CPT code 64445: Sciatic nerve block, single injection2026 Medicare rate & RVUs

Medicare pays $173.35 for 64445 nationally in the office and $66.13 in a hospital or facility. Local office rates run $153.59–$230.35.

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

What 64445 covers

This service is a single-injection block targeting the sciatic nerve, using an anesthetic agent and/or steroid. Anesthesiologists and pain physicians commonly perform it for perioperative anesthesia or postoperative pain relief, including for procedures involving the lower extremity. It may be performed in a facility or office setting. Image guidance, when used, is included in the service.

Select this code for a single injection at the sciatic nerve; use the continuous-infusion catheter code when that is the service performed. Document the indication, nerve targeted, laterality, medication, technique, and whether a catheter was placed. 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 other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 64445 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

64445 rates by state

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

How the 64445 rate is calculated

Each of 64445’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 64445

The CMS indicators that decide how 64445 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

64445 compared with similar codes

How to choose

64446Sciatic nerve blockContinuous catheter infusion

Choose 64445 for a single-injection sciatic block. Choose 64446 when a catheter provides continuous infusion at the sciatic nerve.

64447Femoral nerve blockSingle injection

64445 targets the sciatic nerve; 64447 targets the femoral nerve. Select the code for the nerve actually blocked.

64448Femoral nerve blockContinuous catheter infusion

64448 describes a continuous-infusion catheter block of the femoral nerve. It is not the code for a single-injection sciatic block.

Codes related to 64445

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