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CPT code 64425: Nerve block, ilioinguinal and iliohypogastric2026 Medicare rate & RVUs in Washington, DC area

Reports an anesthetic injection targeting the ilioinguinal and/or iliohypogastric nerves for diagnostic evaluation or relief of groin or lower abdominal wall pain.

CMS RVU26DEffective Oct 1, 2026One payment locality5.9K Medicare services in 2024

In Washington, DC area, Medicare pays $138.18 for 64425 in the office and $54.37 when it’s performed in a hospital or facility.

$138.18Office (non-facility)
$54.37Hospital or facility
+14.3%vs the national office rate ($120.91)

Check a contract rate as a % of Medicare · 64425 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 64425 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 64425 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 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.

How Washington, DC area compares for 64425

Across 109 of 109 payment localities, the office rate for 64425 runs from $107.44 in Arkansas to $160.76 in San Benito County, CA. Washington, DC area pays $138.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

64425 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$138.18
  2. Los Angeles, CA · California$136.83−$1.35
  3. Miami, FL · Florida$129.00−$9.18
  4. Chicago, IL · Illinois$125.46−$12.72
  5. Manhattan, NY · New York$138.57+$0.39
  6. Alaska · Alaska$141.46+$3.28
  7. Alabama · Alabama$108.96−$29.22

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

64425 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$107.44$46.33
ArizonaArizona$117.84$48.90
Bakersfield, CACalifornia$128.53$50.56
Chico, CACalifornia$128.25$50.28
El Centro, CACalifornia$128.26$50.29
Fresno, CACalifornia$128.25$50.28
Hanford, CACalifornia$128.25$50.28
Madera, CACalifornia$128.25$50.28

64425 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.

$107.44

$144.51

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

View every state and territory as a table
64425 office rate range by state
State / territoryOffice rate rangeLocalities
AK$141.461
AL$108.961
AR$107.441
AZ$117.841
CA$128.25–$160.7629
CO$126.101
CT$128.761
DC$138.181
DE$119.751
FL$118.68–$129.003
GA$112.29–$122.982
GU$131.311
HI$131.311
IA$111.861
ID$112.511
IL$115.19–$125.764
IN$113.151
KS$111.241
KY$111.201
LA$110.99–$116.292
MA$125.34–$138.452
MD$122.01–$138.183
ME$112.96–$119.042
MI$113.89–$119.992
MN$121.261
MO$109.08–$116.833
MS$108.291
MT$120.911
NC$114.121
ND$119.131
NE$112.481
NH$124.031
NJ$130.35–$136.812
NM$114.451
NV$120.491
NY$115.76–$141.685
OH$113.531
OK$111.131
OR$119.68–$130.122
PA$113.76–$125.572
PR$121.801
RI$124.021
SC$113.991
SD$118.921
TN$111.771
TX$113.03–$125.578
UT$115.491
VA$118.58–$138.182
VI$121.801
VT$118.571
WA$125.13–$141.332
WI$115.251
WV$111.051
WY$120.131

See 64425 in every payment locality

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.

How the rate is built · 64425

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.98

0.98 RVUs× 1.000 GPCI

Practice expense2.55

2.55 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

3.6200

Conversion factor

$33.4009

Medicare rate

$120.91

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,105

Code
64425
Physician work
0.98
Practice expense
2.55
Malpractice
0.09

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 64425 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0541.0329
Practice expense2.55× 1.1783.0039
Malpractice0.09× 1.1130.1002
Total RVUs4.1370
Conversion factor× 33.4009

Office rate, Washington, DC area$138.18

Office: (0.98 × 1.054 + 2.55 × 1.178 + 0.09 × 1.113) × $33.4009 = $138.18

Facility: (0.98 × 1.054 + 0.42 × 1.178 + 0.09 × 1.113) × $33.4009 = $54.37

Open 64425 in the RVU calculator

Payment rules and modifiers for 64425

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

CMS payment indicators · 64425

Nerve block, ilioinguinal and iliohypogastric

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

64425 without 50 · national office

$120.91

Nerve block, ilioinguinal and iliohypogastric

64425-50 · Bilateral: 150%

$181.37

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 64425

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

Codes related to 64425
CodeHow it relatesOffice range, Washington, DC area
Used instead
64450Nerve block, other peripheral nerve or branchFor an injected peripheral nerve or branch without a more specific code for the documented target.$92.04
64430Nerve block, pudendal nerveTargets the pudendal nerve, a different nerve associated with perineal rather than ilioinguinal distribution.$108.63
64420Intercostal block, single nerveTargets an intercostal nerve rather than the ilioinguinal or iliohypogastric nerves.$120.18

How 64425 has changed in Washington, DC area

64425 · Office / nonfacility

$138.18

Effective 2026-10-01

The base rate is $16.16 higher than on 2025-10-01, moving from $122.02 to $138.18 (13.2%).

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

    $122.02changed to$138.18

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.00 changed to 0.98
    • Practice expense RVU 2.18 changed to 2.55
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $127.16changed to$122.02

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.22 changed to 2.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $125.08changed to$127.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $130.87changed to$125.08

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.21 changed to 2.22
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $136.34changed to$130.87

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.23 changed to 2.21
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $139.64changed to$136.34

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.27 changed to 2.23
    • Malpractice RVU 0.11 changed to 0.10

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $134.58changed to$139.64

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.08 changed to 2.27
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $160.92changed to$134.58

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.75 changed to 1.00
    • Practice expense RVU 2.01 changed to 2.08
    • Malpractice RVU 0.17 changed to 0.11
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $155.97changed to$160.92

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.90 changed to 2.01

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $152.28changed to$155.97

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.82 changed to 1.90
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $153.06changed to$152.28

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.83 changed to 1.82
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $152.72changed to$153.06

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.82 changed to 1.83
    • Malpractice RVU 0.17 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $151.96changed to$152.72

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $153.69changed to$151.96

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.85 changed to 1.82
    • Malpractice RVU 0.19 changed to 0.17
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $156.56changed to$153.69

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.12 changed to 1.85
    • Malpractice RVU 0.20 changed to 0.19
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $156.56

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$138.18$54.37RVU26D
2026-07-01$138.18$54.37RVU26C
2026-04-01$138.18$54.37RVU26B
2026-01-01$138.18$54.37RVU26A
2025-10-01$122.02$58.40RVU25D
2025-07-01$122.02$58.40RVU25C
2025-04-01$122.02$58.40RVU25B
2025-01-01$122.02$58.40RVU25A
2024-10-01$127.16$59.71RVU24D
2024-07-01$127.16$59.71RVU24C
2024-04-01$127.16$59.71RVU24B
2024-03-09$127.16$59.71RVU24AR
2024-01-01$125.08$58.73RVU24A
2023-10-01$130.87$61.35RVU23D
2023-07-01$130.87$61.35RVU23C
2023-04-01$130.87$61.35RVU23B
2023-01-01$130.87$61.35RVU23A
2022-10-01$136.34$62.77RVU22D
2022-07-01$136.34$62.77RVU22C
2022-04-01$136.34$62.77RVU22B
2022-01-01$136.34$62.77RVU22A
2021-10-01$139.64$63.74RVU21D
2021-07-01$139.64$63.74RVU21C
2021-04-01$139.64$63.74RVU21B
2021-01-01$139.64$63.74RVU21A
2020-10-01$134.58$64.52RVU20D
2020-07-01$134.58$64.52RVU20C
2020-04-01$134.58$64.52RVU20B
2020-01-01$134.58$64.52RVU20A
2019-10-01$160.92$108.37RVU19D
2019-07-01$160.92$108.37RVU19C
2019-04-01$160.92$108.37RVU19B
2019-01-01$160.92$108.37RVU19A
2018-10-01$155.97$106.95RVU18D
2018-07-01$155.97$106.95RVU18C
2018-04-01$155.97$106.95RVU18B
2018-01-01$155.97$106.95RVU18AR1
2017-10-01$152.28$106.44RVU17D
2017-07-01$152.28$106.44RVU17C
2017-04-01$152.28$106.44RVU17B
2017-01-01$152.28$106.44RVU17A
2016-10-01$153.06$106.46RVU16D
2016-07-01$153.06$106.46RVU16C
2016-04-01$153.06$106.46RVU16B
2016-01-01$153.06$106.46RVU16A
2015-10-01$152.72$106.38RVU15D
2015-07-01$152.72$106.38RVU15C
2015-04-01$151.96$105.86RVU15B
2015-01-01$151.96$105.86RVU15A
2014-10-01$153.69$107.61RVU14D
2014-07-01$153.69$107.61RVU14C
2014-04-01$153.69$107.61RVU14B
2014-01-01$153.69$107.61RVU14A
2013-10-01$156.56$106.02RVU13D
2013-07-01$156.56$106.02RVU13C
2013-04-01$156.56$106.02RVU13B
2013-01-01$156.56$106.02RVU13AR

Price 64425 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

64425 billing questions

When should this code be selected instead of 64450?

Use this code when the documented target is the ilioinguinal and/or iliohypogastric nerves. Code 64450 describes an injection for another peripheral nerve or branch not identified by a more specific code.

Can both nerves be addressed under this code?

The code identifies the ilioinguinal and iliohypogastric nerve targets. Document which nerve or nerves were injected and the side treated.

How is a bilateral injection reported?

For bilateral service, modifier 50 is paid at 150%. The documentation should support treatment on both sides.

Is same-day evaluation or postoperative care included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

How does CMS handle another procedure performed in the same session?

The highest-valued procedure is paid in full, and other procedures in the session are paid at 50% under the standard multiple procedure reduction.

What documentation supports reporting this nerve block?

Record the clinical indication, the ilioinguinal and/or iliohypogastric target, the side, the medication injected, and the response when relevant.

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 64425PPRRVU2026_Oct_nonQPP.csv, line 7,105 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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