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CPT 64633: Image-Guided Neurolytic Destruction of Single Cervical/Thoracic Facet Joint
CPT code 64633 represents an image-guided neurolytic destruction of a single facet joint nerve in the cervical or thoracic spine. The procedure uses heat, electric current, or chemical agents to interrupt pain transmission from a targeted facet joint, performed with fluoroscopic or CT guidance. This code is clinically important as a minimally invasive option for focal axial neck or thoracic spine pain refractory to conservative therapy and can influence utilization and payment patterns across outpatient surgical settings nationally.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a clinical and billing overview of the service, comparisons to related facet denervation codes for other spinal regions, common practice settings, and payer coverage considerations. The publication outlines typical use cases, coding relationships to adjacent services, and the clinical context for selecting cervical or thoracic single-joint neurolysis.
The material summarizes benchmarks and policy-relevant points that affect authorization, site-of-service decisions, and procedure coding workflows for this intervention. It is intended for clinicians, coding professionals, and policy analysts seeking a concise reference for CPT code 64633 and its role in spine pain management pathways.
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Billing Code Overview
CPT code 64633 describes destruction of a single cervical or thoracic facet joint nerve using a neurolytic agent (for example heat, electric current, or a chemical compound) with imaging guidance such as fluoroscopy or computed tomography. This procedure is a targeted neurolytic intervention aimed at interrupting pain signals from a single facet joint in the cervical or thoracic spine.
Service type: Image-guided neurolytic facet joint denervation
Typical site of service: Outpatient ambulatory surgical center or hospital outpatient department
National Reimbursement Benchmarks
Commercial averages sit meaningfully above Medicare on CPT 64633: Blue Cross Blue Shield’s mean of $903.30 and BUCA’s mean of $730.40 both exceed Medicare’s mean of $476.90, with Blue Cross Blue Shield leading the commercial side. Cigna ($531.30), UnitedHealth Group ($638.20), and Aetna ($330.10) fall between those points, indicating a broad commercial-to-Medicare gap rather than a tight clustering around the Medicare average.
Dispersion measured as the interquartile range (P75–P25) varies notably by payer. Blue Cross Blue Shield shows the widest IQR at $740.40 (P75 $1,226.40 − P25 $486.60), followed by BUCA at $554.40 (P75 $976.40 − P25 $402.00) and UnitedHealth Group at $404.60 (P75 $803.50 − P25 $395.90). The tightest IQR is Aetna at $274.00 (P75 $452.00 − P25 $168.00), with Cigna’s IQR at $375.00 (P75 $673.80 − P25 $303.80).