CPT 64517
Global 000 ActiveN block inj hypogas plxs
CPT 64517 Billing & Documentation Guide
CPT code 64517 (N block inj hypogas plxs) 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 2.15, a non-facility practice expense RVU of 3.72, and a malpractice RVU of 0.2, a total non-facility RVU of 6.07 and facility RVU of 3.41. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $208.67, though rates vary from $181.98 to $262.46 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64517, 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 64517 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 64517 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 64517
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.15 | 2.15 |
| Practice Expense RVU | 3.72 | 1.06 |
| Malpractice RVU | 0.2 | 0.2 |
| Total RVU | 6.07 | 3.41 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64517
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 | $225.03 | $119.9 | $212.79 - $262.46 | 29 |
| Florida | $209.48 | $120.34 | $200.64 - $218.05 | 3 |
| Georgia | $198.45 | $113.69 | $190.61 - $206.29 | 2 |
| Illinois | $204.89 | $119.04 | $195.69 - $212.52 | 4 |
| Michigan | $197.89 | $114.46 | $192.8 - $202.98 | 2 |
| North Carolina | $192.01 | $109.11 | $192.01 - $192.01 | 1 |
| New York | $222.91 | $123.79 | $194.55 - $236.55 | 5 |
| Ohio | $191.99 | $110.87 | $191.99 - $191.99 | 1 |
| Pennsylvania | $201.31 | $114.28 | $192.19 - $210.42 | 2 |
| Texas | $200.74 | $113.27 | $191.09 - $209.33 | 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 64517
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64517 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 | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 64517
What does CPT code 64517 mean? +
CPT code 64517 represents: N block inj hypogas plxs. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 64517? +
The 2026 Medicare national average non-facility payment for CPT 64517 is $208.67. Rates range from $181.98 to $262.46 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64517? +
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 64517? +
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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