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

Reports a single-injection anesthetic or steroid block of the sciatic nerve, commonly used for perioperative anesthesia or pain relief.

CMS RVU26DEffective Oct 1, 2026One payment locality106.9K Medicare services in 2024

In Iowa, Medicare pays $159.88 for 64445 in the office and $61.78 when it’s performed in a hospital or facility.

$159.88Office (non-facility)
$61.78Hospital or facility
−7.8%vs the national office rate ($173.35)

Check a contract rate as a % of Medicare · 64445 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 64445 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 64445 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 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.

How Iowa compares for 64445

Across 109 of 109 payment localities, the office rate for 64445 runs from $153.59 in Arkansas to $230.35 in San Benito County, CA. Iowa pays $159.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

64445 in Iowa vs other payment areas
  1. Iowa · this page$159.88
  2. Los Angeles, CA · California$196.02+$36.14
  3. Washington, DC area · District of Columbia$198.25+$38.37
  4. Miami, FL · Florida$186.05+$26.17
  5. Chicago, IL · Illinois$180.77+$20.89
  6. Manhattan, NY · New York$199.11+$39.23
  7. Alaska · Alaska$201.80+$41.92

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

Every other payment area

64445 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$155.81$62.00
ArkansasArkansas$153.59$61.49
ArizonaArizona$168.82$64.93
Bakersfield, CACalifornia$184.05$66.54
Chico, CACalifornia$183.60$66.09
El Centro, CACalifornia$183.62$66.11
Fresno, CACalifornia$183.60$66.09
Hanford, CACalifornia$183.60$66.09

64445 rates by state

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

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.

$153.59

$206.98

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

View every state and territory as a table
64445 office rate range by state
State / territoryOffice rate rangeLocalities
AK$201.801
AL$155.811
AR$153.591
AZ$168.821
CA$183.60–$230.3529
CO$180.671
CT$184.781
DC$198.251
DE$171.601
FL$170.46–$186.053
GA$161.04–$176.462
GU$188.081
HI$188.081
IA$159.881
ID$160.881
IL$165.48–$180.864
IN$161.801
KS$159.071
KY$159.281
LA$159.00–$166.782
MA$179.57–$198.512
MD$174.87–$198.253
ME$161.62–$170.402
MI$163.30–$172.492
MN$173.391
MO$156.26–$167.463
MS$154.961
MT$173.341
NC$163.311
ND$170.371
NE$160.771
NH$177.761
NJ$186.96–$196.222
NM$164.161
NV$172.641
NY$165.72–$203.785
OH$162.701
OK$159.081
OR$171.37–$186.442
PA$163.00–$180.172
PR$174.631
RI$177.731
SC$163.261
SD$170.021
TN$159.851
TX$161.93–$180.008
UT$165.461
VA$169.79–$198.252
VI$174.631
VT$169.651
WA$179.26–$202.612
WI$164.721
WV$159.411
WY$172.051

See 64445 in every payment locality

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.

How the rate is built · 64445

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.36

1.36 RVUs× 1.000 GPCI

Practice expense3.68

3.68 RVUs× 1.000 GPCI

Malpractice0.15

0.15 RVUs× 1.000 GPCI

Adjusted RVUs

5.1900

Conversion factor

$33.4009

Medicare rate

$173.35

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,108

Code
64445
Physician work
1.36
Practice expense
3.68
Malpractice
0.15

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 64445 in Iowa
ComponentRVULocality factorAdjusted
Physician work1.36× 1.0001.3600
Practice expense3.68× 0.9153.3672
Malpractice0.15× 0.3970.0595
Total RVUs4.7868
Conversion factor× 33.4009

Office rate, Iowa$159.88

Office: (1.36 × 1 + 3.68 × 0.915 + 0.15 × 0.397) × $33.4009 = $159.88

Facility: (1.36 × 1 + 0.47 × 0.915 + 0.15 × 0.397) × $33.4009 = $61.78

Open 64445 in the RVU calculator

Payment rules and modifiers for 64445

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

CMS payment indicators · 64445

Sciatic nerve block, single injection

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

64445 without 50 · national office

$173.35

Sciatic nerve block, single injection

64445-50 · Bilateral: 150%

$260.03

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

How 64445 has changed in Iowa

64445 · Office / nonfacility

$159.88

Effective 2026-10-01

The base rate is $20.12 higher than on 2025-10-01, moving from $139.76 to $159.88 (14.4%).

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

    $139.76changed to$159.88

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.39 changed to 1.36
    • Practice expense RVU 3.13 changed to 3.68
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $146.56changed to$139.76

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.23 changed to 3.13
    • Malpractice RVU 0.14 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $144.17changed to$146.56

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $150.17changed to$144.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.26 changed to 3.23
    • Malpractice RVU 0.17 changed to 0.14
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457
  5. January 1, 2023

    RVU23A

    $119.57changed to$150.17

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.00 changed to 1.39
    • Practice expense RVU 2.66 changed to 3.26
    • Malpractice RVU 0.10 changed to 0.17
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $121.19changed to$119.57

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.68 changed to 2.66

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $118.65changed to$121.19

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.48 changed to 2.68
    • Malpractice RVU 0.09 changed to 0.10
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $129.50changed to$118.65

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.48 changed to 1.00
    • Practice expense RVU 2.26 changed to 2.48
    • Malpractice RVU 0.15 changed to 0.09
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $130.01changed to$129.50

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.28 changed to 2.26

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $127.12changed to$130.01

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.21 changed to 2.28
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $127.35changed to$127.12

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.23 changed to 2.21
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $126.85changed to$127.35

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.20 changed to 2.23

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $126.22changed to$126.85

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $125.55changed to$126.22

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.19 changed to 2.20
    • Malpractice RVU 0.15 changed to 0.16
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $126.77changed to$125.55

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.45 changed to 2.19
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $126.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$159.88$61.78RVU26D
2026-07-01$159.88$61.78RVU26C
2026-04-01$159.88$61.78RVU26B
2026-01-01$159.88$61.78RVU26A
2025-10-01$139.76$65.34RVU25D
2025-07-01$139.76$65.34RVU25C
2025-04-01$139.76$65.34RVU25B
2025-01-01$139.76$65.34RVU25A
2024-10-01$146.56$66.94RVU24D
2024-07-01$146.56$66.94RVU24C
2024-04-01$146.56$66.94RVU24B
2024-03-09$146.56$66.94RVU24AR
2024-01-01$144.17$65.85RVU24A
2023-10-01$150.17$68.45RVU23D
2023-07-01$150.17$68.45RVU23C
2023-04-01$150.17$68.45RVU23B
2023-01-01$150.17$68.45RVU23A
2022-10-01$119.57$50.83RVU22D
2022-07-01$119.57$50.83RVU22C
2022-04-01$119.57$50.83RVU22B
2022-01-01$119.57$50.83RVU22A
2021-10-01$121.19$51.25RVU21D
2021-07-01$121.19$51.25RVU21C
2021-04-01$121.19$51.25RVU21B
2021-01-01$121.19$51.25RVU21A
2020-10-01$118.65$52.52RVU20D
2020-07-01$118.65$52.52RVU20C
2020-04-01$118.65$52.52RVU20B
2020-01-01$118.65$52.52RVU20A
2019-10-01$129.50$70.66RVU19D
2019-07-01$129.50$70.66RVU19C
2019-04-01$129.50$70.66RVU19B
2019-01-01$129.50$70.66RVU19A
2018-10-01$130.01$70.58RVU18D
2018-07-01$130.01$70.58RVU18C
2018-04-01$130.01$70.58RVU18B
2018-01-01$130.01$70.58RVU18AR1
2017-10-01$127.12$69.82RVU17D
2017-07-01$127.12$69.82RVU17C
2017-04-01$127.12$69.82RVU17B
2017-01-01$127.12$69.82RVU17A
2016-10-01$127.35$69.93RVU16D
2016-07-01$127.35$69.93RVU16C
2016-04-01$127.35$69.93RVU16B
2016-01-01$127.35$69.93RVU16A
2015-10-01$126.85$69.86RVU15D
2015-07-01$126.85$69.86RVU15C
2015-04-01$126.22$69.51RVU15B
2015-01-01$126.22$69.51RVU15A
2014-10-01$125.55$69.63RVU14D
2014-07-01$125.55$69.63RVU14C
2014-04-01$125.55$69.63RVU14B
2014-01-01$125.55$69.63RVU14A
2013-10-01$126.77$67.32RVU13D
2013-07-01$126.77$67.32RVU13C
2013-04-01$126.77$67.32RVU13B
2013-01-01$126.77$67.32RVU13AR

Price 64445 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

64445 billing questions

How does 64445 differ from 64446?

64445 is for a single-injection sciatic nerve block. Use 64446 when the sciatic nerve is treated with a continuous-infusion catheter.

Is imaging guidance separately reportable?

Imaging guidance, when performed for this block, is included in 64445. Do not separately report guidance for the same block.

How is a bilateral block reported?

CMS identifies 64445 as a bilateral procedure; modifier 50 is paid at 150%. Document the block on each side.

What happens when 64445 is performed with another procedure?

When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 64445. Co-surgeons and team surgery 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 64445PPRRVU2026_Oct_nonQPP.csv, line 7,108 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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