CPT 64450
Global 000 ActiveNjx aa&/strd other pn/branch
CPT 64450 Billing & Documentation Guide
CPT code 64450 (Njx aa&/strd other pn/branch) 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 0.73, a non-facility practice expense RVU of 1.62, and a malpractice RVU of 0.07, a total non-facility RVU of 2.42 and facility RVU of 1.15. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $83.35, though rates vary from $72.07 to $106.34 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64450, 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 64450 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 10 units of 64450 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 64450
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.73 | 0.73 |
| Practice Expense RVU | 1.62 | 0.35 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 2.42 | 1.15 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64450
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 | $90.55 | $40.36 | $85.35 - $106.34 | 29 |
| Florida | $83.22 | $40.66 | $79.63 - $86.62 | 3 |
| Georgia | $78.84 | $38.37 | $75.44 - $82.24 | 2 |
| Illinois | $81.22 | $40.23 | $77.44 - $84.3 | 4 |
| Michigan | $78.48 | $38.66 | $76.42 - $80.54 | 2 |
| North Carolina | $76.36 | $36.78 | $76.36 - $76.36 | 1 |
| New York | $89.08 | $41.76 | $77.43 - $94.62 | 5 |
| Ohio | $76.14 | $37.41 | $76.14 - $76.14 | 1 |
| Pennsylvania | $80.1 | $38.55 | $76.26 - $83.94 | 2 |
| Texas | $79.96 | $38.2 | $75.79 - $83.75 | 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 64450
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64450 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 |
| 0282T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0283T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0284T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0285T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0333T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 64450
What does CPT code 64450 mean? +
CPT code 64450 represents: Njx aa&/strd other pn/branch. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 64450? +
The 2026 Medicare national average non-facility payment for CPT 64450 is $83.35. Rates range from $72.07 to $106.34 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64450? +
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 64450? +
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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