CPT code 64425: Nerve block, ilioinguinal and iliohypogastric2026 Medicare rate & RVUs

Medicare pays $120.91 for 64425 nationally in the office and $49.77 in a hospital or facility. Local office rates run $107.44–$160.76.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 64425 covers

This service places anesthetic near the ilioinguinal and/or iliohypogastric nerves to evaluate or relieve pain in their distribution. Pain medicine physicians and anesthesiologists commonly perform it for groin or lower abdominal wall pain, including persistent pain after inguinal hernia repair. It may be performed in an office-based pain clinic or a hospital outpatient setting.

Select the code when the documented target is these nerves, rather than another named nerve or an unspecified peripheral nerve branch. The record should identify the nerve target, side, clinical indication, medication injected, and the patient’s response when relevant. CMS assigns 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 the others at 50%. For bilateral service, modifier 50 is paid at 150%. CMS does not pay an assistant at surgery, and does not permit co-surgeons or team surgery for this service.

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 64425 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

64425 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 64425 rate is calculated

Each of 64425’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.

Payment rules and modifiers for 64425

The CMS indicators that decide how 64425 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

64425 compared with similar codes

How to choose

64450Nerve blockOther peripheral nerve or branch

This code identifies the ilioinguinal and/or iliohypogastric target. Code 64450 is for another peripheral nerve or branch without a more specific code.

64430Nerve blockPudendal nerve

Code 64430 targets the pudendal nerve. Choose based on the nerve documented as the injection target, not simply because the complaint involves pelvic or groin pain.

64420Intercostal blockSingle nerve

Code 64420 targets an intercostal nerve. Use this code when the injection targets the ilioinguinal and/or iliohypogastric nerves instead.

Codes related to 64425

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

Open CMS sourceHow we calculate rates