GPCI
Malpractice2.35
2.35 RVUs× 1.000 GPCI
Adjusted RVUs
16.2300
Conversion factor
$33.4009
Medicare rate
$542.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64744
64744 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64744
Occipital neurectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 0 | Not paid without supporting documentation. |
| 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) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 64744
Occipital neurectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
64744 without 50 · national facility
$542.10
Occipital neurectomy
64744-50 · Bilateral: 150%
$813.15
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).
64744 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64722Nerve decompression
- 64722 describes nerve decompression. Use 64744 when the operative service transects or avulses the greater occipital nerve.
- 64742Facial nerve surgery
- 64742 concerns transection of a facial nerve; 64744 is specific to the greater occipital nerve in the back of the head.
- 64732Brow nerve surgery
- 64732 concerns a brow-region nerve. Select 64744 for operative transection or avulsion of the greater occipital nerve.
64744 billing questions
Is 64744 used for occipital nerve decompression?
No. 64744 describes transection or avulsion of the greater occipital nerve; decompression is a different operative approach. Code the procedure actually performed.
What operative documentation supports 64744?
Document the greater occipital nerve, the treated side, the clinical indication, and whether the nerve was transected or avulsed.
How is bilateral surgery reported?
CMS lists bilateral reporting with modifier 50, paid at 150%. The operative documentation should support treatment on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid for 64744?
Assistant-at-surgery payment is allowed only when medical necessity is documented. CMS does not permit co-surgeon or team-surgery payment for this code.
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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