CPT code 64738 denotes surgical transection or forcible tearing of the inferior alveolar nerve through the mandible to reduce refractory facial pain. As an invasive neurosurgical/oral and maxillofacial procedure, it is uncommon and clinically significant because it intentionally reduces sensory input to manage severe pain conditions when other therapies have failed. Nationally, the code matters for coverage determinations, surgical utilization monitoring, and post-procedure care planning.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on the clinical context of the procedure, typical sites of service, and the kinds of benchmarks and policy topics that affect payment and utilization. The publication outlines common billing modifiers and service-line considerations, highlights areas where payer policies often differ (medical necessity criteria, prior authorization requirements, and documentation expectations), and summarizes implications for surgical coding and claims processing.

The report is intended for clinicians, coding professionals, and policy analysts seeking a national-level overview of CPT code 64738, its clinical purpose, and the administrative factors that influence reimbursement and utilization.