Procedure billing guide

Radiofrequency Ablation (RFA) Billing and Coding

Facet joint radiofrequency ablation, also called radiofrequency rhizotomy, is billed with CPT 64633 and +64634 for cervical and thoracic levels and 64635 and +64636 for lumbar and sacral levels. Genicular nerve RFA for knee pain is 64624, and sacroiliac joint RFA is 64625. Payers pay for RFA only after documented diagnostic blocks, and they limit how often it can be repeated.

Updated October 12, 2026

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CPT codes

What are the CPT codes for radiofrequency ablation?

Code	Description
64633	RFA of facet joint nerves, cervical or thoracic, single joint, with imaging
+64634	Cervical or thoracic, each additional joint
64635	RFA of facet joint nerves, lumbar or sacral, single joint, with imaging
+64636	Lumbar or sacral, each additional joint
64624	RFA of genicular nerve branches (knee), including imaging
64625	RFA of nerves innervating the sacroiliac joint, with imaging

Codes shown for reference. Always confirm against the current year’s CPT code set and your payer’s policy.

Billing rules

How do you bill radiofrequency ablation?

What do payers require before RFA?

For facet RFA, Medicare requires two diagnostic medial branch blocks, each providing at least 80 percent relief. Commercial payers have similar rules, though some accept a single block or a lower threshold. Missing or low block results are one of the most common reasons RFA claims are denied.

For repeat RFA at the same level, Medicare expects the previous RFA to have given lasting, documented improvement, and it limits the number of RFA sessions per spinal region in a year.

Is genicular or sacroiliac RFA covered by insurance?

It depends on the payer. Genicular nerve RFA (64624) and sacroiliac joint RFA (64625) are covered by some payers and treated as experimental by others. We check each payer's policy before the procedure and get prior authorization or a signed financial waiver where needed.

How do you code radiofrequency ablation correctly?

Facet RFA is coded per joint, with the add-on code for each additional joint in the same region. Bilateral RFA takes modifier 50 or RT and LT, imaging guidance is already included in every RFA code, and pulsed radiofrequency is not reported with these codes; it usually needs an unlisted code.

Facet RFA codes are per joint: use the add-on code for each additional joint
Bilateral RFA uses modifier 50 (or RT and LT)
Imaging guidance is included in all of these codes
Pulsed radiofrequency does not use these codes and is usually reported with an unlisted code

Common denials

Why are RFA claims denied?

These are the denial reasons we see most often. We check for each one before a claim goes out, instead of finding out from a denial.

Denials we prevent

Diagnostic block results missing or below the payer's threshold
Repeat RFA performed too soon, or without documented relief from the last one
Genicular or SI joint RFA billed to a payer that considers it experimental
Missing modifier 50 or RT/LT for bilateral RFA

FAQ

Radiofrequency Ablation (Rhizotomy) questions

What is the CPT code for lumbar radiofrequency ablation?

Lumbar or sacral facet RFA is CPT 64635 for the first joint and +64636 for each additional joint, with imaging guidance included.

Is rhizotomy the same as radiofrequency ablation?

Yes. Radiofrequency rhizotomy and radiofrequency ablation describe the same procedure: using heat to disable the nerves that carry pain from a joint. It is billed with the RFA codes.

How often can RFA be repeated?

Medicare limits repeat RFA at the same level and requires documented, lasting improvement from the previous RFA. Commercial payers have their own frequency rules, which we check before scheduling.

Sources

Coverage rules change; always check the current version of each policy and your payer’s own rules.

Keep reading

Related services and procedures

Facet Joint Injections

Facet injections and medial branch blocks: levels, modifiers and the Medicare facet LCD.

Sacroiliac Joint Procedures

SI joint injections, nerve blocks, RFA and minimally invasive fusion.

Nerve Blocks

Sympathetic, peripheral and paravertebral blocks coded by nerve, level and side.

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