How much does Medicare pay for CPT 64635?

Medicare allowed an average of $498.61 per service and paid $392.87 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3157.17, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64635?

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint. It was billed 352,333 times to 252,301 Medicare beneficiaries by 6,097 providers in 2024.

Does 64635 pay differently in an office than a hospital?

Yes. The allowed amount averaged $521.28 in an office setting and $488.21 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 64635 most?

Ambulatory Surgical Center, with 126,293 services from 1,194 clinicians. Next are Pain Management, Anesthesiology, Physical Medicine and Rehabilitation.

CPT 64635

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

$498.61Medicare-allowed amount per service, averaged across 352,333 services

Providers submitted

$3157.17

Asking price, not received

Medicare allowed

$498.61

The fee schedule figure

Medicare paid

$392.87

Balance is patient coinsurance

Providers submitted an average of $3157.17 for this code and Medicare allowed $498.61 — 6.3× 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 $392.87 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $521.28
Hospital / facility: $488.21

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. 110,805 services were billed in an office setting and 241,528 in a facility.

Services: 352,333
Beneficiaries: 252,301
Providers billing it: 6,097
Total allowed: $175,676,757

What Medicare pays for CPT 64635

Across 352,333 services billed by 6,097 providers to 252,301 beneficiaries, Medicare allowed an average of $498.61 per service. That is 1.4 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 64635

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	126,293	66,116	$713.50	1,194
Pain Management	69,483	57,310	$378.83	1,441
Anesthesiology	52,539	43,487	$375.28	1,174
Physical Medicine and Rehabilitation	48,303	39,762	$359.57	1,192
Interventional Pain Management	46,592	38,220	$400.65	858
Neurology	1,414	1,132	$436.03	36
Diagnostic Radiology	1,206	970	$402.82	32
Orthopedic Surgery	1,019	845	$360.11	32
Certified Registered Nurse Anesthetist (CRNA)	955	797	$336.52	24
Neurosurgery	748	637	$361.67	21
Emergency Medicine	539	466	$335.38	14
Family Practice	520	443	$406.66	15
Interventional Radiology	508	392	$432.97	10
Internal Medicine	504	364	$417.44	13
Sports Medicine	483	361	$274.39	12

64635 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	38,651	$516.26	$425.88	548
California	30,554	$612.13	$411.25	513
Texas	29,982	$493.53	$407.43	566
Georgia	19,113	$512.25	$425.30	280
Arizona	16,631	$512.08	$414.88	225
Maryland	11,969	$534.53	$428.60	177
New York	11,473	$558.12	$402.99	245
Pennsylvania	11,030	$445.94	$362.98	247
Tennessee	10,727	$477.78	$417.66	141
Illinois	9,919	$460.69	$365.48	189
Ohio	9,382	$420.69	$351.91	207
Louisiana	9,007	$445.36	$387.59	114
North Carolina	8,145	$455.76	$381.43	178
Virginia	8,062	$484.65	$378.40	122
Arkansas	7,891	$459.10	$400.88	93
New Jersey	7,404	$587.12	$439.36	165
Indiana	7,329	$472.97	$395.83	158
South Carolina	7,015	$463.51	$395.10	109
Colorado	6,165	$520.94	$415.81	115
Mississippi	5,947	$444.81	$404.97	63
Kentucky	5,913	$511.37	$444.33	81
Oklahoma	5,739	$455.29	$390.35	79
Michigan	5,350	$491.08	$404.72	140
Massachusetts	5,213	$448.82	$334.70	109
Washington	5,083	$520.32	$391.69	94
Wisconsin	5,061	$419.87	$348.46	131
Minnesota	5,028	$476.26	$375.25	107
Missouri	4,811	$363.18	$300.12	103
Nevada	4,666	$556.64	$434.81	77
Oregon	4,328	$568.13	$432.48	63
Utah	4,288	$466.30	$383.48	74
Alabama	4,072	$438.96	$397.18	79
Kansas	3,662	$430.84	$357.76	66
Iowa	2,711	$447.45	$381.87	41
Nebraska	2,700	$476.65	$397.41	45
New Mexico	2,408	$466.50	$393.10	43
New Hampshire	2,190	$485.41	$384.65	43
Idaho	2,028	$419.36	$358.88	37
Delaware	1,933	$523.29	$411.05	28
Connecticut	1,867	$605.28	$446.73	42
West Virginia	1,536	$290.81	$238.51	26
Montana	1,307	$441.02	$361.82	29
South Dakota	720	$282.91	$232.93	17
Wyoming	578	$531.59	$434.62	9
North Dakota	572	$442.35	$367.64	14
Maine	563	$356.43	$279.96	17
Rhode Island	490	$459.75	$363.35	12
Alaska	435	$661.57	$444.74	13
Vermont	280	$338.29	$262.14	9
District of Columbia	212	$383.33	$276.69	8
Puerto Rico	131	$334.78	$328.58	3
Hawaii	62	$703.02	$527.50	3

Related codes

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
64634Destruction of upper or middle spinal facet joint nerves$174.09
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.