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CPT code 64415: Brachial plexus block, single injection2026 Medicare rate & RVUs in Nevada

Reports a single injection to block the brachial plexus, commonly for anesthesia or pain control during shoulder and upper-arm procedures.

CMS RVU26DEffective Oct 1, 2026One payment locality202.1K Medicare services in 2024

In Nevada, Medicare pays $154.41 for 64415 in the office and $65.81 when it’s performed in a hospital or facility.

$154.41Office (non-facility)
$65.81Hospital or facility
−0.4%vs the national office rate ($154.98)

Check a contract rate as a % of Medicare · 64415 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 64415 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 64415 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 64415 covers

This service is a single injection of anesthetic, steroid, or both to block the brachial plexus. Anesthesiologists, pain physicians, and other clinicians performing regional anesthesia commonly use it for perioperative anesthesia or analgesia for shoulder and upper-arm procedures. The approach may be interscalene, supraclavicular, or infraclavicular, depending on the intended block. Imaging guidance, when performed, is included in the service.

Report this code for a single-injection brachial plexus block; use the continuous-infusion catheter code when the clinician places a catheter for ongoing infusion instead. Document the indication, side, injection approach, medication, and technique, including imaging guidance when used. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 identifies a bilateral service, paid at 150%. 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 Nevada compares for 64415

Across 109 of 109 payment localities, the office rate for 64415 runs from $138.63 in Arkansas to $203.66 in San Benito County, CA. Nevada pays $154.41. The RVUs are the same everywhere; the geographic indexes change the dollars.

64415 in Nevada vs other payment areas
  1. Nevada · this page$154.41
  2. Los Angeles, CA · California$174.34+$19.93
  3. Washington, DC area · District of Columbia$176.26+$21.85
  4. Miami, FL · Florida$165.30+$10.89
  5. Chicago, IL · Illinois$161.02+$6.61
  6. Manhattan, NY · New York$177.01+$22.60
  7. Alaska · Alaska$184.21+$29.80

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

Every other payment area

64415 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$140.46$63.02
ArkansasArkansas$138.63$62.59
ArizonaArizona$151.23$65.47
Bakersfield, CACalifornia$164.15$67.14
Chico, CACalifornia$163.76$66.75
El Centro, CACalifornia$163.78$66.77
Fresno, CACalifornia$163.76$66.75
Hanford, CACalifornia$163.76$66.75

64415 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.

$138.63

$184.21

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

View every state and territory as a table
64415 office rate range by state
State / territoryOffice rate rangeLocalities
AK$184.211
AL$140.461
AR$138.631
AZ$151.231
CA$163.76–$203.6629
CO$161.231
CT$164.671
DC$176.261
DE$153.591
FL$152.50–$165.303
GA$144.71–$157.572
GU$167.301
HI$167.301
IA$143.881
ID$144.691
IL$148.34–$161.184
IN$145.461
KS$143.181
KY$143.291
LA$143.06–$149.502
MA$160.36–$176.372
MD$156.37–$176.263
ME$145.29–$152.582
MI$146.61–$154.152
MN$155.121
MO$140.77–$150.083
MS$139.731
MT$154.971
NC$146.691
ND$152.601
NE$144.621
NH$158.671
NJ$166.72–$174.682
NM$147.301
NV$154.411
NY$148.68–$180.855
OH$146.121
OK$143.151
OR$153.38–$166.082
PA$146.38–$160.822
PR$156.041
RI$158.851
SC$146.611
SD$152.321
TN$143.821
TX$145.50–$160.558
UT$148.441
VA$152.06–$176.262
VI$156.041
VT$151.981
WA$160.07–$179.892
WI$147.911
WV$143.321
WY$153.941

See 64415 in every payment locality

How the 64415 rate is calculated

Each of 64415’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 · 64415

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.46

1.46 RVUs× 1.000 GPCI

Practice expense3.06

3.06 RVUs× 1.000 GPCI

Malpractice0.12

0.12 RVUs× 1.000 GPCI

Adjusted RVUs

4.6400

Conversion factor

$33.4009

Medicare rate

$154.98

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

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,099

Code
64415
Physician work
1.46
Practice expense
3.06
Malpractice
0.12

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 64415 in Nevada
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0001.4600
Practice expense3.06× 1.0013.0631
Malpractice0.12× 0.8330.1000
Total RVUs4.6230
Conversion factor× 33.4009

Office rate, Nevada$154.41

Office: (1.46 × 1 + 3.06 × 1.001 + 0.12 × 0.833) × $33.4009 = $154.41

Facility: (1.46 × 1 + 0.41 × 1.001 + 0.12 × 0.833) × $33.4009 = $65.81

Open 64415 in the RVU calculator

Payment rules and modifiers for 64415

The CMS indicators that decide how 64415 is paid alongside other services.

CMS payment indicators · 64415

Brachial plexus block, single injection

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

64415 without 50 · national office

$154.98

Brachial plexus block, single injection

64415-50 · Bilateral: 150%

$232.47

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 64415

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

Codes related to 64415
CodeHow it relatesOffice range, Nevada
Same family
64416Nerve block, brachial plexus catheter infusionBrachial plexus block using a catheter for continuous infusion rather than a single injection.No office rate
Used instead
64417Axillary nerve block, image guidance includedTargets the axillary nerve rather than the brachial plexus.$185.46
64418Nerve injection, suprascapular nerveTargets the suprascapular nerve rather than the brachial plexus.$89.29
64450Nerve block, other peripheral nerve or branchFor a separately targeted peripheral nerve or branch not represented by a more specific code.$80.49

How 64415 has changed in Nevada

64415 · Office / nonfacility

$154.41

Effective 2026-10-01

The base rate is $26.00 higher than on 2025-10-01, moving from $128.41 to $154.41 (20.2%).

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

    $128.41changed to$154.41

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.50 changed to 1.46
    • Practice expense RVU 2.36 changed to 3.06
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $133.14changed to$128.41

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.39 changed to 2.36

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $130.97changed to$133.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $136.96changed to$130.97

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.41 changed to 2.39
    • Malpractice RVU 0.12 changed to 0.13
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $117.50changed to$136.96

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.35 changed to 1.50
    • Practice expense RVU 1.89 changed to 2.41
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $118.47changed to$117.50

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $116.92changed to$118.47

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.76 changed to 1.89
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $122.62changed to$116.92

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.48 changed to 1.35
    • Practice expense RVU 1.78 changed to 1.76
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $122.12changed to$122.62

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.77 changed to 1.78

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $121.23changed to$122.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.72 changed to 1.77
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $123.70changed to$121.23

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.76 changed to 1.72
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $123.39changed to$123.70

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.74 changed to 1.76

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $122.78changed to$123.39

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $123.95changed to$122.78

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.76 changed to 1.74
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $125.88changed to$123.95

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.97 changed to 1.76
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$125.88

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$154.41$65.81RVU26D
2026-07-01$154.41$65.81RVU26C
2026-04-01$154.41$65.81RVU26B
2026-01-01$154.41$65.81RVU26A
2025-10-01$128.41$66.62RVU25D
2025-07-01$128.41$66.62RVU25C
2025-04-01$128.41$66.62RVU25B
2025-01-01$128.41$66.62RVU25A
2024-10-01$133.14$67.90RVU24D
2024-07-01$133.14$67.90RVU24C
2024-04-01$133.14$67.90RVU24B
2024-03-09$133.14$67.90RVU24AR
2024-01-01$130.97$66.79RVU24A
2023-10-01$136.96$69.87RVU23D
2023-07-01$136.96$69.87RVU23C
2023-04-01$136.96$69.87RVU23B
2023-01-01$136.96$69.87RVU23A
2022-10-01$117.50$65.25RVU22D
2022-07-01$117.50$65.25RVU22C
2022-04-01$117.50$65.25RVU22B
2022-01-01$117.50$65.25RVU22A
2021-10-01$118.47$65.79RVU21D
2021-07-01$118.47$65.79RVU21C
2021-04-01$118.47$65.79RVU21B
2021-01-01$118.47$65.79RVU21A
2020-10-01$116.92$66.75RVU20D
2020-07-01$116.92$66.75RVU20C
2020-04-01$116.92$66.75RVU20B
2020-01-01$116.92$66.75RVU20A
2019-10-01$122.62$67.27RVU19D
2019-07-01$122.62$67.27RVU19C
2019-04-01$122.62$67.27RVU19B
2019-01-01$122.62$67.27RVU19A
2018-10-01$122.12$67.20RVU18D
2018-07-01$122.12$67.20RVU18C
2018-04-01$122.12$67.20RVU18B
2018-01-01$122.12$67.20RVU18AR1
2017-10-01$121.23$67.05RVU17D
2017-07-01$121.23$67.05RVU17C
2017-04-01$121.23$67.05RVU17B
2017-01-01$121.23$67.05RVU17A
2016-10-01$123.70$67.63RVU16D
2016-07-01$123.70$67.63RVU16C
2016-04-01$123.70$67.63RVU16B
2016-01-01$123.70$67.63RVU16A
2015-10-01$123.39$67.50RVU15D
2015-07-01$123.39$67.50RVU15C
2015-04-01$122.78$67.17RVU15B
2015-01-01$122.78$67.17RVU15A
2014-10-01$123.95$68.01RVU14D
2014-07-01$123.95$68.01RVU14C
2014-04-01$123.95$68.01RVU14B
2014-01-01$123.95$68.01RVU14A
2013-10-01$125.88$65.76RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 64415 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

64415 billing questions

When should 64415 be reported instead of 64416?

Use 64415 for a single-injection brachial plexus block. Use 64416 when a catheter is placed for continuous infusion.

Is imaging guidance separately reported with this block?

Imaging guidance, when performed, is included in 64415. Document the guidance and block approach in the procedure record.

What documentation supports 64415?

Record the clinical indication, laterality, brachial plexus approach, medication injected, and whether imaging guidance was used.

How is a bilateral block reported?

Report modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.

How does the multiple-procedure reduction affect 64415?

When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.

Can an assistant or co-surgeon be reported for this procedure?

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

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 64415PPRRVU2026_Oct_nonQPP.csv, line 7,099 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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