CPT code 64416: Nerve block, brachial plexus catheter infusion2026 Medicare rate & RVUs in Illinois
Report this service for brachial plexus catheter placement to deliver continuous anesthetic infusion, commonly for pain control after shoulder surgery.
CMS doesn’t publish an office rate for 64416 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 64416 covers
This service places a catheter at the brachial plexus for continuous delivery of anesthetic, often to control pain after shoulder or upper-arm surgery. An anesthesiologist or other physician trained in regional anesthesia may perform it in an operating room, procedure area, or outpatient surgical setting. Imaging guidance is included when performed. The code represents the continuous catheter technique, not a one-time nerve injection.
Choose 64416 when the documented target is the brachial plexus and medication is delivered through a catheter for continuous infusion. The record should identify the nerve target, catheter placement, and continuous infusion plan; do not select it solely because a single injection is followed by pain relief. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Modifier 50 for a bilateral service is paid at 150%. Assistant-at-surgery services are not paid, and co-surgeon and team-surgery billing 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.
Where 64416 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $79.42 |
| East St. Louis, IL | Unavailable | $76.87 |
| Rest of Illinois | Unavailable | $74.55 |
| Suburban Chicago, IL | Unavailable | $76.99 |
How the 64416 rate is calculated
Each of 64416’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 · 64416
RVUs × geographic indexes × conversion factor
Work1.76
1.76 RVUs× 1.000 GPCI
Practice expense0.26
0.26 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
2.1700
Conversion factor
$33.4009
Medicare rate
$72.48
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64416
The CMS indicators that decide how 64416 is paid alongside other services.
CMS payment indicators · 64416
Nerve block, brachial plexus catheter infusion
| 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
64416 without 50 · national facility
$72.48
Nerve block, brachial plexus catheter infusion
64416-50 · Bilateral: 150%
$108.72
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).
64416 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64415Brachial plexus blockSingle injection
- Both target the brachial plexus, but 64416 is for continuous infusion through a catheter; 64415 is for a single injection.
- 64417Axillary nerve blockImage guidance included
- 64417 targets the axillary nerve. Use 64416 when the documented target is the brachial plexus and a continuous catheter infusion is placed.
- 64446Sciatic nerve blockContinuous catheter infusion
- Both describe continuous catheter infusion, but 64446 targets the sciatic nerve rather than the brachial plexus.
64416 billing questions
How is 64416 different from 64415?
64416 describes a brachial plexus catheter for continuous infusion. Use 64415 for a single injection rather than continuous catheter delivery.
Is imaging guidance separately reported?
Imaging guidance is included in 64416 when performed. The code does not require that imaging be used.
Can the catheter placement and a single-shot block both be reported?
The documentation must support distinct services. A catheter placement for continuous infusion is not converted into a separate single-shot service merely because medication is injected during placement.
How should bilateral services be reported?
For a bilateral procedure, report modifier 50; CMS pays the service at 150%.
Does the code cover postoperative catheter management on later days?
The code identifies catheter placement for continuous infusion, and its 0-day global period includes same-day preoperative and postoperative care. Document any later-day service separately according to the service actually performed.
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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