CPT code 64425: Nerve block, ilioinguinal and iliohypogastric2026 Medicare rate & RVUs in Missouri
Reports an anesthetic injection targeting the ilioinguinal and/or iliohypogastric nerves for diagnostic evaluation or relief of groin or lower abdominal wall pain.
Medicare pays $109.08–$116.83 for 64425 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
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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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$109.08 to $116.83
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $115.65 | $48.84 |
| Metropolitan St. Louis, MO | $116.83 | $49.10 |
| Rest of Missouri | $109.08 | $47.75 |
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
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.
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
| 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
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).
64425 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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