Summary & Overview

CPT 64763: Obturator Nerve Neurectomy or Decompression

CPT code 64763 denotes surgical severing or partial removal of the obturator nerve, performed to relieve groin pain from nerve damage or entrapment; the operation may include adductor tendon release. This targeted neurolysis/neurectomy is clinically significant because it addresses persistent, focal neuropathic groin pain that can impair mobility and quality of life and often requires specialized surgical management. Nationally, the code matters for procedure classification, facility planning, and payer coverage determinations for peripheral nerve surgery.

Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical service settings, a summary of common billing modifiers and coding considerations (listed separately), and guidance on typical documentation elements relevant to coverage. The publication also provides benchmarking context where available and flags areas where input data are not provided.

This summary equips clinicians, coding professionals, and policy analysts with the essential facts about procedure intent, common sites of service, and the payer landscape to inform coding, authorization, and administrative workflows for CPT code 64763.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 64763obturator nerveneurectomyperipheral nerve surgeryadductor tendon releasesurgical procedureambulatory surgerynerve entrapmentbilling code

Billing Code Overview

CPT code 64763 describes a surgical procedure in which the provider severs or removes part of the obturator nerve through an incision in the buttocks and thigh to treat groin pain caused by nerve damage or entrapment. The procedure may include release of the tendon of the adductor muscle when indicated.

Service type: Entrapment/denervation surgery of the obturator nerve, potentially combined with adductor tendon release
Typical site of service: Hospital inpatient or outpatient surgical setting, or ambulatory surgery center, with incisions in the buttocks and proximal thigh for access to the obturator nerve

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45–65-year-old adult experiencing chronic medial thigh and groin pain following pelvic trauma, prior pelvic surgery, or prolonged entrapment from adductor muscle hypertrophy. The patient presents to a multidisciplinary clinic (orthopedics, neurosurgery, or pain management) after conservative care — including physical therapy, analgesics, nerve blocks, and/or image-guided injections — fails to provide durable relief. Diagnostic workup includes focused history and physical exam with sensory deficits or pain in the obturator nerve distribution, pelvic MRI or ultrasound to evaluate entrapment or neuromas, and diagnostic local anesthetic obturator nerve block confirming pain source. When neurolysis or less invasive measures are unsuccessful and the pain is refractory and function-limiting, the surgeon schedules a targeted obturator nerve neurectomy via a posterior approach with incision in the buttock and medial thigh. The procedure may include selective release of the adductor tendon if tendinous entrapment contributes to symptoms. Typical perioperative workflow includes preoperative clearance, informed consent documenting expected motor and sensory deficits, intraoperative positioning for access to the buttock and medial thigh, regional or general anesthesia, exposure and identification of the obturator nerve branches, partial or complete transection of the affected nerve segment, hemostasis, possible tendon release, and layered wound closure. Postoperative care includes pain control, wound checks, physical therapy to address adductor weakness, and follow-up to monitor pain relief and complications such as persistent numbness, weakness in thigh adduction, hematoma, or infection. Typical sites of service are the hospital operating room or ambulatory surgery center. Common providers performing this procedure include orthopedic surgeons with peripheral nerve expertise, neurosurgeons, and pain medicine surgeons.

Coding Specifications

Modifier	Description	When to Use

`22`	Increased procedural services	Use when work required to perform the procedure is substantially greater than typically required (extensive dissection, unexpected adhesions).
`52`	Reduced services	Use if the procedure is partially performed or limited relative to the full descriptor.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances or patient instability.
`62`	Two surgeons	Use when two surgeons from different specialties work together as primary surgeons.
`63`	Procedure performed on infants less than 4 kg	Use when applicable for neonatal patients meeting weight criteria.
`66`	Surgical team (more than one physician performing distinct portions)	Use when a surgical team approach is documented.
`78`	Unplanned return to the operating room for a related procedure during the global period	Use for reoperation related to a complication of the original procedure.
`79`	(Not in provided list)	Data not available in the input.
`80`	Assistant surgeon	Use when an assistant surgeon is authorized and documents participation.
`62`	Two surgeons	Data duplicate removed; see above.

Taxonomy Code	Specialty	Notes
207L00000X	Orthopaedic Surgery	Orthopedic surgeons with peripheral nerve or pelvic soft-tissue expertise commonly perform obturator neurectomy.
2084P0800X	Neurosurgery	Neurosurgeons perform peripheral nerve procedures when neuroma or complex nerve pathology is present.
2084N0400X	Pain Medicine	Pain specialists may perform diagnostic blocks and coordinate surgical referral; some perform peripheral neurolysis.
2080P0207X	General Surgery	General surgeons with pelvic or soft-tissue expertise may perform neurectomy in select settings.
207ZP0102X	Physical Medicine & Rehabilitation	PM&R physicians coordinate perioperative rehabilitation and nonsurgical management.

CPT Code	Description	Relationship to This Procedure
`64450`	Injection, anesthetic agent; other peripheral nerve or branch	Used diagnostically as an image-guided obturator nerve block to confirm pain source prior to neurectomy.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., hip)	May be performed preoperatively for diagnostic or therapeutic relief of adjacent joint pathology contributing to groin pain.
`64718`	Neuroplasty and/or transposition; other peripheral nerve (e.g., axillary, radial)	Performed for nerve decompression/repair; conceptually related when neurolysis rather than transection is attempted.
`27599`	Unlisted procedure, femur or knee region	Billing option for adjunct tendon procedures of the adductor complex not described by a specific CPT.
`65778`	Partial tarsorrhaphy (listed as analogous soft-tissue procedure)	Data not directly related; included only if soft-tissue releases are coded with analogous unlisted codes.

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