CPT code 64400: Nerve block, trigeminal nerve or branch2026 Medicare rate & RVUs in South Dakota
Reports an injection around a trigeminal nerve division or branch, commonly for facial pain or trigeminal neuralgia treatment or diagnostic evaluation.
In South Dakota, Medicare pays $117.26 for 64400 in the office and $42.77 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $117.26. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$117.26
- Los Angeles, CA · California$137.12+$19.86
- Washington, DC area · District of Columbia$140.13+$22.87
- Miami, FL · Florida$136.35+$19.09
- Chicago, IL · Illinois$131.62+$14.36
- Manhattan, NY · New York$142.25+$24.99
- Alaska · Alaska$136.84+$19.58
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $127.76 | $46.13 |
| Merced, CACalifornia | $127.76 | $46.13 |
| Modesto, CACalifornia | $127.76 | $46.13 |
| Napa, CACalifornia | $148.78 | $50.61 |
| Oxnard, CACalifornia | $136.43 | $48.39 |
| Redding, CACalifornia | $127.76 | $46.13 |
| Rest of CaliforniaCalifornia | $127.76 | $46.13 |
| Riverside, CACalifornia | $130.01 | $48.38 |
| Sacramento, CACalifornia | $134.29 | $47.67 |
| Salinas, CACalifornia | $133.81 | $47.48 |
| San Diego, CACalifornia | $137.17 | $48.09 |
| Marin County, CACalifornia | $157.55 | $52.52 |
| San Francisco, CACalifornia | $157.31 | $52.29 |
| San Benito County, CACalifornia | $161.35 | $53.94 |
| Santa Clara County, CACalifornia | $160.37 | $52.97 |
| San Luis Obispo, CACalifornia | $131.65 | $46.82 |
| Santa Cruz, CACalifornia | $138.63 | $48.13 |
| Santa Maria, CACalifornia | $134.37 | $47.52 |
| Santa Rosa, CACalifornia | $140.03 | $48.56 |
| Stockton, CACalifornia | $127.76 | $46.13 |
| Vallejo, CACalifornia | $148.44 | $50.27 |
| Visalia, CACalifornia | $127.76 | $46.13 |
| Yuba City, CACalifornia | $127.76 | $46.13 |
| ColoradoColorado | $126.46 | $47.21 |
| ConnecticutConnecticut | $130.84 | $50.62 |
| DelawareDelaware | $120.24 | $46.65 |
| Fort Lauderdale, FLFlorida | $128.76 | $53.31 |
| Rest of FloridaFlorida | $121.46 | $50.25 |
| Atlanta, GAGeorgia | $124.84 | $49.17 |
| Rest of GeorgiaGeorgia | $113.48 | $47.04 |
| Hawaii, Guam, HIHawaii | $131.36 | $46.67 |
| IowaIowa | $109.99 | $41.84 |
| IdahoIdaho | $110.98 | $42.45 |
| East St. Louis, ILIllinois | $121.78 | $53.26 |
| Rest of IllinoisIllinois | $117.99 | $49.98 |
| Suburban Chicago, ILIllinois | $129.94 | $53.45 |
| IndianaIndiana | $111.70 | $42.65 |
| KansasKansas | $109.74 | $42.41 |
| KentuckyKentucky | $111.27 | $45.05 |
| New Orleans, LALouisiana | $117.53 | $47.44 |
| Rest of LouisianaLouisiana | $111.21 | $45.29 |
| Metropolitan Boston, MAMassachusetts | $139.70 | $50.77 |
| Rest of MassachusettsMassachusetts | $125.68 | $47.25 |
| Baltimore area, MDMaryland | $130.57 | $50.65 |
| Rest of MarylandMaryland | $122.67 | $47.29 |
| Rest of MaineMaine | $112.02 | $43.50 |
| Southern Maine, MEMaine | $118.51 | $44.70 |
| Detroit, MIMichigan | $123.56 | $51.68 |
| Rest of MichiganMichigan | $114.94 | $46.94 |
| MinnesotaMinnesota | $119.60 | $42.96 |
| Metropolitan Kansas City, MOMissouri | $116.23 | $46.29 |
| Metropolitan St. Louis, MOMissouri | $117.58 | $46.67 |
| Rest of MissouriMissouri | $109.24 | $45.03 |
| MississippiMississippi | $107.50 | $43.37 |
| MontanaMontana | $121.90 | $47.42 |
| North CarolinaNorth Carolina | $113.32 | $43.82 |
| North DakotaNorth Dakota | $117.75 | $43.26 |
| NebraskaNebraska | $110.58 | $41.83 |
| New HampshireNew Hampshire | $124.75 | $47.21 |
| Northern New JerseyNew Jersey | $138.41 | $52.01 |
| Rest of New JerseyNew Jersey | $131.90 | $50.56 |
| New MexicoNew Mexico | $115.81 | $47.51 |
| NevadaNevada | $120.83 | $46.27 |
| NYC suburbs and Long Island, NYNew York | $146.59 | $58.03 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $133.08 | $51.52 |
| Queens, NYNew York | $143.05 | $55.01 |
| Rest of New YorkNew York | $115.30 | $44.54 |
| OhioOhio | $114.09 | $46.09 |
| OklahomaOklahoma | $110.66 | $44.15 |
| Portland, OROregon | $130.56 | $47.80 |
| Rest of OregonOregon | $119.47 | $45.28 |
| Metropolitan Philadelphia, PAPennsylvania | $127.42 | $49.88 |
| Rest of PennsylvaniaPennsylvania | $114.11 | $45.73 |
| Puerto RicoPuerto Rico | $122.80 | $47.50 |
| Rhode IslandRhode Island | $124.61 | $47.66 |
| South CarolinaSouth Carolina | $113.98 | $45.16 |
| TennesseeTennessee | $110.43 | $42.72 |
| Austin, TXTexas | $126.41 | $47.61 |
| Beaumont, TXTexas | $113.27 | $45.49 |
| Brazoria, TXTexas | $119.75 | $45.94 |
| Dallas, TXTexas | $120.77 | $46.59 |
| Fort Worth, TXTexas | $119.96 | $46.52 |
| Galveston, TXTexas | $120.27 | $46.31 |
| Houston, TXTexas | $124.11 | $50.15 |
| Rest of TexasTexas | $116.62 | $45.93 |
| UtahUtah | $115.77 | $45.75 |
| VirginiaVirginia | $118.31 | $45.09 |
| Virgin Islands, VIUnited States Virgin Islands | $122.80 | $47.50 |
| VermontVermont | $117.54 | $43.80 |
| Rest of WashingtonWashington | $125.35 | $46.92 |
| King County, WAWashington | $142.40 | $51.00 |
| WisconsinWisconsin | $113.26 | $41.90 |
| West VirginiaWest Virginia | $113.08 | $48.35 |
| WyomingWyoming | $120.09 | $45.61 |
64400 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $136.84 | 1 |
| AL | $107.55 | 1 |
| AR | $105.75 | 1 |
| AZ | $118.10 | 1 |
| CA | $127.76–$161.35 | 29 |
| CO | $126.46 | 1 |
| CT | $130.84 | 1 |
| DC | $140.13 | 1 |
| DE | $120.24 | 1 |
| FL | $121.46–$136.35 | 3 |
| GA | $113.48–$124.84 | 2 |
| GU | $131.36 | 1 |
| HI | $131.36 | 1 |
| IA | $109.99 | 1 |
| ID | $110.98 | 1 |
| IL | $117.99–$131.62 | 4 |
| IN | $111.70 | 1 |
| KS | $109.74 | 1 |
| KY | $111.27 | 1 |
| LA | $111.21–$117.53 | 2 |
| MA | $125.68–$139.70 | 2 |
| MD | $122.67–$140.13 | 3 |
| ME | $112.02–$118.51 | 2 |
| MI | $114.94–$123.56 | 2 |
| MN | $119.60 | 1 |
| MO | $109.24–$117.58 | 3 |
| MS | $107.50 | 1 |
| MT | $121.90 | 1 |
| NC | $113.32 | 1 |
| ND | $117.75 | 1 |
| NE | $110.58 | 1 |
| NH | $124.75 | 1 |
| NJ | $131.90–$138.41 | 2 |
| NM | $115.81 | 1 |
| NV | $120.83 | 1 |
| NY | $115.30–$146.59 | 5 |
| OH | $114.09 | 1 |
| OK | $110.66 | 1 |
| OR | $119.47–$130.56 | 2 |
| PA | $114.11–$127.42 | 2 |
| PR | $122.80 | 1 |
| RI | $124.61 | 1 |
| SC | $113.98 | 1 |
| SD | $117.26 | 1 |
| TN | $110.43 | 1 |
| TX | $113.27–$126.41 | 8 |
| UT | $115.77 | 1 |
| VA | $118.31–$140.13 | 2 |
| VI | $122.80 | 1 |
| VT | $117.54 | 1 |
| WA | $125.35–$142.40 | 2 |
| WI | $113.26 | 1 |
| WV | $113.08 | 1 |
| WY | $120.09 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.73 | × 1.000 | 0.7300 |
| Practice expense | 2.71 | × 1.000 | 2.7100 |
| Malpractice | 0.21 | × 0.336 | 0.0706 |
| Total RVUs | 3.5106 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$117.26
Office: (0.73 × 1 + 2.71 × 1 + 0.21 × 0.336) × $33.4009 = $117.26
Facility: (0.73 × 1 + 0.48 × 1 + 0.21 × 0.336) × $33.4009 = $42.77
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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).
How 64400 has changed in South Dakota
64400 · Office / nonfacility
$117.26
Effective 2026-10-01
The base rate is $12.45 higher than on 2025-10-01, moving from $104.81 to $117.26 (11.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$104.81changed to$117.26
- 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
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$109.52changed to$104.81
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.46 changed to 2.41
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$107.74changed to$109.52
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$109.77changed to$107.74
- 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
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$112.80changed to$109.77
- 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
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$112.21changed to$112.80
- 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.
January 1, 2021
RVU21A
$105.97changed to$112.21
- 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
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$134.33changed to$105.97
- 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
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$129.36changed to$134.33
- 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.
January 1, 2018
RVU18AR1
$125.28changed to$129.36
- 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
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$125.24changed to$125.28
- 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 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$125.70changed to$125.24
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$125.07changed to$125.70
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$122.54changed to$125.07
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$122.75changed to$122.54
- 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
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $122.75
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $117.26 | $42.77 | RVU26D |
| 2026-07-01 | $117.26 | $42.77 | RVU26C |
| 2026-04-01 | $117.26 | $42.77 | RVU26B |
| 2026-01-01 | $117.26 | $42.77 | RVU26A |
| 2025-10-01 | $104.81 | $46.59 | RVU25D |
| 2025-07-01 | $104.81 | $46.59 | RVU25C |
| 2025-04-01 | $104.81 | $46.59 | RVU25B |
| 2025-01-01 | $104.81 | $46.59 | RVU25A |
| 2024-10-01 | $109.52 | $47.28 | RVU24D |
| 2024-07-01 | $109.52 | $47.28 | RVU24C |
| 2024-04-01 | $109.52 | $47.28 | RVU24B |
| 2024-03-09 | $109.52 | $47.28 | RVU24AR |
| 2024-01-01 | $107.74 | $46.50 | RVU24A |
| 2023-10-01 | $109.77 | $46.74 | RVU23D |
| 2023-07-01 | $109.77 | $46.74 | RVU23C |
| 2023-04-01 | $109.77 | $46.74 | RVU23B |
| 2023-01-01 | $109.77 | $46.74 | RVU23A |
| 2022-10-01 | $112.80 | $47.04 | RVU22D |
| 2022-07-01 | $112.80 | $47.04 | RVU22C |
| 2022-04-01 | $112.80 | $47.04 | RVU22B |
| 2022-01-01 | $112.80 | $47.04 | RVU22A |
| 2021-10-01 | $112.21 | $46.96 | RVU21D |
| 2021-07-01 | $112.21 | $46.96 | RVU21C |
| 2021-04-01 | $112.21 | $46.96 | RVU21B |
| 2021-01-01 | $112.21 | $46.96 | RVU21A |
| 2020-10-01 | $105.97 | $47.86 | RVU20D |
| 2020-07-01 | $105.97 | $47.86 | RVU20C |
| 2020-04-01 | $105.97 | $47.86 | RVU20B |
| 2020-01-01 | $105.97 | $47.86 | RVU20A |
| 2019-10-01 | $134.33 | $69.46 | RVU19D |
| 2019-07-01 | $134.33 | $69.46 | RVU19C |
| 2019-04-01 | $134.33 | $69.46 | RVU19B |
| 2019-01-01 | $134.33 | $69.46 | RVU19A |
| 2018-10-01 | $129.36 | $69.24 | RVU18D |
| 2018-07-01 | $129.36 | $69.24 | RVU18C |
| 2018-04-01 | $129.36 | $69.24 | RVU18B |
| 2018-01-01 | $129.36 | $69.24 | RVU18AR1 |
| 2017-10-01 | $125.28 | $68.58 | RVU17D |
| 2017-07-01 | $125.28 | $68.58 | RVU17C |
| 2017-04-01 | $125.28 | $68.58 | RVU17B |
| 2017-01-01 | $125.28 | $68.58 | RVU17A |
| 2016-10-01 | $125.24 | $68.31 | RVU16D |
| 2016-07-01 | $125.24 | $68.31 | RVU16C |
| 2016-04-01 | $125.24 | $68.31 | RVU16B |
| 2016-01-01 | $125.24 | $68.31 | RVU16A |
| 2015-10-01 | $125.70 | $68.56 | RVU15D |
| 2015-07-01 | $125.70 | $68.56 | RVU15C |
| 2015-04-01 | $125.07 | $68.22 | RVU15B |
| 2015-01-01 | $125.07 | $68.22 | RVU15A |
| 2014-10-01 | $122.54 | $67.37 | RVU14D |
| 2014-07-01 | $122.54 | $67.37 | RVU14C |
| 2014-04-01 | $122.54 | $67.37 | RVU14B |
| 2014-01-01 | $122.54 | $67.37 | RVU14A |
| 2013-10-01 | $122.75 | $66.61 | RVU13D |
| 2013-07-01 | $122.75 | $66.61 | RVU13C |
| 2013-04-01 | $122.75 | $66.61 | RVU13B |
| 2013-01-01 | $122.75 | $66.61 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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