CPT 64455
Global 000 ActiveNjx aa&/strd pltr com dg nrv
CPT 64455 Billing & Documentation Guide
CPT code 64455 (Njx aa&/strd pltr com dg nrv) 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 0.7, and a malpractice RVU of 0.07, a total non-facility RVU of 1.5 and facility RVU of 0.9. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $51.28, though rates vary from $45.67 to $62.76 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64455, 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 64455 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 64455 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 64455
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.73 | 0.73 |
| Practice Expense RVU | 0.7 | 0.1 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 1.5 | 0.9 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64455
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 | $54.19 | $30.48 | $51.68 - $62.03 | 29 |
| Florida | $52.39 | $32.28 | $50.25 - $54.63 | 3 |
| Georgia | $49.53 | $30.41 | $48.03 - $51.02 | 2 |
| Illinois | $51.53 | $32.17 | $49.38 - $53.42 | 4 |
| Michigan | $49.63 | $30.81 | $48.37 - $50.89 | 2 |
| North Carolina | $47.69 | $28.99 | $47.69 - $47.69 | 1 |
| New York | $54.8 | $32.44 | $48.24 - $58.08 | 5 |
| Ohio | $48.09 | $29.79 | $48.09 - $48.09 | 1 |
| Pennsylvania | $50.01 | $30.38 | $48.06 - $51.95 | 2 |
| Texas | $49.71 | $29.98 | $47.83 - $51.24 | 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 64455
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64455 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 | Yes | 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 |
| 0464T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 64455
What does CPT code 64455 mean? +
CPT code 64455 represents: Njx aa&/strd pltr com dg nrv. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 64455? +
The 2026 Medicare national average non-facility payment for CPT 64455 is $51.28. Rates range from $45.67 to $62.76 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64455? +
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 64455? +
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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