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

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 Virginia, Medicare pays $152.06 for 64415 in the office and $65.06 when it’s performed in a hospital or facility.

$152.06Office (non-facility)
$65.06Hospital or facility
−1.9%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 Virginia
  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 Virginia 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. Virginia pays $152.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

64415 in Virginia vs other payment areas
  1. Virginia · this page$152.06
  2. Los Angeles, CA · California$174.34+$22.28
  3. Washington, DC area · District of Columbia$176.26+$24.20
  4. Miami, FL · Florida$165.30+$13.24
  5. Chicago, IL · Illinois$161.02+$8.96
  6. Manhattan, NY · New York$177.01+$24.95
  7. Alaska · Alaska$184.21+$32.15

Other areas in Virginia 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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 64415 in Virginia
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0001.4600
Practice expense3.06× 0.9833.0080
Malpractice0.12× 0.7060.0847
Total RVUs4.5527
Conversion factor× 33.4009

Office rate, Virginia$152.06

Office: (1.46 × 1 + 3.06 × 0.983 + 0.12 × 0.706) × $33.4009 = $152.06

Facility: (1.46 × 1 + 0.41 × 0.983 + 0.12 × 0.706) × $33.4009 = $65.06

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, Virginia
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.$182.40
64418Nerve injection, suprascapular nerveTargets the suprascapular nerve rather than the brachial plexus.$87.91
64450Nerve block, other peripheral nerve or branchFor a separately targeted peripheral nerve or branch not represented by a more specific code.$79.22

How 64415 has changed in Virginia

64415 · Office / nonfacility

$152.06

Effective 2026-10-01

The base rate is $25.15 higher than on 2025-10-01, moving from $126.91 to $152.06 (19.8%).

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

    $126.91changed to$152.06

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $131.58changed to$126.91

    • 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

    $129.43changed to$131.58

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $135.04changed to$129.43

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $115.21changed to$135.04

    • 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
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $116.17changed to$115.21

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $115.25changed to$116.17

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.76 changed to 1.89
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $120.52changed to$115.25

    • 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
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $120.03changed to$120.52

    • 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

    $117.65changed to$120.03

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.72 changed to 1.77
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $118.47changed to$117.65

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.76 changed to 1.72
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $118.20changed to$118.47

    • 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

    $117.61changed to$118.20

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $117.87changed to$117.61

    • 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
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $118.57changed to$117.87

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.97 changed to 1.76
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $118.57

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$152.06$65.06RVU26D
2026-07-01$152.06$65.06RVU26C
2026-04-01$152.06$65.06RVU26B
2026-01-01$152.06$65.06RVU26A
2025-10-01$126.91$66.11RVU25D
2025-07-01$126.91$66.11RVU25C
2025-04-01$126.91$66.11RVU25B
2025-01-01$126.91$66.11RVU25A
2024-10-01$131.58$67.38RVU24D
2024-07-01$131.58$67.38RVU24C
2024-04-01$131.58$67.38RVU24B
2024-03-09$131.58$67.38RVU24AR
2024-01-01$129.43$66.28RVU24A
2023-10-01$135.04$68.62RVU23D
2023-07-01$135.04$68.62RVU23C
2023-04-01$135.04$68.62RVU23B
2023-01-01$135.04$68.62RVU23A
2022-10-01$115.21$63.22RVU22D
2022-07-01$115.21$63.22RVU22C
2022-04-01$115.21$63.22RVU22B
2022-01-01$115.21$63.22RVU22A
2021-10-01$116.17$63.74RVU21D
2021-07-01$116.17$63.74RVU21C
2021-04-01$116.17$63.74RVU21B
2021-01-01$116.17$63.74RVU21A
2020-10-01$115.25$65.54RVU20D
2020-07-01$115.25$65.54RVU20C
2020-04-01$115.25$65.54RVU20B
2020-01-01$115.25$65.54RVU20A
2019-10-01$120.52$66.86RVU19D
2019-07-01$120.52$66.86RVU19C
2019-04-01$120.52$66.86RVU19B
2019-01-01$120.52$66.86RVU19A
2018-10-01$120.03$66.79RVU18D
2018-07-01$120.03$66.79RVU18C
2018-04-01$120.03$66.79RVU18B
2018-01-01$120.03$66.79RVU18AR1
2017-10-01$117.65$66.04RVU17D
2017-07-01$117.65$66.04RVU17C
2017-04-01$117.65$66.04RVU17B
2017-01-01$117.65$66.04RVU17A
2016-10-01$118.47$66.03RVU16D
2016-07-01$118.47$66.03RVU16C
2016-04-01$118.47$66.03RVU16B
2016-01-01$118.47$66.03RVU16A
2015-10-01$118.20$65.92RVU15D
2015-07-01$118.20$65.92RVU15C
2015-04-01$117.61$65.59RVU15B
2015-01-01$117.61$65.59RVU15A
2014-10-01$117.87$65.91RVU14D
2014-07-01$117.87$65.91RVU14C
2014-04-01$117.87$65.91RVU14B
2014-01-01$117.87$65.91RVU14A
2013-10-01$118.57$63.06RVU13D
2013-07-01$118.57$63.06RVU13C
2013-04-01$118.57$63.06RVU13B
2013-01-01$118.57$63.06RVU13AR

Price 64415 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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