How much does Medicare pay for CPT 64634?

Medicare allowed an average of $174.09 per service and paid $138.66 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $980.79, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64634?

Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint. It was billed 45,260 times to 34,210 Medicare beneficiaries by 1,612 providers in 2024.

Does 64634 pay differently in an office than a hospital?

Yes. The allowed amount averaged $275.80 in an office setting and $75.51 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 64634 most?

Pain Management, with 15,074 services from 539 clinicians. Next are Interventional Pain Management, Anesthesiology, Physical Medicine and Rehabilitation.

CPT 64634

Destruction of upper or middle spinal facet joint nerves using imaging guidance, each additional facet joint

$174.09Medicare-allowed amount per service, averaged across 45,260 services

Providers submitted

$980.79

Asking price, not received

Medicare allowed

$174.09

The fee schedule figure

Medicare paid

$138.66

Balance is patient coinsurance

Providers submitted an average of $980.79 for this code and Medicare allowed $174.09 — 5.6× 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 $138.66 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $275.80
Hospital / facility: $75.51

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. 22,277 services were billed in an office setting and 22,983 in a facility.

Services: 45,260
Beneficiaries: 34,210
Providers billing it: 1,612
Total allowed: $7,879,313

What Medicare pays for CPT 64634

Across 45,260 services billed by 1,612 providers to 34,210 beneficiaries, Medicare allowed an average of $174.09 per service. That is 1.3 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 64634

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pain Management	15,074	11,410	$178.61	539
Interventional Pain Management	12,064	9,015	$186.58	382
Anesthesiology	10,261	7,850	$168.70	369
Physical Medicine and Rehabilitation	6,418	4,871	$149.24	266
Neurology	399	285	$195.79	12
Diagnostic Radiology	207	157	$196.47	8
Neurosurgery	133	107	$115.07	5
Orthopedic Surgery	101	73	$196.24	4
Family Practice	87	66	$99.84	3
Sports Medicine	86	57	$116.30	3
Emergency Medicine	85	69	$153.34	5
Psychiatry	81	61	$139.75	3
Interventional Radiology	66	51	$176.75	3
Internal Medicine	59	22	$139.52	2
Certified Registered Nurse Anesthetist (CRNA)	50	46	$252.63	3

64634 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
Florida	6,384	$202.14	$163.55	190
Texas	4,567	$183.39	$152.52	163
Arizona	3,276	$191.23	$159.01	108
California	2,778	$147.53	$110.40	100
Georgia	1,764	$101.77	$85.80	62
Oklahoma	1,697	$224.92	$204.69	40
Virginia	1,472	$252.54	$199.07	46
Louisiana	1,368	$101.73	$87.42	41
Tennessee	1,272	$140.10	$125.27	52
North Carolina	1,269	$218.76	$186.43	48
Colorado	1,077	$175.23	$138.52	38
New York	1,025	$254.71	$177.39	35
South Carolina	1,005	$198.95	$174.45	33
Kentucky	984	$235.61	$215.38	34
Ohio	939	$105.42	$88.17	41
Illinois	929	$166.31	$131.62	37
Arkansas	924	$152.20	$136.94	34
Pennsylvania	917	$183.05	$149.58	39
Maryland	857	$106.03	$83.28	34
Utah	828	$217.41	$181.09	32
Michigan	776	$220.76	$186.07	30
Mississippi	762	$112.25	$98.88	23
Minnesota	754	$88.38	$73.28	33
Missouri	713	$97.41	$81.62	27
Alabama	690	$222.76	$205.73	26
Massachusetts	572	$225.68	$167.41	23
Indiana	566	$138.32	$122.75	24
Nevada	506	$179.06	$148.95	21
Washington	504	$127.85	$99.99	18
Oregon	429	$128.73	$105.14	22
New Jersey	429	$158.40	$114.97	21
Kansas	417	$88.92	$74.32	18
Nebraska	395	$140.04	$122.03	13
Wisconsin	362	$78.98	$67.37	18
New Mexico	308	$134.55	$121.52	10
Idaho	303	$93.79	$83.49	13
Iowa	280	$121.01	$106.97	10
West Virginia	205	$124.93	$107.85	7
New Hampshire	195	$219.99	$174.00	9
Connecticut	172	$311.62	$232.67	8
South Dakota	131	$111.52	$92.54	7
Delaware	129	$165.32	$127.53	6
North Dakota	82	$122.84	$100.22	4
Alaska	68	$248.35	$173.58	3
Vermont	47	$221.74	$193.57	3
Rhode Island	44	$169.40	$131.20	2
Montana	44	$159.80	$126.40	3
Maine	27	$163.02	$132.05	2
Wyoming	18	$74.45	$57.92	1

Related codes

64635Destruction of lower or sacral spinal facet joint nerves$498.61
64636Destruction of lower or sacral spinal facet joint nerves$170.99
64615Injection of chemical for paralysis of facial and neck nerve muscles o$139.05
64633Destruction of upper or middle spinal facet joint nerves$505.48
64640Destruction of peripheral nerve or branch$128.51
64616Injection of chemical for paralysis of nerve muscles on side of neck e$175.81
64612Injection of chemical for paralysis of nerve muscles on side of face$170.37
64642Injection of chemical for paralysis of nerve muscles on arm or leg$120.67
64643Injection of chemical for paralysis of nerve muscles on arm or leg$81.52
64644Injection of chemical for paralysis of nerve muscles on arm or leg$147.30
64624Destruction of nerve branches of knee$425.22
64617Injection of chemical for paralysis of nerve muscles on side of voice$193.92

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.