# CPT 64520: Injection, anesthetic agent, lumbar sympathetic nerve

Medicare CPT 64520 pays $242.16 in a non-facility setting and $76.82 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $212.85 in Arkansas to $279.53 in District of Columbia, a 31% spread.

Web page: https://www.med-reveal.com/rates/64520-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Pain Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $242.16 |
| National facility | $76.82 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| District of Columbia | $279.53 | $84.77 |
| California | $277.47 | $81.83 |
| Alaska | $275.02 | $98.93 |
| Washington | $269.87 | $81.38 |
| New Jersey | $269.21 | $83.05 |
| New York | $268.12 | $83.68 |
| Hawaii | $267.06 | $79.07 |
| Massachusetts | $266.75 | $81.00 |
| Connecticut | $258.82 | $80.76 |
| Colorado | $254.23 | $78.31 |
| Oregon | $251.79 | $77.60 |
| Maryland | $251.29 | $78.93 |
| New Hampshire | $249.61 | $77.50 |
| Rhode Island | $248.97 | $78.17 |
| Florida | $246.60 | $80.71 |
| Minnesota | $244.96 | $74.83 |
| Puerto Rico | $244.23 | $77.08 |
| Virgin Islands | $244.23 | $77.08 |
| Montana | $242.15 | $76.81 |
| Nevada | $241.68 | $76.18 |
| Wyoming | $241.11 | $75.78 |
| North Dakota | $239.78 | $74.44 |
| Delaware | $239.64 | $76.29 |
| South Dakota | $239.50 | $74.16 |
| Illinois | $239.42 | $79.66 |
| Texas | $239.11 | $76.33 |
| Pennsylvania | $238.85 | $76.91 |
| Vermont | $238.24 | $74.55 |
| Virginia | $237.68 | $75.16 |
| Arizona | $235.56 | $75.35 |
| Georgia | $234.08 | $76.35 |
| Maine | $232.03 | $74.05 |
| Michigan | $231.95 | $76.71 |
| Wisconsin | $231.23 | $72.84 |
| Utah | $230.10 | $74.69 |
| North Carolina | $227.71 | $73.45 |
| New Mexico | $226.86 | $75.24 |
| South Carolina | $226.81 | $74.04 |
| Missouri | $226.12 | $74.39 |
| Indiana | $225.93 | $72.66 |
| Louisiana | $225.46 | $74.51 |
| Ohio | $225.31 | $74.36 |
| Nebraska | $224.72 | $72.12 |
| Idaho | $224.52 | $72.41 |
| Iowa | $223.24 | $71.96 |
| Tennessee | $222.64 | $72.35 |
| Kansas | $221.54 | $72.08 |
| Oklahoma | $220.50 | $72.85 |
| Kentucky | $220.28 | $73.29 |
| West Virginia | $218.46 | $74.79 |
| Alabama | $216.16 | $71.49 |
| Mississippi | $214.14 | $71.78 |
| Arkansas | $212.85 | $70.83 |

## Related codes

- 61105: Twist drill hole for subdural/ventricular puncture — https://www.med-reveal.com/rates/61105-cpt-fee-schedule
- 61120: Burr hole(s) for ventricular puncture — https://www.med-reveal.com/rates/61120-cpt-fee-schedule
- 61150: Burr hole(s) with evacuation/drainage of abscess, superficial — https://www.med-reveal.com/rates/61150-cpt-fee-schedule
- 61312: Craniectomy/craniotomy for evacuation of hematoma, supratentorial, extradural/subdural — https://www.med-reveal.com/rates/61312-cpt-fee-schedule
- 61510: Craniectomy for excision of brain tumor, supratentorial — https://www.med-reveal.com/rates/61510-cpt-fee-schedule
- 61520: Craniectomy for excision of brain tumor, infratentorial/posterior fossa — https://www.med-reveal.com/rates/61520-cpt-fee-schedule
- 61533: Craniotomy with subdural implantation of electrodes for seizure focus — https://www.med-reveal.com/rates/61533-cpt-fee-schedule
- 61548: Hypophysectomy, transnasal/transseptal approach — https://www.med-reveal.com/rates/61548-cpt-fee-schedule

Commercial negotiated rates for 64520 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules