How much does Medicare pay for CPT 64520?

Medicare allowed an average of $263.66 per service and paid $205.50 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1430.80, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64520?

Injection of anesthetic agent into middle or lower spine sympathetic nerve. It was billed 2,252 times to 1,124 Medicare beneficiaries by 51 providers in 2024.

Does 64520 pay differently in an office than a hospital?

Yes. The allowed amount averaged $273.79 in an office setting and $248.69 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 64520 most?

Anesthesiology, with 513 services from 7 clinicians. Next are Ambulatory Surgical Center, Pain Management, Interventional Pain Management.

CPT 64520

Injection of anesthetic agent into middle or lower spine sympathetic nerve

$263.66Medicare-allowed amount per service, averaged across 2,252 services

Providers submitted

$1430.80

Asking price, not received

Medicare allowed

$263.66

The fee schedule figure

Medicare paid

$205.50

Balance is patient coinsurance

Providers submitted an average of $1430.80 for this code and Medicare allowed $263.66 — 5.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $205.50 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $273.79
Hospital / facility: $248.69

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,343 services were billed in an office setting and 909 in a facility.

Services: 2,252
Beneficiaries: 1,124
Providers billing it: 51
Total allowed: $593,762

What Medicare pays for CPT 64520

Across 2,252 services billed by 51 providers to 1,124 beneficiaries, Medicare allowed an average of $263.66 per service. That is 2.0 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 64520

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	513	255	$264.61	7
Ambulatory Surgical Center	488	244	$386.32	15
Pain Management	481	222	$181.11	13
Interventional Pain Management	276	124	$171.32	8
Physical Medicine and Rehabilitation	236	96	$260.04	3
Family Practice	127	92	$267.97	2
Internal Medicine	87	59	$335.83	2
Neurology	44	32	$238.10	1

64520 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	510	$263.56	$178.94	7
Alaska	382	$316.74	$205.14	1
Arkansas	279	$253.12	$234.66	4
Texas	233	$270.87	$227.62	8
California	117	$318.24	$224.44	4
Arizona	109	$308.44	$239.53	4
Alabama	109	$104.21	$92.63	4
Illinois	94	$226.25	$184.95	3
Pennsylvania	90	$174.47	$145.29	3
Indiana	89	$257.94	$212.65	2
Mississippi	59	$243.78	$219.81	2
Minnesota	46	$289.35	$228.01	2
Kentucky	40	$335.23	$282.65	2
Missouri	29	$382.25	$313.14	1
Georgia	20	$240.16	$196.68	1
New Jersey	20	$95.85	$70.99	1
Nevada	15	$184.40	$183.46	1
Louisiana	11	$73.32	$66.29	1

Related codes

64566Insertion of lower leg neurostimulator electrode$111.18
64561Insertion of sacral nerve neurostimulator electrode array$2661.59
64590Insertion or replacement of peripheral$7256.19
64555Insertion of peripheral nerve neurostimulator electrode through skin$2824.92
64582Insertion of hypoglossal nerve neurostimulator electrode and generator$1710.79
64510Injection of anesthetic agent into sympathetic nerve bundle$184.69

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.