CPT 64530
Global 000 ActiveN block inj celiac pelus
CPT 64530 Billing & Documentation Guide
CPT code 64530 (N block inj celiac pelus) 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 1.54, a non-facility practice expense RVU of 5.37, and a malpractice RVU of 0.15, a total non-facility RVU of 7.06 and facility RVU of 2.56. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $243.97, though rates vary from $208.09 to $318.42 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64530, 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 64530 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 64530 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 64530
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.54 | 1.54 |
| Practice Expense RVU | 5.37 | 0.87 |
| Malpractice RVU | 0.15 | 0.15 |
| Total RVU | 7.06 | 2.56 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64530
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 | $268.23 | $90.38 | $251.58 - $318.42 | 29 |
| Florida | $241.15 | $90.35 | $230.44 - $250.82 | 3 |
| Georgia | $228.62 | $85.23 | $217.4 - $239.84 | 2 |
| Illinois | $234.5 | $89.27 | $223.03 - $244.88 | 4 |
| Michigan | $226.91 | $85.78 | $220.85 - $232.97 | 2 |
| North Carolina | $221.98 | $81.75 | $221.98 - $221.98 | 1 |
| New York | $260.79 | $93.1 | $225.35 - $277.3 | 5 |
| Ohio | $220.25 | $83.02 | $220.25 - $220.25 | 1 |
| Pennsylvania | $232.95 | $85.72 | $220.83 - $245.06 | 2 |
| Texas | $232.96 | $84.98 | $219.31 - $245.75 | 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 64530
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64530 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 64530
What does CPT code 64530 mean? +
CPT code 64530 represents: N block inj celiac pelus. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 64530? +
The 2026 Medicare national average non-facility payment for CPT 64530 is $243.97. Rates range from $208.09 to $318.42 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64530? +
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 64530? +
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 June 1, 2026.
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