CPT Code 64635Complete Billing & Coding Guide (2026)Destroy lumb/sac facet jnt
About CPT 64635
CPT 64635 is a Current Procedural Terminology code in the Surgery (Endocrine/Nervous/Eye/Ear) category maintained by the American Medical Association. The CMS short descriptor reads "Destroy lumb/sac facet jnt". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
Minor surgical codes carry a 10-day global period. Most post-op E/M visits in those 10 days are bundled into the procedure payment unless the visit is for an unrelated reason (modifier 24). Documentation tying the encounter to the procedure determines the bundling decision.
CPT 64635 has a 10-day global period. Office visits for post-op care during those 10 days are not separately billable unless unrelated to the procedure.
Code Properties
RVU Breakdown
Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.
Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.
Medicare Payment by State
Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.
Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.
NCCI Bundling Edits
10 pairsThese codes trigger National Correct Coding Initiative edits when billed with 64635. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.
Billing 64635 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.
Misuse of Column Two code with Column One code
CPT Manual or CMS manual coding instruction
CPT Manual or CMS manual coding instruction
CPT Manual or CMS manual coding instruction
Standards of medical/surgical practice
Standards of medical/surgical practice
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Multi-procedure NCCI edits hit surgical specialties harder than any other category. CO-97 denials on 64635 are frequently recoverable when the operative note documents distinct anatomic sites or staged steps. Our coders read the op note against the edit pair and pick the right modifier (XS preferred over modifier 59 for distinct structures).
Applicable Modifiers
Modifiers commonly paired with 64635 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.
Modifier 24, 79, 78, and 58 on global-period claims are the highest-recovery surgical billing levers. 64635 carries a 010 global indicator. Our team flags every encounter inside an active global period for the right modifier decision.
Supporting ICD-10 Diagnoses
These diagnosis codes commonly support medical necessity for CPT 64635. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.
Surgical CO-50 denials usually trace to ICD-10 specificity gaps (E11.9 instead of E11.65, M17.11 instead of M17.0, etc.). Our coders map every diagnosis to the highest-specificity code the chart supports, eliminating the common medical-necessity denial pattern.
Find the revenue leakage in your 64635 claims.
Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Surgery (Endocrine/Nervous/Eye/Ear) claims. Our AAPC-certified team audits your last 90 days of 64635 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.
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Related CPT Codes
Codes in the same family as 64635
Specialty billing guides
CPT 64635 is among the top codes profiled in these specialty billing guides.
Everything about CPT 64635
What does CPT code 64635 cover?
CPT 64635 is a Current Procedural Terminology code in the Surgery (Endocrine/Nervous/Eye/Ear) category maintained by the American Medical Association. The CMS short descriptor reads "Destroy lumb/sac facet jnt". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
What is the Medicare payment for CPT 64635?
The national average Medicare payment for CPT 64635 is approximately $464.94 in a non-facility setting and $173.02 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 13.92 with a conversion factor of $33.4009.
What is the global period for CPT 64635?
CPT 64635 has a 10-day global period (indicator 010). Routine post-op care for the next 10 days is bundled into the procedure payment. Bill modifier 24 for unrelated E/M, modifier 79 for unrelated procedures, or modifier 78 for related returns to the OR during this window.
What codes bundle with CPT 64635?
CPT 64635 has NCCI Procedure-to-Procedure edits with 10+ codes including 0213T, 0216T, 0333T. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.
CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.
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We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.