CPT 64629
Global ZZZ ActiveTrml dstrj ios bvn ea addl
CPT 64629 Billing & Documentation Guide
CPT code 64629 (Trml dstrj ios bvn ea addl) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.68, a non-facility practice expense RVU of 0.94, and a malpractice RVU of 0.39, a total non-facility RVU of 5.01 and facility RVU of 5.01. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $169.35, though rates vary from $156.59 to $224.99 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64629, 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 64629 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 64629 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 64629
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.68 | 3.68 |
| Practice Expense RVU | 0.94 | 0.94 |
| Malpractice RVU | 0.39 | 0.39 |
| Total RVU | 5.01 | 5.01 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64629
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 | $171.54 | $171.54 | $166.4 - $188.69 | 29 |
| Florida | $179.77 | $179.77 | $172.51 - $188.54 | 3 |
| Georgia | $168.64 | $168.64 | $166.45 - $170.83 | 2 |
| Illinois | $178.58 | $178.58 | $171.94 - $185.23 | 4 |
| Michigan | $170.74 | $170.74 | $166.29 - $175.18 | 2 |
| North Carolina | $160.53 | $160.53 | $160.53 - $160.53 | 1 |
| New York | $181.48 | $181.48 | $161.9 - $192.3 | 5 |
| Ohio | $164.71 | $164.71 | $164.71 - $164.71 | 1 |
| Pennsylvania | $168.7 | $168.7 | $164.05 - $173.35 | 2 |
| Texas | $166.6 | $166.6 | $163.59 - $173 | 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 64629
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64629 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 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 | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 12001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12002 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12004 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 64629
What does CPT code 64629 mean? +
CPT code 64629 represents: Trml dstrj ios bvn ea addl. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 64629? +
The 2026 Medicare national average non-facility payment for CPT 64629 is $169.35. Rates range from $156.59 to $224.99 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64629? +
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 64629? +
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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