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64420 Njx aa&/strd ntrcost nrv 1

What 64420 is

CMS fee schedule short descriptor: Njx aa&/strd ntrcost nrv 1.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 64420 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)1.052.030.093.17$105.88
Facility (hospital, ASC)1.050.430.091.57$52.44

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).

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Medically Unlikely Edit (MUE)

Medicare caps 64420 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 64420? These codes are bundled into it

64420 is a Column 1 code in 166 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
01991Anes dx/ther nrv blk&inj oth0 - no modifier bypassCheck pair
01992Anes dx/ther nrv blk&inj prn0 - no modifier bypassCheck pair
0333TVisual ep scr acuity auto0 - no modifier bypassCheck pair
0464TVisual ep test for glaucoma0 - no modifier bypassCheck pair
0543TTa mv rpr w/artif chord tend0 - no modifier bypassCheck pair
0544TTcat mv annulus rcnstj0 - no modifier bypassCheck pair
0569TTtvr perq appr 1st prosth0 - no modifier bypassCheck pair
0570TTtvr perq ea addl prosth0 - no modifier bypassCheck pair
0571TInsj/rplcmt icds ss eltrd0 - no modifier bypassCheck pair
0572TInsertion ss dfb electrode0 - no modifier bypassCheck pair
0573TRemoval ss dfb electrode0 - no modifier bypassCheck pair
0574TRepos prev ss impl dfb eltrd0 - no modifier bypassCheck pair
0580TRmvl ss impl dfb pg only0 - no modifier bypassCheck pair
0581TAbltj mal brst tum perq crtx0 - no modifier bypassCheck pair
0655TTprnl focal abltj mal prst80 - no modifier bypassCheck pair
0903TEcg alg 12 lead reduced i&r0 - no modifier bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only0 - no modifier bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only0 - no modifier bypassCheck pair
20550Njx 1 tendon sheath/ligament1 - modifier may bypassCheck pair
20551Njx 1 tendon origin/insj1 - modifier may bypassCheck pair
20560Ndl insj w/o njx 1 or 2 musc0 - no modifier bypassCheck pair
20561Ndl insj w/o njx 3+ musc0 - no modifier bypassCheck pair
36000Place needle in vein1 - modifier may bypassCheck pair
36400Vnpnxr<3yrs phy/qhp fem/jug1 - modifier may bypassCheck pair
36405Vnpnxr<3yrs phy/qhp scalp vn1 - modifier may bypassCheck pair
36406Vnpnxr<3yrs phy/qhp other vn1 - modifier may bypassCheck pair
36410Vnpnxr 3yr/> phy/qhp dx/ther1 - modifier may bypassCheck pair
36420Venipuncture cutdown < 1 yr1 - modifier may bypassCheck pair
36425Venipuncture cutdown 1 yr/>1 - modifier may bypassCheck pair
36430Transfusion bld/bld compnt1 - modifier may bypassCheck pair

Showing 30 of 166 column 2 codes. Use the pair checker for any specific combination.

64420 is bundled into these codes

64420 appears as a Column 2 code in 6023 active edits. Reported with one of these Column 1 codes on the same date of service, 64420 is the code that denies.

Column 1 codeShort descriptionModifier indicator
00100Anes px salivary gland w/bx1Check pair
00102Anes px plstc rpr cleft lip1Check pair
00103Anes rcnstv px eyelid1Check pair
00104Anes electroconvulsive ther1Check pair
00120Anes px ear w/bx nos1Check pair
00124Anes px ear otoscopy1Check pair
00126Anes px ear tympanotomy1Check pair
00140Anes procedures on eye nos1Check pair
00142Anes px on eye lens surgery1Check pair
00144Anes px eye corneal trnspl1Check pair
00145Anes px eye vitreortnl surg1Check pair
00147Anes px on eye iridectomy1Check pair
00148Anes px eye ophthalmoscopy1Check pair
00160Anes px nose&sinus nos1Check pair
00162Anes px nose&sinus rad surg1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.