CPT code 64635 denotes an image-guided neurolytic procedure in which an agent is applied to lumbar facet joint nerve tissue to ablate pain-transmitting fibers. Nationally, this procedure matters because it provides a non-open surgical option for chronic lower back pain management and can affect utilization, imaging resources, and outpatient procedural volumes. Key payers considered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of clinical context and service setting, payer coverage patterns, typical billing considerations, common modifiers, and benchmarks where available. The publication highlights how the code fits into practice workflows—performed under fluoroscopic or CT guidance in outpatient suites, ambulatory surgery centers, or hospital outpatient departments—and summarizes what payers typically evaluate when processing claims for image-guided lumbar neurolysis. Data not available in the input is noted where applicable. The content is intended to inform billing teams, revenue cycle managers, and policy analysts about clinical intent, coding identity, and where to look next for coverage specifics and coding guidance.