iovera˚ REIMBURSEMENT

It is the sole responsibility of the health care provider to correctly report all procedures and therapies. The following information is shared solely for informational and educational purposes.


The diagnosis associated with the use of cryoneurolysis with iovera° may include knee pain (ICD-10-CM code M25.56X) or osteoarthritis of the knee (M17.X). The X is replaced with “1” to identify the left knee and “2” to identify the right knee.

Anterior knee pain commonly involves the femoral nerve and most commonly the AFCN and 2 branches of the ISN. Other superficial nerves that innervate the knee such as the LFCN may also be involved. CPT code 64640 is applicable to iovera° treatments applied to peripheral nerves and is used to bill for EACH of the peripheral nerve or nerve branches treated.

Posterior knee pain can involve the following deep genicular nerves: superolateral (superolateral articulating branch of the common peroneal nerve), superomedial (superomedial articulating branch of the tibial nerve), and inferomedial (inferomedial articulating branch of the tibial nerve). CPT 64624 defines all 3 of the specified nerves as 1 billable unit and is used for iovera° treatments of the referenced nerves. In the event that all 3 nerves are not treated, a modifier is to be used. Contact the Reimbursement Helpline for additional information.

CPT Code Definition
64640 Destruction by neurolytic agent; other peripheral nerve or branch
64624 Destruction by neurolytic agent; genicular nerve branches including imagin; destruction of each of the following genicular nerve branches: superolateral, superomedial, and inferomedial

For in-depth iovera˚ reimbursement details, download the iovera˚ Coding and Reimbursement Guide.

We can support your team’s planning process when adopting the use of iovera° and address reimbursement needs that arise. Please feel free to contact the helpline even before iovera° is used, so that questions or potential reimbursement issues can be addressed ahead of time.

You can contact a dedicated reimbursement specialist:

IndicationThe iovera° system is used to destroy tissue during surgical procedures by applying freezing cold. It can also be used to produce lesions in peripheral nervous tissue by the application of cold to the selected site for the blocking of pain. It is also indicated for the relief of pain and symptoms associated with osteoarthritis of the knee for up to 90 days. The iovera° system is not indicated for treatment of central nervous system tissue. The iovera° system’s “1x90” Smart Tip configuration (indicating one needle which is 90 mm long) can also facilitate target nerve location by conducting electrical nerve stimulation from a separate nerve stimulator.

Important Safety Information

ContraindicationsThe iovera° system is contraindicated for use in patients with the following:

  • Cryoglobulinemia, paroxysmal cold hemoglobinuria, cold urticaria, Raynaud’s disease, and open and/or infected wounds at or near the treatment site

Potential ComplicationsAs with any surgical treatment that uses needle-based therapy and local anesthesia, there is a potential for site-specific reactions, including, but not limited to:

  • Ecchymosis, edema, erythema, local pain and/or tenderness, and localized dysesthesia

Proper use of the device as described in the User Guide can help reduce or prevent the following complications:

  • At the treatment site(s): injury to the skin related to application of cold or heat, hyper- or hypopigmentation, and skin dimpling
  • Outside the treatment site(s): loss of motor function