Summary & Overview
CPT 64734: Infraorbital Nerve Transection for Facial Pain
CPT code 64734 represents a surgical neurodestructive procedure — transection of the infraorbital nerve — performed to reduce facial pain by diminishing sensation in the affected distribution. Nationally, this code is relevant for specialist surgical practices (otolaryngology, plastic surgery, oral and maxillofacial surgery, and pain surgery) and for payers managing coverage of invasive pain interventions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines clinical context for use of 64734, typical settings where it is provided, and the administrative considerations that commonly affect billing and coverage decisions.
Readers will learn: clinical indication and procedural context for 64734; typical sites of service and provider specialties involved; the payer landscape and which major insurers are commonly engaged; and the types of benchmarks and policy issues that influence authorization, coding accuracy, and reimbursement. Data not available in the input is noted where applicable. The focus is national in scope and intended to support coding, billing oversight, and payer policy discussions related to infraorbital nerve transection.
Billing Code Overview
CPT code 64734 describes a surgical procedure in which the provider transects or forcibly tears the infraorbital nerve to reduce facial pain by diminishing sensation. This procedure is a form of nerve destruction intended to relieve chronic or intractable pain localized to the infraorbital nerve distribution.
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Service type: Surgical nerve transection/neurodestructive procedure
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Typical site of service: Ambulatory surgical center or hospital operating room, depending on clinical setting and patient needs
Data not available in the input for payers, associated taxonomies, and ICD-10 diagnoses.
Clinical & Coding Specifications
Clinical Context
A typical patient undergoing 64734 is an adult with chronic, refractory infraorbital or midface neuropathic pain (for example post-traumatic infraorbital neuralgia or persistent idiopathic facial pain) who has failed conservative management including medications, nerve blocks, and physical therapy. The patient presents to an outpatient ambulatory surgery center or hospital operating room for a targeted peripheral nerve neurectomy/transaction of the infraorbital nerve to reduce pain by interrupting sensory transmission. Preoperative workflow includes history and examination confirming localized infraorbital nerve distribution pain, diagnostic infraorbital nerve block demonstrating temporary pain relief, informed consent discussing expected sensory loss, risks, and alternatives, and preoperative anesthesia evaluation (local with sedation or general anesthesia). Intraoperative steps include localization of the infraorbital foramen, incision and dissection to the infraorbital nerve, transection or controlled tearing of the nerve per the procedure description, hemostasis, and layered wound closure. Postoperative workflow includes immediate recovery monitoring, discharge instructions addressing numbness and pain control, follow-up visit to assess wound healing and pain outcomes, and documentation of diagnostic blocks, operative report with exact nerve addressed, and any intraoperative complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services |