CPT code 64430: Nerve block, pudendal nerve2026 Medicare rate & RVUs
Reports injection of anesthetic, with or without steroid, around the pudendal nerve for pelvic or perineal pain or procedural anesthesia.
Medicare pays $95.86 for 64430 nationally in the office and $48.77 in a hospital or facility. Local office rates run $85.70–$124.03.
Medicare rate · 64430
Nerve block, pudendal nerve
- Work RVUs
- 0.98
- Total RVUs
- 2.87
- Global days
- 000
National rate · 2026
$95.86
Office setting, before claim adjustments.
See every locality for 64430 →Billed by an NP, PA or therapist? →
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 10 sections
What 64430 covers
A clinician places medication near the pudendal nerve to interrupt sensation in the perineum and nearby pelvic structures. Pain medicine physicians and anesthesiologists may use the block to evaluate or treat suspected pudendal neuralgia or other pelvic pain; gynecologists and obstetric clinicians may use it for perineal or procedural anesthesia. The injection may be performed in an office, procedure suite, or hospital, using an approach suited to the patient and clinical target.
Report the code for the pudendal nerve injection whether the goal is diagnostic or therapeutic. The record should identify the indication, nerve targeted, side or sides, approach, and medications injected. CMS assigns 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 are performed in one session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is restricted; 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.
Where 64430 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$85.70 to $124.03
109 of 109 payment localities
64430 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$85.70
$114.44
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $114.44 | 1 |
| AL | $86.83 | 1 |
| AR | $85.70 | 1 |
| AZ | $93.49 | 1 |
| CA | $100.42–$124.03 | 29 |
| CO | $99.25 | 1 |
| CT | $101.86 | 1 |
| DC | $108.63 | 1 |
| DE | $94.94 | 1 |
| FL | $95.09–$103.92 | 3 |
| GA | $90.15–$97.65 | 2 |
| GU | $102.46 | 1 |
| HI | $102.46 | 1 |
| IA | $88.59 | 1 |
| ID | $89.17 | 1 |
| IL | $92.76–$101.14 | 4 |
| IN | $89.63 | 1 |
| KS | $88.33 | 1 |
| KY | $88.95 | 1 |
| LA | $88.87–$92.85 | 2 |
| MA | $98.79–$108.33 | 2 |
| MD | $96.60–$108.63 | 3 |
| ME | $89.72–$93.97 | 2 |
| MI | $91.16–$96.30 | 2 |
| MN | $95.00 | 1 |
| MO | $87.56–$93.01 | 3 |
| MS | $86.64 | 1 |
| MT | $95.85 | 1 |
| NC | $90.55 | 1 |
| ND | $93.68 | 1 |
| NE | $89.00 | 1 |
| NH | $97.84 | 1 |
| NJ | $103.00–$107.69 | 2 |
| NM | $91.66 | 1 |
| NV | $95.31 | 1 |
| NY | $91.80–$112.34 | 5 |
| OH | $90.72 | 1 |
| OK | $88.68 | 1 |
| OR | $94.53–$102.04 | 2 |
| PA | $90.78–$99.60 | 2 |
| PR | $96.46 | 1 |
| RI | $98.05 | 1 |
| SC | $90.79 | 1 |
| SD | $93.42 | 1 |
| TN | $88.75 | 1 |
| TX | $90.25–$98.96 | 8 |
| UT | $91.92 | 1 |
| VA | $93.77–$108.63 | 2 |
| VI | $96.46 | 1 |
| VT | $93.45 | 1 |
| WA | $98.56–$110.32 | 2 |
| WI | $90.82 | 1 |
| WV | $89.66 | 1 |
| WY | $94.91 | 1 |
How the 64430 rate is calculated
Each of 64430’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 · 64430
RVUs × geographic indexes × conversion factor
Work0.98
0.98 RVUs× 1.000 GPCI
Practice expense1.78
1.78 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
2.8700
Conversion factor
$33.4009
Medicare rate
$95.86
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64430
The CMS indicators that decide how 64430 is paid alongside other services.
CMS payment indicators · 64430
Nerve block, pudendal nerve
| 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
64430 without 50 · national office
$95.86
Nerve block, pudendal nerve
64430-50 · Bilateral: 150%
$143.79
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).
64430 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64425Nerve blockIlioinguinal and iliohypogastric
- This code targets the ilioinguinal or iliohypogastric nerves. Use 64430 when the injected target is the pudendal nerve.
- 64435Nerve blockParacervical (uterine)
- This code targets the paracervical nerve. A block directed to the pudendal nerve is reported with 64430.
- 64450Nerve blockOther peripheral nerve or branch
- This code is for an unspecified peripheral nerve or branch. 64430 identifies the pudendal nerve as the target.
64430 billing questions
When should 64430 be chosen instead of 64450?
Use 64430 when the pudendal nerve is the documented target. Code 64450 is for an otherwise unspecified peripheral nerve or branch, not a substitute for a named pudendal nerve block.
Does the code depend on whether the block is diagnostic or therapeutic?
No. The code describes injection at the pudendal nerve; document whether the purpose is diagnostic, pain relief, or anesthesia.
How is a bilateral pudendal nerve block reported?
CMS identifies this as a bilateral procedure: report modifier 50 for bilateral treatment. Its Medicare payment is 150%.
Can another procedure be reported in the same session?
A distinct procedure may be reported when separately performed and supported by the record. Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
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
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