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CPT 64625 Fee Schedule

Last Verified: July 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Treat Pain In Hip And Spine, An Electrical Current Produced By A Radio Wave Is Used To Heat Up A Small Area Of Nerve Tissue At The Joint Of The Spine And Hip. This Procedure (Radiofrequency Ablation) Is Used To Treat Chronic Pain.
Key FactDetail
Service Type

Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) Procedures on the Somatic Nerves

Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) and Chemodenervation Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System

Common Place of Service

24 - Ambulatory Surgical Center

11 - Office

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 64625

National average reimbursement for CPT 64625 by major payers:

bcbs

$618.66

uhc

$681.27

aetna

$668.52

cigna

$796.84

Preview provider-level rates for...
For billing codeCPT 64625
PayerCodeRateNPITax IDStateSpecialty
United
64625$2353.001316508252 - MINIMALLY INVASIVE SURGICENTER LLC842130499 - (FL) MINIMALLY INVASIVE SURGICENTER LFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$390.001861596967 - G.I.ENDOSCOPY CENTER581862189 - (GA) GIENDOSCOPY CENTERGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$2859.001447797105 - SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS, LLC, SOUTH DENVER SURGERY CENTER364821257 - (CO) SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$1025.001295015212 - MOSC, LLC452913174 - (AZ) MOSC LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$1300.001275132094 - COASTAL CARDIOVASCULAR CENTER, LLC, COASTAL CARDIOVASCULAR CENTER845144651 - (TX) COASTAL CARDIOVASCULAR CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$1100.001871941468 - AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC812463581 - (MD) AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$1500.001487280871 - MARYLAND AMBULATORY SURGERY CENTER LLC845098442 - (MD) MARYLAND AMBULATORY SURGERY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$3993.001699738112 - NORTH AUSTIN SURGERY CENTER, L.P.200648730 - (TX) NORTH AUSTIN SURGERY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$1819.001588619811 - LAWRENCEVILLE SURGERY CENTER, LLC582591488 - (GA) LAWRENCEVILLE SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$3500.001992721591 - DAY SURGERY CENTER OF NORTH TEXAS LTD260308454TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$1490.001932856945 - UPPER VALLEY DIALYSIS ACCESS CENTER, LLC863328769 - (TX) UPPER VALLEY DIALYSIS ACCESS CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$1309.001699256404 - LEGACY SURGERY CENTER LLC831722822 - (FL) LEGACY SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$1419.001609825298 - SURGERY CENTER OF IDAHO LLC204831740 - (ID) SURGERY CENTER OF IDAHO LLCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$2101.001063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER862679471TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
64625$1838.001093595696 - NEW LEXINGTON CLINIC PSC, DERMATOLOGY ASSOCIATES OF KENTUCKY PSC611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C.KYAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 64625 vs. Other Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) and Chemodenervation Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System Codes

The CPT 64625 code is part of the Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) Procedures on the Somatic Nerves services used for Destruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) and Chemodenervation Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 64625 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
64620-CPTModerateInject Nerve For Pain Control, An Injection Into A Nerve To Deaden The Sensation Of Pain At A Location.
64624-CPTModerateDestruction By Neurolytic Agen, Destruction By Neurolytic Agent Genicular Nerve Branches Including Imaging Guidance When Performed
64625-CPTModerateTreat Pain In Hip And Spine, An Electrical Current Produced By A Radio Wave Is Used To Heat Up A Small Area Of Nerve Tissue At The Joint Of The Spine And Hip. This Procedure (Radiofrequency Ablation) Is Used To Treat Chronic Pain.
64630-CPTModerateDestruct Neurolytic Pudendal

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64625. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 64625 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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