Sphenopalatine Ganglion Block CPT Code, Procedure, Indications, Complications, Technique

What is Sphenopalatine Ganglion Block?

A sphenopalatine ganglion block (SPGB) is a technique in which a local anesthetic is delivered to the sphenopalatine ganglion (SPG) to help reduce headache and face pain. The SPG is an extracranial parasympathetic ganglion connected to the brainstem and the meninges, which envelop the brain. It is located in the pterygopalatine fossa of the cranium. It is involved in sensory and autonomic processes, including nasal congestion and tear production.


    Transnasal, transoral, and percutaneous procedures are all possible for the Sphenopalatine Ganglion Block procedure to be performed. The most popular method is the transnasal technique, in which the ganglion is accessed by inserting a tiny, flexible catheter via the nostril. Once in place, a local anesthetic, frequently in conjunction with a corticosteroid, is administered to the ganglion. The patient experiences relief as a result of the pain pathways being disrupted.

    Sphenopalatine Ganglion Block CPT Code, Procedure, Indications, Complications, Technique

    Here is a general overview of the procedure:

    Patient Preparation:

    Usually, the patient is placed on an examining table or in a cozy, reclining chair. The sphenopalatine ganglion is positioned in the back of the throat or inside the nose; the medical professional may use a local anesthetic to numb this area.

    Insertion of Catheter or Nasal Spray:

    The sphenopalatine ganglion block can be done in a few different ways. An alternative method for accessing the ganglion is by administering anesthetic medication via nasal spray, whereas a prevalent technique entails inserting a thin catheter through the nose.

    Confirmation of Placement:

    The medical professional may verify that the catheter is positioned correctly by using image guiding techniques like fluoroscopy or ultrasound.

    Medication Administration:

    The medical professional applies a local anesthetic or a mix of anesthetics and anti-inflammatory drugs directly to the sphenopalatine ganglion after confirming the exact spot.


    A medical procedure known as a sphenopalatine ganglion (SPG) block involves injecting a local anesthetic into the sphenopalatine ganglion, a group of nerves positioned below the nose. This procedure is used to treat or lessen certain symptoms related to a range of conditions. A sphenopalatine ganglion block may be indicated in the following circumstances:

    • Cluster Headaches
    • Migraines
    • Facial Pain
    • Nasal and Sinus Disorders
    • Neuropathic Pain Temporomandibular Joint (TMJ) Disorders
    • Facial Spasms


    Sphenopalatine ganglion block (SPGB) might result in either minor or serious complications. Local symptoms including epistaxis, transitory numbness, or hypoesthesia of the palate, pharynx, or root of the nose, together with lacrimation of the ipsilateral eye, are sometimes observed as minor adverse effects. Although they are rare, major side effects can include local or retroorbital hematoma and infection when aseptic technique is not followed.

    Sphenopalatine Ganglion Block CPT Code

    For sphenopalatine ganglion blocks, the most often used CPT codes are 64999 and 644505. Additionally, the American Medical Association advises reporting this procedure with the unlisted code 64999.

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