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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 64636
  4. Cost Analysis

How Much Does Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint Cost on Medicare?

Cost analysis for CPT 64636 — Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint

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Average Medicare Payment

$130.31

2023 data

Total Payments (2023)

$30.6M

Services (2023)

223.6K

Price Change (2014–2023)

+40.2%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$92.94$25.9M268.1K—
2015$89.62$28.2M303.2K-3.6%
2016$89.55$31.9M347.7K-0.1%
2017$88.04$34.2M378.6K-1.7%
2018$88.77$36.6M404.3K+0.8%
2019$89.24$38.4M417.7K+0.5%
2020$91.32$34.5M361.8K+2.3%
2021$95.07$33.0M339.5K+4.1%
2022$126.71$32.7M248.8K+33.3%
2023$130.31$30.6M223.6K+2.8%

🗺️ State-by-State Cost Variation

The most expensive state pays 3.8x more than the cheapest for this procedure. CT averages $229.70 vs WV at $59.74.

StateAvg PaymentTotal PaymentsServicesProviders
CT$229.70$246.5K1.1K30
VA$206.19$1.5M7.3K115
AK$202.74$38.5K1907
NY$191.53$1.5M7.6K196
KY$188.16$819.1K4.4K84
OK$178.04$991.9K5.6K70
NC$171.05$1.3M7.7K152
MI$170.39$873.4K5.1K133
UT$167.30$574.7K3.4K65
AZ$163.85$1.7M10.2K157
FL$162.96$4.4M27.1K430
SC$154.66$937.7K6.1K99
AL$150.15$524.0K3.5K59
NJ$149.26$554.5K3.7K107
MA$141.62$561.9K4.0K93
NV$140.51$272.6K1.9K47
TX$140.16$2.9M20.9K437
IL$136.75$876.8K6.4K145
CO$134.06$450.3K3.4K79
NM$130.73$223.4K1.7K31
DE$129.46$152.2K1.2K25
TN$127.01$732.8K5.8K112
NH$125.89$155.9K1.2K32
OR$125.55$233.0K1.9K58
CA$124.41$1.5M12.3K292
PA$120.60$836.6K6.9K168
DC$120.34$24.9K2079
PR$119.21$16.0K1343
ME$117.43$66.3K56518
WA$116.57$276.3K2.4K67
WY$115.66$16.5K1435
RI$110.16$22.3K2028
NE$105.95$201.6K1.9K29
IN$104.92$457.2K4.4K110
AR$104.34$546.3K5.2K69
OH$100.80$671.1K6.7K173
VT$99.66$29.4K29510
IA$95.00$176.8K1.9K36
MO$89.67$339.1K3.8K79
MD$86.72$533.7K6.2K97
MS$84.24$287.7K3.4K45
GA$84.00$731.3K8.7K171
ID$82.74$83.3K1.0K24
LA$79.86$449.8K5.6K86
MN$78.56$193.9K2.5K74
ND$75.60$27.4K36311
SD$72.27$44.7K61817
WI$71.96$206.5K2.9K91
KS$71.92$146.5K2.0K48
MT$70.28$36.4K51816
WV$59.74$99.2K1.7K23

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Daniel KendallInterventional Pain ManagementVA$167.3K506$330.60
Ellen LinInterventional Pain ManagementTX$131.9K499$264.30
Sanjoy SundaresanPain ManagementTX$106.2K396$268.28
Martin MartucciPain ManagementOK$96.2K381$252.37
Emad Attallah-WasifAnesthesiologyOK$90.7K370$245.15
Francis PecoraroInterventional Pain ManagementNC$90.1K489$184.29
Farzad SabetPhysical Medicine and RehabilitationCA$87.8K296$296.50
Larina GutenbergInterventional Pain ManagementTX$82.5K309$266.92
Sergey BogdanInterventional Pain ManagementNY$80.6K306$263.30
Theodore WorkmanPain ManagementCA$78.4K259$302.68
Katiuska Dos SantosPhysical Medicine and RehabilitationFL$75.5K409$184.51
Yurii BorshchInterventional Pain ManagementTX$72.9K282$258.34
Donald ErbInterventional Pain ManagementFL$71.4K304$234.72
Jason RosenbergPain ManagementSC$70.4K431$163.44
Clifford BakerInterventional Pain ManagementAZ$70.1K258$271.62
Joseph CartwrightInterventional Pain ManagementFL$67.5K364$185.41
Yin YuInterventional Pain ManagementNJ$63.2K294$215.12
Lee JamesInterventional Pain ManagementFL$61.1K231$264.43
Forrest MonroeAnesthesiologyCA$60.7K219$276.95
Ji HanPain ManagementNY$60.4K170$355.03

🤔 Is Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint Overpriced?

The data suggests significant pricing inconsistencies for CPT 64636. With a 3.8x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.

Costs have risen 40.2% since 2014, outpacing inflation and raising questions about whether reimbursement rates reflect actual costs.

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.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.