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

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 Houston, TX, Medicare pays $156.16 for 64415 in the office and $68.27 when it’s performed in a hospital or facility.

$156.16Office (non-facility)
$68.27Hospital or facility
+0.8%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $156.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

64415 in Houston, TX vs other payment areas
  1. Houston, TX · this page$156.16
  2. Austin, TX · Texas$160.55+$4.39
  3. Beaumont, TX · Texas$145.50−$10.66
  4. Brazoria, TX · Texas$153.57−$2.59
  5. Dallas, TX · Texas$154.44−$1.72
  6. Fort Worth, TX · Texas$153.47−$2.69
  7. Galveston, TX · Texas$153.97−$2.19

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

Every other payment area

64415 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$149.38$65.38
Los Angeles, CACalifornia$174.34$69.63
Washington, DC areaDistrict of Columbia$176.26$71.99
Miami, FLFlorida$165.30$73.16
Chicago, ILIllinois$161.02$72.07
Manhattan, NYNew York$177.01$74.16
AlaskaAlaska$184.21$89.94
AlabamaAlabama$140.46$63.02

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 64415 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0081.4717
Practice expense3.06× 0.9933.0386
Malpractice0.12× 1.3760.1651
Total RVUs4.6754
Conversion factor× 33.4009

Office rate, Houston, TX$156.16

Office: (1.46 × 1.008 + 3.06 × 0.993 + 0.12 × 1.376) × $33.4009 = $156.16

Facility: (1.46 × 1.008 + 0.41 × 0.993 + 0.12 × 1.376) × $33.4009 = $68.27

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, Houston, TX
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.$187.05
64418Nerve injection, suprascapular nerveTargets the suprascapular nerve rather than the brachial plexus.$91.16
64450Nerve block, other peripheral nerve or branchFor a separately targeted peripheral nerve or branch not represented by a more specific code.$81.53

How 64415 has changed in Houston, TX

64415 · Office / nonfacility

$156.16

Effective 2026-10-01

The base rate is $24.47 higher than on 2025-10-01, moving from $131.69 to $156.16 (18.6%).

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

    $131.69changed to$156.16

    • 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
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $136.52changed to$131.69

    • 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

    $134.30changed to$136.52

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $139.67changed to$134.30

    • 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
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $118.94changed to$139.67

    • 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 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $119.93changed to$118.94

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $118.42changed to$119.93

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.76 changed to 1.89
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $123.37changed to$118.42

    • 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 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $122.87changed to$123.37

    • 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

    $120.54changed to$122.87

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.72 changed to 1.77
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $121.49changed to$120.54

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.76 changed to 1.72
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $121.21changed to$121.49

    • 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

    $120.61changed to$121.21

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $120.76changed to$120.61

    • 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 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $121.42changed to$120.76

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.97 changed to 1.76
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $121.42

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$156.16$68.27RVU26D
2026-07-01$156.16$68.27RVU26C
2026-04-01$156.16$68.27RVU26B
2026-01-01$156.16$68.27RVU26A
2025-10-01$131.69$69.72RVU25D
2025-07-01$131.69$69.72RVU25C
2025-04-01$131.69$69.72RVU25B
2025-01-01$131.69$69.72RVU25A
2024-10-01$136.52$71.08RVU24D
2024-07-01$136.52$71.08RVU24C
2024-04-01$136.52$71.08RVU24B
2024-03-09$136.52$71.08RVU24AR
2024-01-01$134.30$69.92RVU24A
2023-10-01$139.67$71.50RVU23D
2023-07-01$139.67$71.50RVU23C
2023-04-01$139.67$71.50RVU23B
2023-01-01$139.67$71.50RVU23A
2022-10-01$118.94$65.17RVU22D
2022-07-01$118.94$65.17RVU22C
2022-04-01$118.94$65.17RVU22B
2022-01-01$118.94$65.17RVU22A
2021-10-01$119.93$65.71RVU21D
2021-07-01$119.93$65.71RVU21C
2021-04-01$119.93$65.71RVU21B
2021-01-01$119.93$65.71RVU21A
2020-10-01$118.42$67.25RVU20D
2020-07-01$118.42$67.25RVU20C
2020-04-01$118.42$67.25RVU20B
2020-01-01$118.42$67.25RVU20A
2019-10-01$123.37$68.30RVU19D
2019-07-01$123.37$68.30RVU19C
2019-04-01$123.37$68.30RVU19B
2019-01-01$123.37$68.30RVU19A
2018-10-01$122.87$68.23RVU18D
2018-07-01$122.87$68.23RVU18C
2018-04-01$122.87$68.23RVU18B
2018-01-01$122.87$68.23RVU18AR1
2017-10-01$120.54$67.67RVU17D
2017-07-01$120.54$67.67RVU17C
2017-04-01$120.54$67.67RVU17B
2017-01-01$120.54$67.67RVU17A
2016-10-01$121.49$67.83RVU16D
2016-07-01$121.49$67.83RVU16C
2016-04-01$121.49$67.83RVU16B
2016-01-01$121.49$67.83RVU16A
2015-10-01$121.21$67.71RVU15D
2015-07-01$121.21$67.71RVU15C
2015-04-01$120.61$67.37RVU15B
2015-01-01$120.61$67.37RVU15A
2014-10-01$120.76$67.53RVU14D
2014-07-01$120.76$67.53RVU14C
2014-04-01$120.76$67.53RVU14B
2014-01-01$120.76$67.53RVU14A
2013-10-01$121.42$64.49RVU13D
2013-07-01$121.42$64.49RVU13C
2013-04-01$121.42$64.49RVU13B
2013-01-01$121.42$64.49RVU13AR

Price 64415 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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