Cost analysis for CPT 64635 — Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint
Average Medicare Payment
N/A
Total Payments (Latest)
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Services (Latest)
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Price Change (–)
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The most expensive state pays 2.5x more than the cheapest for this procedure. AK averages $496.65 vs WV at $197.29.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $496.65 | $159.4K | 321 | 11 |
| CT | $470.53 | $739.7K | 1.6K | 40 |
| CA | $461.27 | $12.6M | 27.2K | 478 |
| NJ | $444.38 | $3.2M | 7.2K | 175 |
| NV | $440.12 | $1.9M | 4.4K | 77 |
| NY | $430.30 | $4.8M | 11.1K | 240 |
| OR | $426.35 | $1.8M | 4.3K | 77 |
| MD | $406.95 | $4.6M | 11.3K | 164 |
| WY | $402.00 | $199.0K | 495 | 11 |
| CO | $399.95 | $2.2M | 5.6K | 110 |
| FL | $398.21 | $14.7M | 37.0K | 558 |
| WA | $397.70 | $2.0M | 4.9K | 92 |
| AZ | $392.20 | $6.3M | 16.0K | 207 |
| DE | $391.49 | $793.2K | 2.0K | 32 |
| VA | $390.72 | $2.9M | 7.4K | 122 |
| GA | $386.89 | $7.4M | 19.1K | 267 |
| KY | $385.55 | $2.2M | 5.7K | 93 |
| MI | $375.99 | $2.2M | 5.8K | 152 |
| TX | $375.46 | $10.2M | 27.2K | 535 |
| RI | $371.12 | $168.9K | 455 | 11 |
| MN | $365.62 | $1.6M | 4.5K | 101 |
| NH | $364.79 | $693.8K | 1.9K | 43 |
| NM | $362.31 | $764.5K | 2.1K | 36 |
| TN | $361.04 | $3.8M | 10.4K | 147 |
| OK | $360.60 | $1.8M | 5.0K | 77 |
| IN | $360.17 | $2.4M | 6.8K | 151 |
| PA | $358.87 | $3.6M | 10.1K | 225 |
| NE | $357.56 | $785.2K | 2.2K | 40 |
| SC | $353.54 | $2.5M | 7.0K | 110 |
| UT | $352.96 | $1.5M | 4.3K | 75 |
| NC | $352.52 | $2.7M | 7.7K | 167 |
| AL | $352.17 | $1.2M | 3.5K | 73 |
| IL | $351.84 | $3.1M | 8.9K | 183 |
| MA | $351.70 | $1.7M | 5.0K | 106 |
| AR | $350.26 | $2.7M | 7.6K | 90 |
| IA | $343.50 | $939.1K | 2.7K | 43 |
| MS | $339.60 | $2.0M | 6.0K | 65 |
| ID | $337.91 | $689.0K | 2.0K | 36 |
| DC | $337.56 | $68.9K | 204 | 9 |
| LA | $334.82 | $2.8M | 8.3K | 118 |
| ND | $327.73 | $178.9K | 546 | 14 |
| KS | $323.35 | $1.0M | 3.2K | 62 |
| MT | $322.22 | $415.7K | 1.3K | 27 |
| WI | $318.29 | $1.6M | 4.9K | 127 |
| OH | $312.35 | $3.0M | 9.7K | 206 |
| ME | $286.84 | $186.4K | 650 | 19 |
| MO | $284.92 | $1.2M | 4.2K | 92 |
| PR | $269.11 | $39.6K | 147 | 4 |
| VT | $239.03 | $78.6K | 329 | 10 |
| SD | $231.83 | $170.4K | 735 | 20 |
| WV | $197.29 | $319.0K | 1.6K | 25 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| The Southeastern Spine Institute Ambulatory Surgery Center, Llc | Ambulatory Surgical Center | SC | $441.3K | 910 | $484.93 |
| Interventional Therapeutics Institute, Llc | Ambulatory Surgical Center | FL | $342.6K | 766 | $447.26 |
| Chattanooga Pain Management Center Llc | Ambulatory Surgical Center | TN | $309.2K | 665 | $465.01 |
| Arklamiss Surgery Center,llc | Ambulatory Surgical Center | LA | $305.9K | 533 | $573.91 |
| Mays & Schnapp Pain Clinic & Rehabilitation Center | Ambulatory Surgical Center | TN | $296.6K | 650 | $456.38 |
| Surgery Center At University Park, Llc | Ambulatory Surgical Center | FL | $289.4K | 590 | $490.53 |
| Orthoarkansas Spine Institute Procedure Center Llc | Ambulatory Surgical Center | AR | $282.8K | 600 | $471.33 |
| Christus Cabrini Surgery Center, Llc | Ambulatory Surgical Center | LA | $280.0K | 459 | $609.97 |
| Union Hills Pain Partners Llc | Ambulatory Surgical Center | AZ | $272.2K | 525 | $518.43 |
| Daniel Kendall | Interventional Pain Management | VA | $265.0K | 444 | $596.89 |
| Athens Spine Procedural Center Llc | Ambulatory Surgical Center | GA | $261.9K | 552 | $474.43 |
| Heritage One Day Surgery Llc | Ambulatory Surgical Center | NY | $256.6K | 517 | $496.40 |
| Pisa Asc Holdco Llc | Ambulatory Surgical Center | AZ | $252.9K | 534 | $473.62 |
| Alliance Surgery Center At Augusta, Llc | Ambulatory Surgical Center | GA | $250.3K | 531 | $471.34 |
| National Surgical Centers Of America Llc | Ambulatory Surgical Center | FL | $249.7K | 501 | $498.47 |
| Tennessee Pain Surgery Center, Llc | Ambulatory Surgical Center | TN | $244.1K | 516 | $473.11 |
| Harmony Surgery Center, Llc | Ambulatory Surgical Center | CO | $241.6K | 478 | $505.46 |
| Apc-Amarillo Surgical Operating Company, Llc | Ambulatory Surgical Center | TX | $239.0K | 518 | $461.43 |
| Round Rock Surgery Center Llc | Ambulatory Surgical Center | TX | $235.6K | 484 | $486.77 |
| West Florida Medical Center Clinic Pa | Ambulatory Surgical Center | FL | $232.1K | 417 | $556.64 |
The data suggests significant pricing inconsistencies for CPT 64635. With a 2.5x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.