CPT 64425
Global 000 ActiveNjx aa&/strd ii ih nerves
CPT 64425 Billing & Documentation Guide
CPT code 64425 (Njx aa&/strd ii ih nerves) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.98, a non-facility practice expense RVU of 2.55, and a malpractice RVU of 0.09, a total non-facility RVU of 3.62 and facility RVU of 1.49. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $124.86, though rates vary from $107.44 to $160.76 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64425, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 64425 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 64425 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 64425
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.98 | 0.98 |
| Practice Expense RVU | 2.55 | 0.42 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 3.62 | 1.49 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64425
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $136.32 | $52.14 | $128.25 - $160.76 | 29 |
| Florida | $124.04 | $52.66 | $118.68 - $129 | 3 |
| Georgia | $117.64 | $49.76 | $112.29 - $122.98 | 2 |
| Illinois | $120.89 | $52.15 | $115.19 - $125.76 | 4 |
| Michigan | $116.94 | $50.14 | $113.89 - $119.99 | 2 |
| North Carolina | $114.12 | $47.74 | $114.12 - $114.12 | 1 |
| New York | $133.39 | $54.02 | $115.76 - $141.68 | 5 |
| Ohio | $113.53 | $48.57 | $113.53 - $113.53 | 1 |
| Pennsylvania | $119.66 | $49.98 | $113.76 - $125.57 | 2 |
| Texas | $119.56 | $49.52 | $113.03 - $125.57 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 64425
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64425 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0178T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0179T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0180T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 01991 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01992 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0333T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0464T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0543T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0544T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0548T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 64425
What does CPT code 64425 mean? +
CPT code 64425 represents: Njx aa&/strd ii ih nerves. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 64425? +
The 2026 Medicare national average non-facility payment for CPT 64425 is $124.86. Rates range from $107.44 to $160.76 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64425? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 64425? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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