CPT 64635 Surgery - Nervous

How Much Does Radiofrequency Ablation of Spinal Nerves (Lumbar) Cost?

Also known as: Destroy lumb/sac facet jnt (CPT 64635)

Radiofrequency ablation of lumbar facet nerve.

The total estimated cost of Radiofrequency Ablation of Spinal Nerves (Lumbar) (CPT 64635) is $582 to $1,091, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $173.

Total Estimated Cost of Care

$582 — $1,091

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$173
Hospital Facility Fee
$519
Anesthesia (est.)
$35
Important: The physician fee of $173 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$173
Physician component only — CMS PFS 2026
Medicare Physician Fee (Office/Clinic)
$465
Non-facility setting

Patient Guide: Radiofrequency Ablation of Spinal Nerves (Lumbar)

What you need to know before your appointment

What to Expect

Using X-ray guidance, heat is applied to nerves supplying lumbar facet joints to provide prolonged pain relief.

How Long Does It Take?

30-60 minutes

Common Reasons Doctors Order This

Chronic lower back pain from facet arthritis confirmed by diagnostic blocks

How to Prepare

Arrange a driver. Fast 4-6 hours. Relief lasts 6-12 months typically.

Procedures Commonly Done Together

These procedures are frequently performed alongside Destroy lumb/sac facet jnt

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How to Reduce Your Cost for Destroy lumb/sac facet jnt

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($465) differs from the facility rate ($173). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

3.24
Work RVU
1.65
Practice Expense RVU
0.29
Malpractice RVU
13.92
Total RVU

Payment = Total RVU (13.92) x CF ($33.40) = $465

Frequently Asked Questions

How much does Destroy lumb/sac facet jnt cost?

The Medicare facility rate for Destroy lumb/sac facet jnt is $173. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Destroy lumb/sac facet jnt cost without insurance?

Without insurance, the cost of Destroy lumb/sac facet jnt can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Destroy lumb/sac facet jnt?

Most commercial health insurance plans and Medicare cover Destroy lumb/sac facet jnt when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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