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

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 Puerto Rico, Medicare pays $174.63 for 64445 in the office and $66.23 when it’s performed in a hospital or facility.

$174.63Office (non-facility)
$66.23Hospital or facility
+0.7%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $174.63. The RVUs are the same everywhere; the geographic indexes change the dollars.

64445 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$174.63
  2. Los Angeles, CA · California$196.02+$21.39
  3. Washington, DC area · District of Columbia$198.25+$23.62
  4. Miami, FL · Florida$186.05+$11.42
  5. Chicago, IL · Illinois$180.77+$6.14
  6. Manhattan, NY · New York$199.11+$24.48
  7. Alaska · Alaska$201.80+$27.17

Other areas in Puerto Rico 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.

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.

$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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 64445 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.36× 1.0001.3600
Practice expense3.68× 1.0113.7205
Malpractice0.15× 0.9850.1477
Total RVUs5.2282
Conversion factor× 33.4009

Office rate, Puerto Rico$174.63

Office: (1.36 × 1 + 3.68 × 1.011 + 0.15 × 0.985) × $33.4009 = $174.63

Facility: (1.36 × 1 + 0.47 × 1.011 + 0.15 × 0.985) × $33.4009 = $66.23

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

Codes related to 64445

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

Codes related to 64445
CodeHow it relatesOffice range, Puerto Rico
Same family
64446Sciatic nerve block, continuous catheter infusionSciatic nerve block using continuous catheter infusion rather than a single injection.No office rate
Used instead
64447Femoral nerve block, single injectionTargets the femoral nerve instead of the sciatic nerve.$135.16
64448Femoral nerve block, continuous catheter infusionFemoral nerve block using a continuous-infusion catheter.No office rate
64449Lumbar plexus block, anesthetic or steroid injectionTargets the lumbar plexus rather than the sciatic nerve.No office rate

How 64445 has changed in Puerto Rico

64445 · Office / nonfacility

$174.63

Effective 2026-10-01

The base rate is $22.63 higher than on 2025-10-01, moving from $152.00 to $174.63 (14.9%).

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

    $152.00changed to$174.63

    • 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 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $159.12changed to$152.00

    • 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

    $156.52changed to$159.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $164.13changed to$156.52

    • 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 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $163.34changed to$164.13

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $130.81changed to$163.34

    • 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 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $132.60changed to$130.81

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

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $129.52changed to$132.60

    • 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 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $140.71changed to$129.52

    • 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
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $141.28changed to$140.71

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

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $124.46changed to$141.28

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.21 changed to 2.28
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $110.96changed to$124.46

    • 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 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $110.60changed to$110.96

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

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $110.05changed to$110.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $108.76changed to$110.05

    • 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 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $108.23changed to$108.76

    • 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 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $108.23

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$174.63$66.23RVU26D
2026-07-01$174.63$66.23RVU26C
2026-04-01$174.63$66.23RVU26B
2026-01-01$174.63$66.23RVU26A
2025-10-01$152.00$69.91RVU25D
2025-07-01$152.00$69.91RVU25C
2025-04-01$152.00$69.91RVU25B
2025-01-01$152.00$69.91RVU25A
2024-10-01$159.12$71.29RVU24D
2024-07-01$159.12$71.29RVU24C
2024-04-01$159.12$71.29RVU24B
2024-03-09$159.12$71.29RVU24AR
2024-01-01$156.52$70.13RVU24A
2023-10-01$164.13$73.61RVU23D
2023-07-01$163.34$73.54RVU23C
2023-04-01$163.34$73.54RVU23B
2023-01-01$163.34$73.54RVU23A
2022-10-01$130.81$54.41RVU22D
2022-07-01$130.81$54.41RVU22C
2022-04-01$130.81$54.41RVU22B
2022-01-01$130.81$54.41RVU22A
2021-10-01$132.60$54.86RVU21D
2021-07-01$132.60$54.86RVU21C
2021-04-01$132.60$54.86RVU21B
2021-01-01$132.60$54.86RVU21A
2020-10-01$129.52$56.03RVU20D
2020-07-01$129.52$56.03RVU20C
2020-04-01$129.52$56.03RVU20B
2020-01-01$129.52$56.03RVU20A
2019-10-01$140.71$75.38RVU19D
2019-07-01$140.71$75.38RVU19C
2019-04-01$140.71$75.38RVU19B
2019-01-01$140.71$75.38RVU19A
2018-10-01$141.28$75.30RVU18D
2018-07-01$141.28$75.30RVU18C
2018-04-01$141.28$75.30RVU18B
2018-01-01$141.28$75.30RVU18AR1
2017-10-01$124.46$70.09RVU17D
2017-07-01$124.46$70.09RVU17C
2017-04-01$124.46$70.09RVU17B
2017-01-01$124.46$70.09RVU17A
2016-10-01$110.96$65.78RVU16D
2016-07-01$110.96$65.78RVU16C
2016-04-01$110.96$65.78RVU16B
2016-01-01$110.96$65.78RVU16A
2015-10-01$110.60$65.76RVU15D
2015-07-01$110.60$65.76RVU15C
2015-04-01$110.05$65.43RVU15B
2015-01-01$110.05$65.43RVU15A
2014-10-01$108.76$65.38RVU14D
2014-07-01$108.76$65.38RVU14C
2014-04-01$108.76$65.38RVU14B
2014-01-01$108.76$65.38RVU14A
2013-10-01$108.23$62.78RVU13D
2013-07-01$108.23$62.78RVU13C
2013-04-01$108.23$62.78RVU13B
2013-01-01$108.23$62.78RVU13AR

Price 64445 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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