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CPT code 64418: Nerve injection, suprascapular nerve2026 Medicare rate & RVUs in El Centro, CA

Report this service for an anesthetic and/or steroid injection targeting the suprascapular nerve to evaluate or relieve shoulder pain.

CMS RVU26DEffective Oct 1, 2026One payment locality24.3K Medicare services in 2024

In El Centro, CA, Medicare pays $93.61 for 64418 in the office and $47.85 when it’s performed in a hospital or facility.

$93.61Office (non-facility)
$47.85Hospital or facility
+4.2%vs the national office rate ($89.85)

Check a contract rate as a % of Medicare · 64418 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 64418 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in El Centro, CA
  2. What 64418 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 64418 covers

The clinician places an injection at the suprascapular nerve, which supplies sensation to parts of the shoulder. Pain medicine physicians, anesthesiologists, physiatrists, and other clinicians may use the block diagnostically or therapeutically for shoulder pain, including pain associated with rotator cuff disease or glenohumeral arthritis. The injected medication may be anesthetic, steroid, or both; the service is defined by the nerve targeted, not simply by an injection into the shoulder joint.

Report 64418 when documentation identifies the suprascapular nerve as the injection target and supports the clinical indication, side, approach, and medication administered. The code has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this service; 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 El Centro, CA compares for 64418

Across 109 of 109 payment localities, the office rate for 64418 runs from $80.96 in Arkansas to $114.37 in San Benito County, CA. El Centro, CA pays $93.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

64418 in El Centro, CA vs other payment areas
  1. El Centro, CA · this page$93.61
  2. Bakersfield, CA · California$93.93+$0.32
  3. Chico, CA · California$93.59−$0.02
  4. Fresno, CA · California$93.59−$0.02
  5. Hanford, CA · California$93.59−$0.02
  6. Los Angeles, CA · California$99.31+$5.70
  7. Madera, CA · California$93.59−$0.02

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

Every other payment area

64418 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$93.59$47.83
Modesto, CACalifornia$93.59$47.83
Napa, CACalifornia$106.33$51.30
Oxnard, CACalifornia$98.64$49.29
Redding, CACalifornia$93.59$47.83
Rest of CaliforniaCalifornia$93.59$47.83
Riverside, CACalifornia$94.79$49.03
Sacramento, CACalifornia$97.65$49.09

64418 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.

$80.96

$109.35

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

View every state and territory as a table
64418 office rate range by state
State / territoryOffice rate rangeLocalities
AK$109.351
AL$81.951
AR$80.961
AZ$87.761
CA$93.59–$114.3729
CO$92.701
CT$95.221
DC$101.171
DE$89.051
FL$89.48–$97.533
GA$85.11–$91.502
GU$95.211
HI$95.211
IA$83.351
ID$83.881
IL$87.53–$95.114
IN$84.281
KS$83.181
KY$83.941
LA$83.89–$87.372
MA$92.35–$100.692
MD$90.51–$101.173
ME$84.42–$88.042
MI$85.93–$90.602
MN$88.721
MO$82.79–$87.433
MS$81.881
MT$89.841
NC$85.141
ND$87.671
NE$83.681
NH$91.461
NJ$96.27–$100.422
NM$86.401
NV$89.291
NY$86.24–$104.825
OH$85.491
OK$83.631
OR$88.56–$95.082
PA$85.51–$93.272
PR$90.351
RI$91.801
SC$85.461
SD$87.411
TN$83.561
TX$85.05–$92.438
UT$86.451
VA$87.91–$101.172
VI$90.351
VT$87.531
WA$92.11–$102.412
WI$85.191
WV$84.821
WY$88.891

See 64418 in every payment locality

How the 64418 rate is calculated

Each of 64418’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 · 64418

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.07

1.07 RVUs× 1.000 GPCI

Practice expense1.51

1.51 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

2.6900

Conversion factor

$33.4009

Medicare rate

$89.85

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

The exact El Centro, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,102

Code
64418
Physician work
1.07
Practice expense
1.51
Malpractice
0.11

GPCI2026.csv

10

Locality
El Centro, CA
Physician work
1.017
Practice expense
1.096
Malpractice
0.541
Office calculation for 64418 in El Centro, CA
ComponentRVULocality factorAdjusted
Physician work1.07× 1.0171.0882
Practice expense1.51× 1.0961.6550
Malpractice0.11× 0.5410.0595
Total RVUs2.8027
Conversion factor× 33.4009

Office rate, El Centro, CA$93.61

Office: (1.07 × 1.017 + 1.51 × 1.096 + 0.11 × 0.541) × $33.4009 = $93.61

Facility: (1.07 × 1.017 + 0.26 × 1.096 + 0.11 × 0.541) × $33.4009 = $47.85

Open 64418 in the RVU calculator

Payment rules and modifiers for 64418

The CMS indicators that decide how 64418 is paid alongside other services.

CMS payment indicators · 64418

Nerve injection, suprascapular nerve

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

64418 without 50 · national office

$89.85

Nerve injection, suprascapular nerve

64418-50 · Bilateral: 150%

$134.78

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 64418

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

Codes related to 64418
CodeHow it relatesOffice range, El Centro, CA
Used instead
64417Axillary nerve block, image guidance includedTargets the axillary nerve, a distinct shoulder nerve target.$198.12
64415Brachial plexus block, single injectionTargets the brachial plexus rather than the suprascapular nerve.$163.78
64450Nerve block, other peripheral nerve or branchFor a peripheral nerve or branch without a more specific injection code.$85.37
Often billed with
76942Ultrasound needle guidance, biopsy, aspiration, injection, or localizationMay report ultrasound needle guidance when performed and separately documented.$67.83

How 64418 has changed in El Centro, CA

64418 · Office / nonfacility

$93.61

Effective 2026-10-01

The base rate is $7.40 higher than on 2025-10-01, moving from $86.21 to $93.61 (8.6%).

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

    $86.21changed to$93.61

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.10 changed to 1.07
    • Practice expense RVU 1.35 changed to 1.51
    • Malpractice RVU 0.13 changed to 0.11
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.570 changed to 0.541

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $89.25changed to$86.21

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.37 changed to 1.35
    • Malpractice RVU 0.12 changed to 0.13

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $87.79changed to$89.25

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $90.94changed to$87.79

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.38 changed to 1.37
    • Work GPCI 1.021 changed to 1.014
    • Practice expense GPCI 1.079 changed to 1.093
    • Malpractice GPCI 0.595 changed to 0.570

  5. January 1, 2023

    RVU23A

    $93.27changed to$90.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.40 changed to 1.38
    • Work GPCI 1.027 changed to 1.021
    • Practice expense GPCI 1.065 changed to 1.079
    • Malpractice GPCI 0.620 changed to 0.595

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $93.71changed to$93.27

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.38 changed to 1.40
    • Malpractice RVU 0.14 changed to 0.12
    • Malpractice GPCI 0.616 changed to 0.620

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $89.61changed to$93.71

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.20 changed to 1.38
    • Malpractice RVU 0.12 changed to 0.14
    • Work GPCI 1.024 changed to 1.027
    • Practice expense GPCI 1.070 changed to 1.065
    • Malpractice GPCI 0.606 changed to 0.616

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $100.57changed to$89.61

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.49 changed to 1.20
    • Work GPCI 1.020 changed to 1.024
    • Practice expense GPCI 1.074 changed to 1.070
    • Malpractice GPCI 0.570 changed to 0.606

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $124.81changed to$100.57

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.12 changed to 1.49
    • Malpractice GPCI 0.567 changed to 0.570

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $154.58changed to$124.81

    • Conversion factor 35.8887 changed to 35.9996
    • Work RVU 1.32 changed to 1.10
    • Practice expense RVU 2.66 changed to 2.12
    • Malpractice RVU 0.14 changed to 0.12
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.079 changed to 1.074
    • Malpractice GPCI 0.610 changed to 0.567

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$154.58

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$93.61$47.85RVU26D
2026-07-01$93.61$47.85RVU26C
2026-04-01$93.61$47.85RVU26B
2026-01-01$93.61$47.85RVU26A
2025-10-01$86.21$53.68RVU25D
2025-07-01$86.21$53.68RVU25C
2025-04-01$86.21$53.68RVU25B
2025-01-01$86.21$53.68RVU25A
2024-10-01$89.25$55.05RVU24D
2024-07-01$89.25$55.05RVU24C
2024-04-01$89.25$55.05RVU24B
2024-03-09$89.25$55.05RVU24AR
2024-01-01$87.79$54.15RVU24A
2023-10-01$90.94$56.20RVU23D
2023-07-01$90.94$56.20RVU23C
2023-04-01$90.94$56.20RVU23B
2023-01-01$90.94$56.20RVU23A
2022-10-01$93.27$57.52RVU22D
2022-07-01$93.27$57.52RVU22C
2022-04-01$93.27$57.52RVU22B
2022-01-01$93.27$57.52RVU22A
2021-10-01$93.71$58.78RVU21D
2021-07-01$93.71$58.78RVU21C
2021-04-01$93.71$58.78RVU21B
2021-01-01$93.71$58.78RVU21A
2020-10-01$89.61$59.49RVU20D
2020-07-01$89.61$59.49RVU20C
2020-04-01$89.61$59.49RVU20B
2020-01-01$89.61$59.49RVU20A
2019-10-01$100.57$59.16RVU19D
2019-07-01$100.57$59.16RVU19C
2019-04-01$100.57$59.16RVU19B
2019-01-01$100.57$59.16RVU19A
2018-10-01$124.81$64.49RVU18D
2018-07-01$124.81$64.49RVU18C
2018-04-01$124.81$64.49RVU18B
2018-01-01$124.81$64.49RVU18AR1
2017-10-01$154.58$79.84RVU17D
2017-07-01$154.58$79.84RVU17C
2017-04-01$154.58$79.84RVU17B
2017-01-01$154.58$79.84RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 64418 for an earlier date of service

Where the El Centro, CA rate applies

El Centro, CA is a Medicare payment area, not a city. Our Census mapping connects it to 18 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • El Centro
  • Bombay Beach
  • Brawley
  • Calexico
  • Calipatria
  • Desert Shores
  • El Centro Naval Air Facility
  • Heber

Browse all communities in California

64418 billing questions

How is 64418 different from a shoulder joint injection?

64418 targets the suprascapular nerve. An injection placed into the shoulder joint itself is a different service and should not be selected based only on the shared shoulder-pain indication.

When should 64450 be considered instead?

Use 64418 when the suprascapular nerve is the target. Code 64450 is for an injection targeting a peripheral nerve or branch without a more specific code for that nerve.

What documentation supports reporting 64418?

Document the shoulder-pain indication, the suprascapular nerve as the target, laterality, injection approach, and medication administered.

Can ultrasound guidance be reported separately?

When ultrasound needle guidance is performed and documented, 76942 may be separately reportable. The record should support the guidance service as well as the nerve injection.

How does Medicare pay when both sides are treated?

For bilateral treatment, Medicare pays 150% when the service is reported with modifier 50.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures in that session are subject to 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

Show the CMS file lines behind this rate
RVUs for 64418PPRRVU2026_Oct_nonQPP.csv, line 7,102 (RVU26D)
Geographic factors for El Centro, CAGPCI2026.csv, line 10 (RVU26D)

Open CMS sourceHow we calculate rates

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