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CPT code 64400: Nerve block, trigeminal nerve or branch2026 Medicare rate & RVUs in Ohio

Reports an injection around a trigeminal nerve division or branch, commonly for facial pain or trigeminal neuralgia treatment or diagnostic evaluation.

CMS RVU26DEffective Oct 1, 2026One payment locality25.4K Medicare services in 2024

In Ohio, Medicare pays $114.09 for 64400 in the office and $46.09 when it’s performed in a hospital or facility.

$114.09Office (non-facility)
$46.09Hospital or facility
−6.4%vs the national office rate ($121.91)

Check a contract rate as a % of Medicare · 64400 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 64400 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Ohio
  2. What 64400 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 64400 covers

This service places an anesthetic, with or without a steroid, around a trigeminal nerve division or branch to evaluate or relieve facial pain. Pain medicine physicians and anesthesiologists commonly perform it in an office, pain clinic, or outpatient facility. Typical situations include a diagnostic block or treatment directed at trigeminal neuralgia or another facial pain condition. The documented target must be part of the trigeminal nerve, not another cranial or peripheral nerve.

Report the service when the clinician performs the trigeminal injection; document the indication, targeted division or branch, side, and injectate. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral service, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Ohio compares for 64400

Across 109 of 109 payment localities, the office rate for 64400 runs from $105.75 in Arkansas to $161.35 in San Benito County, CA. Ohio pays $114.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

64400 in Ohio vs other payment areas
  1. Ohio · this page$114.09
  2. Los Angeles, CA · California$137.12+$23.03
  3. Washington, DC area · District of Columbia$140.13+$26.04
  4. Miami, FL · Florida$136.35+$22.26
  5. Chicago, IL · Illinois$131.62+$17.53
  6. Manhattan, NY · New York$142.25+$28.16
  7. Alaska · Alaska$136.84+$22.75

Other areas in Ohio first, then benchmark localities. Bars start at $0.

Every other payment area

64400 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$107.55$42.38
ArkansasArkansas$105.75$41.77
ArizonaArizona$118.10$45.92
Bakersfield, CACalifornia$128.32$46.69
Chico, CACalifornia$127.76$46.13
El Centro, CACalifornia$127.80$46.16
Fresno, CACalifornia$127.76$46.13
Hanford, CACalifornia$127.76$46.13

64400 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$105.75

$144.56

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
64400 office rate range by state
State / territoryOffice rate rangeLocalities
AK$136.841
AL$107.551
AR$105.751
AZ$118.101
CA$127.76–$161.3529
CO$126.461
CT$130.841
DC$140.131
DE$120.241
FL$121.46–$136.353
GA$113.48–$124.842
GU$131.361
HI$131.361
IA$109.991
ID$110.981
IL$117.99–$131.624
IN$111.701
KS$109.741
KY$111.271
LA$111.21–$117.532
MA$125.68–$139.702
MD$122.67–$140.133
ME$112.02–$118.512
MI$114.94–$123.562
MN$119.601
MO$109.24–$117.583
MS$107.501
MT$121.901
NC$113.321
ND$117.751
NE$110.581
NH$124.751
NJ$131.90–$138.412
NM$115.811
NV$120.831
NY$115.30–$146.595
OH$114.091
OK$110.661
OR$119.47–$130.562
PA$114.11–$127.422
PR$122.801
RI$124.611
SC$113.981
SD$117.261
TN$110.431
TX$113.27–$126.418
UT$115.771
VA$118.31–$140.132
VI$122.801
VT$117.541
WA$125.35–$142.402
WI$113.261
WV$113.081
WY$120.091

See 64400 in every payment locality

How the 64400 rate is calculated

Each of 64400’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 64400

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.73

0.73 RVUs× 1.000 GPCI

Practice expense2.71

2.71 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

3.6500

Conversion factor

$33.4009

Medicare rate

$121.91

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Ohio inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,096

Code
64400
Physician work
0.73
Practice expense
2.71
Malpractice
0.21

GPCI2026.csv

85

Locality
Ohio
Physician work
1.000
Practice expense
0.913
Malpractice
1.008
Office calculation for 64400 in Ohio
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0000.7300
Practice expense2.71× 0.9132.4742
Malpractice0.21× 1.0080.2117
Total RVUs3.4159
Conversion factor× 33.4009

Office rate, Ohio$114.09

Office: (0.73 × 1 + 2.71 × 0.913 + 0.21 × 1.008) × $33.4009 = $114.09

Facility: (0.73 × 1 + 0.48 × 0.913 + 0.21 × 1.008) × $33.4009 = $46.09

Open 64400 in the RVU calculator

Payment rules and modifiers for 64400

The CMS indicators that decide how 64400 is paid alongside other services.

CMS payment indicators · 64400

Nerve block, trigeminal nerve or branch

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

64400 without 50 · national office

$121.91

Nerve block, trigeminal nerve or branch

64400-50 · Bilateral: 150%

$182.87

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 64400

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 64400
CodeHow it relatesOffice range, Ohio
Same family
64405Occipital nerve block, greater occipital nerveA named-nerve injection in the same general code series, directed to the greater occipital nerve.$75.31
64408Vagus nerve block, anesthetic injectionA named-nerve injection in the same general code series, directed to the vagus nerve.$75.35
64450Nerve block, other peripheral nerve or branchFor an injection of another peripheral nerve or branch without a more specific code.$76.14

How 64400 has changed in Ohio

64400 · Office / nonfacility

$114.09

Effective 2026-10-01

The base rate is $11.80 higher than on 2025-10-01, moving from $102.29 to $114.09 (11.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $102.29changed to$114.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.75 changed to 0.73
    • Practice expense RVU 2.41 changed to 2.71
    • Practice expense GPCI 0.911 changed to 0.913
    • Malpractice GPCI 1.033 changed to 1.008

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $106.79changed to$102.29

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.46 changed to 2.41

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $105.04changed to$106.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $107.05changed to$105.04

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.42 changed to 2.46
    • Malpractice RVU 0.19 changed to 0.21
    • Practice expense GPCI 0.912 changed to 0.911
    • Malpractice GPCI 1.063 changed to 1.033

  5. January 1, 2023

    RVU23A

    $110.62changed to$107.05

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.44 changed to 2.42
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 0.913 changed to 0.912
    • Malpractice GPCI 1.094 changed to 1.063

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $109.88changed to$110.62

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.40 changed to 2.44
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $103.89changed to$109.88

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.12 changed to 2.40
    • Malpractice RVU 0.18 changed to 0.19
    • Practice expense GPCI 0.915 changed to 0.913
    • Malpractice GPCI 1.049 changed to 1.094

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $132.34changed to$103.89

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.11 changed to 0.75
    • Practice expense RVU 2.52 changed to 2.12
    • Malpractice RVU 0.25 changed to 0.18
    • Practice expense GPCI 0.917 changed to 0.915
    • Malpractice GPCI 1.005 changed to 1.049

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $127.54changed to$132.34

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.39 changed to 2.52
    • Malpractice RVU 0.24 changed to 0.25

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $123.53changed to$127.54

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.29 changed to 2.39
    • Malpractice RVU 0.23 changed to 0.24
    • Practice expense GPCI 0.918 changed to 0.917
    • Malpractice GPCI 0.999 changed to 1.005

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $123.16changed to$123.53

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.30 changed to 2.29
    • Malpractice RVU 0.22 changed to 0.23
    • Malpractice GPCI 0.993 changed to 0.999

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $123.61changed to$123.16

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $122.99changed to$123.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $120.63changed to$122.99

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.24 changed to 2.30
    • Malpractice RVU 0.17 changed to 0.22
    • Practice expense GPCI 0.923 changed to 0.918
    • Malpractice GPCI 1.117 changed to 0.993

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $121.68changed to$120.63

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.42 changed to 2.24
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.240 changed to 1.117

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $121.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$114.09$46.09RVU26D
2026-07-01$114.09$46.09RVU26C
2026-04-01$114.09$46.09RVU26B
2026-01-01$114.09$46.09RVU26A
2025-10-01$102.29$49.25RVU25D
2025-07-01$102.29$49.25RVU25C
2025-04-01$102.29$49.25RVU25B
2025-01-01$102.29$49.25RVU25A
2024-10-01$106.79$50.08RVU24D
2024-07-01$106.79$50.08RVU24C
2024-04-01$106.79$50.08RVU24B
2024-03-09$106.79$50.08RVU24AR
2024-01-01$105.04$49.26RVU24A
2023-10-01$107.05$49.57RVU23D
2023-07-01$107.05$49.57RVU23C
2023-04-01$107.05$49.57RVU23B
2023-01-01$107.05$49.57RVU23A
2022-10-01$110.62$50.59RVU22D
2022-07-01$110.62$50.59RVU22C
2022-04-01$110.62$50.59RVU22B
2022-01-01$110.62$50.59RVU22A
2021-10-01$109.88$50.31RVU21D
2021-07-01$109.88$50.31RVU21C
2021-04-01$109.88$50.31RVU21B
2021-01-01$109.88$50.31RVU21A
2020-10-01$103.89$50.72RVU20D
2020-07-01$103.89$50.72RVU20C
2020-04-01$103.89$50.72RVU20B
2020-01-01$103.89$50.72RVU20A
2019-10-01$132.34$72.85RVU19D
2019-07-01$132.34$72.85RVU19C
2019-04-01$132.34$72.85RVU19B
2019-01-01$132.34$72.85RVU19A
2018-10-01$127.54$72.41RVU18D
2018-07-01$127.54$72.41RVU18C
2018-04-01$127.54$72.41RVU18B
2018-01-01$127.54$72.41RVU18AR1
2017-10-01$123.53$71.47RVU17D
2017-07-01$123.53$71.47RVU17C
2017-04-01$123.53$71.47RVU17B
2017-01-01$123.53$71.47RVU17A
2016-10-01$123.16$70.90RVU16D
2016-07-01$123.16$70.90RVU16C
2016-04-01$123.16$70.90RVU16B
2016-01-01$123.16$70.90RVU16A
2015-10-01$123.61$71.16RVU15D
2015-07-01$123.61$71.16RVU15C
2015-04-01$122.99$70.80RVU15B
2015-01-01$122.99$70.80RVU15A
2014-10-01$120.63$69.71RVU14D
2014-07-01$120.63$69.71RVU14C
2014-04-01$120.63$69.71RVU14B
2014-01-01$120.63$69.71RVU14A
2013-10-01$121.68$69.64RVU13D
2013-07-01$121.68$69.64RVU13C
2013-04-01$121.68$69.64RVU13B
2013-01-01$121.68$69.64RVU13AR

Price 64400 for an earlier date of service

Where the Ohio rate applies

Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Ada
  • Adamsville
  • Addyston
  • Adelphi
  • Adena
  • Ai
  • Akron

Browse all communities in Ohio

64400 billing questions

When should 64400 be selected instead of a general peripheral nerve block code?

Use 64400 when the documented target is a trigeminal nerve division or branch. A different peripheral nerve target calls for the code specific to that nerve, when available.

Does the code identify the facial pain diagnosis by itself?

No. The record should support the indication for the injection and identify the trigeminal division or branch treated.

How is a bilateral trigeminal injection reported for Medicare payment?

Use modifier 50 for a bilateral procedure; CMS pays it at 150%.

Is same-day pre- and postoperative care separately included?

The code has a 0-day global period, and same-day preoperative and postoperative care is included.

Can an assistant, co-surgeon, or surgical team be reported for this service?

CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

CMS pays the highest-valued procedure in full and the other procedures at 50% under the standard multiple procedure reduction.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 64400PPRRVU2026_Oct_nonQPP.csv, line 7,096 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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