CPT 64468
Global 000 ActiveThrc fascial pln blk bi njx
CPT 64468 Billing & Documentation Guide
CPT code 64468 (Thrc fascial pln blk bi njx) 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 1.63, a non-facility practice expense RVU of 3.14, and a malpractice RVU of 0.15, a total non-facility RVU of 4.92 and facility RVU of 2.04. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $169.3, though rates vary from $147.11 to $214.35 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64468, 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 64468 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 64468 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 64468
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.63 | 1.63 |
| Practice Expense RVU | 3.14 | 0.26 |
| Malpractice RVU | 0.15 | 0.15 |
| Total RVU | 4.92 | 2.04 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64468
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 | $183.21 | $69.39 | $173 - $214.35 | 29 |
| Florida | $169.42 | $72.91 | $162.24 - $176.29 | 3 |
| Georgia | $160.58 | $68.81 | $153.97 - $167.18 | 2 |
| Illinois | $165.55 | $72.6 | $158.03 - $171.73 | 4 |
| Michigan | $159.98 | $69.65 | $155.85 - $164.1 | 2 |
| North Carolina | $155.5 | $65.75 | $155.5 - $155.5 | 1 |
| New York | $180.84 | $73.53 | $157.6 - $191.93 | 5 |
| Ohio | $155.25 | $67.42 | $155.25 - $155.25 | 1 |
| Pennsylvania | $163.02 | $68.8 | $155.46 - $170.58 | 2 |
| Texas | $162.65 | $67.95 | $154.54 - $169.95 | 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 64468
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64468 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 | No | Anesthesia service included in surgical procedure |
| 0333T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0464T | Column 1 (primary), can be billed with modifier | Yes | 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 |
| 0545T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0563T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0565T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0566T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 64468
What does CPT code 64468 mean? +
CPT code 64468 represents: Thrc fascial pln blk bi njx. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 64468? +
The 2026 Medicare national average non-facility payment for CPT 64468 is $169.3. Rates range from $147.11 to $214.35 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64468? +
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 64468? +
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 July 16, 2026.
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