How much does Medicare pay for CPT 64636?

Medicare allowed an average of $170.99 per service and paid $136.19 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1025.56, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64636?

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint. It was billed 225,364 times to 173,922 Medicare beneficiaries by 4,682 providers in 2024.

Does 64636 pay differently in an office than a hospital?

Yes. The allowed amount averaged $270.67 in an office setting and $71.32 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 64636 most?

Pain Management, with 70,660 services from 1,406 clinicians. Next are Anesthesiology, Interventional Pain Management, Physical Medicine and Rehabilitation.

CPT 64636

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

$170.99Medicare-allowed amount per service, averaged across 225,364 services

Providers submitted

$1025.56

Asking price, not received

Medicare allowed

$170.99

The fee schedule figure

Medicare paid

$136.19

Balance is patient coinsurance

Providers submitted an average of $1025.56 for this code and Medicare allowed $170.99 — 6.0× 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 $136.19 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $270.67
Hospital / facility: $71.32

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. 112,673 services were billed in an office setting and 112,691 in a facility.

Services: 225,364
Beneficiaries: 173,922
Providers billing it: 4,682
Total allowed: $38,534,990

What Medicare pays for CPT 64636

Across 225,364 services billed by 4,682 providers to 173,922 beneficiaries, Medicare allowed an average of $170.99 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 64636

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pain Management	70,660	54,620	$168.58	1,406
Anesthesiology	52,213	40,750	$168.67	1,124
Interventional Pain Management	47,025	36,186	$187.30	826
Physical Medicine and Rehabilitation	46,572	35,806	$159.31	1,110
Neurology	1,477	1,056	$214.64	35
Diagnostic Radiology	1,224	836	$194.69	26
Certified Registered Nurse Anesthetist (CRNA)	964	745	$146.34	23
Orthopedic Surgery	869	667	$170.42	25
Neurosurgery	678	528	$155.13	18
Internal Medicine	567	323	$196.79	12
Emergency Medicine	478	402	$144.48	13
Interventional Radiology	461	364	$216.39	9
Sports Medicine	461	318	$104.92	12
Family Practice	447	369	$204.07	14
Psychiatry	301	226	$125.85	3

64636 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	25,826	$203.60	$163.50	424
Texas	19,565	$174.46	$145.23	449
California	13,700	$154.10	$113.50	340
Arizona	10,934	$203.89	$167.47	180
New York	8,898	$216.80	$150.55	197
Georgia	8,496	$112.54	$94.74	180
Virginia	7,929	$247.28	$195.62	117
North Carolina	7,761	$210.47	$177.00	165
Illinois	7,278	$176.23	$140.02	155
Pennsylvania	7,114	$146.78	$118.68	187
Ohio	6,177	$125.36	$105.12	168
Tennessee	5,927	$152.07	$134.83	105
South Carolina	5,904	$202.28	$176.66	100
Oklahoma	5,492	$213.43	$190.93	71
Maryland	5,408	$115.77	$89.63	103
Louisiana	5,221	$104.49	$89.12	83
Arkansas	5,193	$135.44	$121.18	71
Kentucky	4,665	$246.90	$222.10	74
Michigan	4,491	$216.25	$180.71	122
Indiana	4,276	$129.60	$111.60	111
Massachusetts	4,236	$182.02	$134.01	95
Missouri	4,112	$103.08	$85.49	88
Alabama	3,715	$190.69	$174.30	65
Utah	3,585	$216.96	$181.85	65
New Jersey	3,581	$179.02	$129.11	105
Colorado	3,487	$174.44	$137.02	89
Mississippi	3,165	$111.65	$97.75	47
Wisconsin	2,874	$95.54	$80.84	90
Minnesota	2,707	$94.50	$78.01	82
Washington	2,561	$149.66	$115.51	68
Nevada	2,274	$170.84	$138.60	47
Kansas	2,115	$84.69	$71.45	50
Nebraska	1,938	$116.98	$100.92	34
Oregon	1,811	$154.13	$124.41	47
New Mexico	1,724	$152.98	$132.90	37
Iowa	1,717	$121.37	$103.61	33
West Virginia	1,491	$85.16	$70.26	24
New Hampshire	1,375	$151.47	$119.72	33
Connecticut	1,188	$268.26	$197.55	29
Idaho	1,117	$96.07	$84.38	26
Delaware	1,039	$166.76	$134.93	21
South Dakota	627	$91.61	$76.62	16
Maine	526	$142.99	$113.87	16
Montana	475	$94.69	$74.91	18
North Dakota	353	$94.34	$77.44	9
Alaska	288	$304.30	$211.00	9
Rhode Island	270	$124.06	$100.19	11
Vermont	254	$132.14	$105.45	9
District of Columbia	203	$155.59	$114.47	8
Wyoming	158	$130.38	$104.02	5
Puerto Rico	106	$130.09	$187.21	2
Hawaii	37	$333.22	$263.62	2

Related codes

64635Destruction of lower or sacral spinal facet joint nerves$498.61
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.