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    v1.0.28
    OpenPayerBilling CodesDestruction by Neurolytic Agent (eg, Chemical, Thermal, Electrical or Radiofrequency) Procedures on the Somatic NervesCPT cpt-64630-neurolysis-nerve-destruction-for-pain-management
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    CPT 64630: Neurolysis (Chemical, Heat, or Radiofrequency)

    Medicare pays $282 on average nationally for this procedure.

    CPT code 64630 describes neurolysis, the destruction of peripheral nerves that transmit pain signals using chemical, heat, or radiofrequency techniques; the service is a percutaneous neurolytic procedure typically performed in an outpatient surgical suite, ambulatory surgery center, or interventional pain clinic and billed for targeted destruction of nociceptive nerve fibers to provide pain relief.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old male with a multi-year history of refractory lumbar radicular pain from post-lumbar discectomy scarring presents to an interventional pain clinic after failing conservative care including oral analgesics, physical therapy, and epidural steroid injections. Imaging demonstrates focal scar encasing the S1 nerve root concordant with dermatomal pain and neurologic exam correlates. The interventional pain specialist discusses a percutaneous image-guided radiofrequency neurolysis targeting the affected dorsal root ganglion to interrupt nociceptive signals.

    The clinical workflow includes pre-procedure evaluation and informed consent, review of risks/benefits and anticoagulation status, procedural time-out, sterile preparation in an ambulatory surgery center or hospital outpatient setting, fluoroscopic or CT-guided needle placement, sensory/motor stimulation testing as indicated, delivery of thermal radiofrequency lesioning (or chemical/neurolytic agent if selected), post-procedure monitoring for anesthesia recovery and neurologic assessment, discharge with post-procedure instructions, and scheduled follow-up to assess pain relief and possible repeat neurolysis if indicated. Typical site of service is an ambulatory surgery center or hospital outpatient department using fluoroscopy or CT guidance.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    20552Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)May be performed before neurolysis for diagnostic or adjunctive pain control.
    62287Injection procedure for sacroiliac joint, anesthetic/corticosteroid, with image guidancePerformed in differential diagnosis of sacroiliac-related radicular pain prior to neurolysis.
    64483Injection(s), anesthetic agent and/or steroid, paravertebral facet joint or facet nerve; lumbar, single levelDiagnostic or therapeutic facet interventions that may be part of the pain management plan before considering neurolysis.
    76942Ultrasonic guidance for needle placement (eg, vascular access, regional nerve block), imaging supervision and interpretationUsed adjunctively when ultrasound guidance is used during neurolysis for needle localization.
    77012CT guidance for percutaneous needle placementUsed when CT guidance is employed for needle placement during neurolysis.
    76000Fluoroscopy, first imageFacility imaging codes used when fluoroscopic guidance is used during neurolytic procedures.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207X00000XOrthopaedic Surgery PhysicianAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    246Z00000XOther Specialist/TechnologistGeneral classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthca…
    1835P2201XAmbulatory Care PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmaci…
    224Y00000XClinical Exercise PhysiologistA Clinical Exercise Physiologist is a health care professional who is trained to work with patients with chronic disease where exercise training has b…
    261QA0600XAdult Day Care Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    9 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    Related Codes

    CPT-64600-TRIGEMINAL-NERVE-NEURODESTRUCTIVE-INJECTION

    CPT 64600: Trigeminal Nerve Neurodestruction by Injection

    CPT-64605-TRIGEMINAL-NERVE-NEURODESTRUCTIVE-INJECTION

    CPT 64605: Trigeminal Nerve Neurodestructive Injection

    CPT-64610-TRIGEMINAL-NERVE-NEURODESTRUCTIVE-INJECTION

    CPT 64610: Trigeminal Nerve Neurodestructive Injection

    CPT-64611-SALIVARY-GLAND-CHEMICAL-DENERVATION-BILATERAL

    CPT 64611: Bilateral Salivary Gland Chemical Injection for Sialorrhea

    CPT-64612-FACIAL-NERVE-CHEMICAL-NEUROLYSIS-UNILATERAL

    CPT 64612: Facial Nerve Chemical Neurolysis, Unilateral

    CPT-64615-BILATERAL-CHEMICAL-DENERVATION-FACIAL-CERVICAL-MUSCLES

    CPT 64615: Bilateral Chemical Denervation of Head and Neck Muscles

    CPT-64616-UNILATERAL-CERVICAL-MUSCLE-CHEMICAL-DENERVATION

    CPT 64616: Unilateral Neck Muscle Chemodenervation

    CPT-64617-PERCUTANEOUS-LARYNGEAL-CHEMODENERVATION-UNILATERAL

    CPT 64617: Percutaneous Chemodenervation of Larynx, Unilateral

    CPT-64620-INTERCOSTAL-NERVE-ABLATION

    CPT 64620: Intercostal Nerve Destruction (Chemical/Heat/Radiofrequency)

    CPT-64624-GENICULAR-NERVE-NEUROLYSIS-KNEE

    CPT 64624: Genicular Nerve Neurolysis for Knee Pain

    Showing 1–10 of 26

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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