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CPT code 64430: Nerve block, pudendal nerve2026 Medicare rate & RVUs in Virginia

Reports injection of anesthetic, with or without steroid, around the pudendal nerve for pelvic or perineal pain or procedural anesthesia.

CMS RVU26DEffective Oct 1, 2026One payment locality3.9K Medicare services in 2024

In Virginia, Medicare pays $93.77 for 64430 in the office and $47.48 when it’s performed in a hospital or facility.

$93.77Office (non-facility)
$47.48Hospital or facility
−2.2%vs the national office rate ($95.86)

Check a contract rate as a % of Medicare · 64430 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 64430 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 64430 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 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.

How Virginia compares for 64430

Across 109 of 109 payment localities, the office rate for 64430 runs from $85.70 in Arkansas to $124.03 in San Benito County, CA. Virginia pays $93.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

64430 in Virginia vs other payment areas
  1. Virginia · this page$93.77
  2. Los Angeles, CA · California$106.85+$13.08
  3. Washington, DC area · District of Columbia$108.63+$14.86
  4. Miami, FL · Florida$103.92+$10.15
  5. Chicago, IL · Illinois$101.14+$7.37
  6. Manhattan, NY · New York$109.74+$15.97
  7. Alaska · Alaska$114.44+$20.67

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

Every other payment area

64430 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$86.83$45.63
ArkansasArkansas$85.70$45.24
ArizonaArizona$93.49$47.85
Bakersfield, CACalifornia$100.75$49.14
Chico, CACalifornia$100.42$48.80
El Centro, CACalifornia$100.44$48.82
Fresno, CACalifornia$100.42$48.80
Hanford, CACalifornia$100.42$48.80

64430 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.

$85.70

$114.44

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

View every state and territory as a table
64430 office rate range by state
State / territoryOffice rate rangeLocalities
AK$114.441
AL$86.831
AR$85.701
AZ$93.491
CA$100.42–$124.0329
CO$99.251
CT$101.861
DC$108.631
DE$94.941
FL$95.09–$103.923
GA$90.15–$97.652
GU$102.461
HI$102.461
IA$88.591
ID$89.171
IL$92.76–$101.144
IN$89.631
KS$88.331
KY$88.951
LA$88.87–$92.852
MA$98.79–$108.332
MD$96.60–$108.633
ME$89.72–$93.972
MI$91.16–$96.302
MN$95.001
MO$87.56–$93.013
MS$86.641
MT$95.851
NC$90.551
ND$93.681
NE$89.001
NH$97.841
NJ$103.00–$107.692
NM$91.661
NV$95.311
NY$91.80–$112.345
OH$90.721
OK$88.681
OR$94.53–$102.042
PA$90.78–$99.602
PR$96.461
RI$98.051
SC$90.791
SD$93.421
TN$88.751
TX$90.25–$98.968
UT$91.921
VA$93.77–$108.632
VI$96.461
VT$93.451
WA$98.56–$110.322
WI$90.821
WV$89.661
WY$94.911

See 64430 in every payment locality

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

Office or facility?

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.

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,106

Code
64430
Physician work
0.98
Practice expense
1.78
Malpractice
0.11

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 64430 in Virginia
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense1.78× 0.9831.7497
Malpractice0.11× 0.7060.0777
Total RVUs2.8074
Conversion factor× 33.4009

Office rate, Virginia$93.77

Office: (0.98 × 1 + 1.78 × 0.983 + 0.11 × 0.706) × $33.4009 = $93.77

Facility: (0.98 × 1 + 0.37 × 0.983 + 0.11 × 0.706) × $33.4009 = $47.48

Open 64430 in the RVU calculator

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

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

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).

When to use modifier 50

Codes related to 64430

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

Codes related to 64430
CodeHow it relatesOffice range, Virginia
Same family
64425Nerve block, ilioinguinal and iliohypogastricNamed-nerve injection code for ilioinguinal or iliohypogastric nerves, rather than the pudendal nerve.$118.58
64435Nerve block, paracervical (uterine)Named-nerve injection code for the paracervical nerve, a different pelvic target.$73.09
Used instead
64450Nerve block, other peripheral nerve or branchFor an unspecified peripheral nerve or branch when the documented target is not a specifically named nerve.$79.22

How 64430 has changed in Virginia

64430 · Office / nonfacility

$93.77

Effective 2026-10-01

The base rate is $0.89 higher than on 2025-10-01, moving from $92.88 to $93.77 (1.0%).

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

    $92.88changed to$93.77

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.00 changed to 0.98
    • Practice expense RVU 1.80 changed to 1.78
    • Malpractice RVU 0.13 changed to 0.11
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $96.31changed to$92.88

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.83 changed to 1.80
    • Malpractice RVU 0.12 changed to 0.13

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $94.74changed to$96.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $98.64changed to$94.74

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $101.03changed to$98.64

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $99.03changed to$101.03

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.73 changed to 1.83
    • Malpractice RVU 0.13 changed to 0.11

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $91.89changed to$99.03

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.46 changed to 1.73
    • Malpractice RVU 0.11 changed to 0.13
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $147.46changed to$91.89

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.46 changed to 1.00
    • Practice expense RVU 2.54 changed to 1.46
    • Malpractice RVU 0.14 changed to 0.11
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $139.13changed to$147.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.31 changed to 2.54

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $138.05changed to$139.13

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.30 changed to 2.31
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $138.71changed to$138.05

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.33 changed to 2.30
    • Malpractice RVU 0.15 changed to 0.14
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $140.56changed to$138.71

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.36 changed to 2.33
    • Malpractice RVU 0.16 changed to 0.15

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $139.86changed to$140.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $137.02changed to$139.86

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.31 changed to 2.36
    • Malpractice RVU 0.13 changed to 0.16
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $136.59changed to$137.02

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.51 changed to 2.31
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $136.59

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$93.77$47.48RVU26D
2026-07-01$93.77$47.48RVU26C
2026-04-01$93.77$47.48RVU26B
2026-01-01$93.77$47.48RVU26A
2025-10-01$92.88$52.14RVU25D
2025-07-01$92.88$52.14RVU25C
2025-04-01$92.88$52.14RVU25B
2025-01-01$92.88$52.14RVU25A
2024-10-01$96.31$53.07RVU24D
2024-07-01$96.31$53.07RVU24C
2024-04-01$96.31$53.07RVU24B
2024-03-09$96.31$53.07RVU24AR
2024-01-01$94.74$52.21RVU24A
2023-10-01$98.64$54.02RVU23D
2023-07-01$98.64$54.02RVU23C
2023-04-01$98.64$54.02RVU23B
2023-01-01$98.64$54.02RVU23A
2022-10-01$101.03$54.55RVU22D
2022-07-01$101.03$54.55RVU22C
2022-04-01$101.03$54.55RVU22B
2022-01-01$101.03$54.55RVU22A
2021-10-01$99.03$55.63RVU21D
2021-07-01$99.03$55.63RVU21C
2021-04-01$99.03$55.63RVU21B
2021-01-01$99.03$55.63RVU21A
2020-10-01$91.89$56.84RVU20D
2020-07-01$91.89$56.84RVU20C
2020-04-01$91.89$56.84RVU20B
2020-01-01$91.89$56.84RVU20A
2019-10-01$147.46$82.07RVU19D
2019-07-01$147.46$82.07RVU19C
2019-04-01$147.46$82.07RVU19B
2019-01-01$147.46$82.07RVU19A
2018-10-01$139.13$82.34RVU18D
2018-07-01$139.13$82.34RVU18C
2018-04-01$139.13$82.34RVU18B
2018-01-01$139.13$82.34RVU18AR1
2017-10-01$138.05$82.55RVU17D
2017-07-01$138.05$82.55RVU17C
2017-04-01$138.05$82.55RVU17B
2017-01-01$138.05$82.55RVU17A
2016-10-01$138.71$83.10RVU16D
2016-07-01$138.71$83.10RVU16C
2016-04-01$138.71$83.10RVU16B
2016-01-01$138.71$83.10RVU16A
2015-10-01$140.56$84.40RVU15D
2015-07-01$140.56$84.40RVU15C
2015-04-01$139.86$83.98RVU15B
2015-01-01$139.86$83.98RVU15A
2014-10-01$137.02$82.61RVU14D
2014-07-01$137.02$82.61RVU14C
2014-04-01$137.02$82.61RVU14B
2014-01-01$137.02$82.61RVU14A
2013-10-01$136.59$80.08RVU13D
2013-07-01$136.59$80.08RVU13C
2013-04-01$136.59$80.08RVU13B
2013-01-01$136.59$80.08RVU13AR

Price 64430 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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
RVUs for 64430PPRRVU2026_Oct_nonQPP.csv, line 7,106 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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