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CPT code 64445: Sciatic nerve block, single injection2026 Medicare rate & RVUs in King County, WA

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 King County, WA, Medicare pays $202.61 for 64445 in the office and $71.05 when it’s performed in a hospital or facility.

$202.61Office (non-facility)
$71.05Hospital or facility
+16.9%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 King County, WA
  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 King County, WA 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. King County, WA pays $202.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

64445 in King County, WA vs other payment areas
  1. King County, WA · this page$202.61
  2. Rest of Washington · Washington$179.26−$23.35
  3. Los Angeles, CA · California$196.02−$6.59
  4. Washington, DC area · District of Columbia$198.25−$4.36
  5. Miami, FL · Florida$186.05−$16.56
  6. Chicago, IL · Illinois$180.77−$21.84
  7. Manhattan, NY · New York$199.11−$3.50

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

Every other payment area

64445 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$201.80$87.62
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

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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 64445 in King County, WA
ComponentRVULocality factorAdjusted
Physician work1.36× 1.0501.4280
Practice expense3.68× 1.2274.5154
Malpractice0.15× 0.8170.1225
Total RVUs6.0659
Conversion factor× 33.4009

Office rate, King County, WA$202.61

Office: (1.36 × 1.05 + 3.68 × 1.227 + 0.15 × 0.817) × $33.4009 = $202.61

Facility: (1.36 × 1.05 + 0.47 × 1.227 + 0.15 × 0.817) × $33.4009 = $71.05

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, King County, WA
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.$155.36
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 King County, WA

64445 · Office / nonfacility

$202.61

Effective 2026-10-01

The base rate is $27.78 higher than on 2025-10-01, moving from $174.83 to $202.61 (15.9%).

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

    $174.83changed to$202.61

    • 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
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $183.41changed to$174.83

    • 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

    $180.41changed to$183.41

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $186.98changed to$180.41

    • 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
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $148.45changed to$186.98

    • 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
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $150.51changed to$148.45

    • 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

    $144.70changed to$150.51

    • 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
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $153.15changed to$144.70

    • 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
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $153.81changed to$153.15

    • 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

    $149.63changed to$153.81

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.21 changed to 2.28
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $149.37changed to$149.63

    • 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
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $148.66changed to$149.37

    • 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

    $147.92changed to$148.66

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $148.26changed to$147.92

    • 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 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $151.77changed to$148.26

    • 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 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $151.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$202.61$71.05RVU26D
2026-07-01$202.61$71.05RVU26C
2026-04-01$202.61$71.05RVU26B
2026-01-01$202.61$71.05RVU26A
2025-10-01$174.83$75.38RVU25D
2025-07-01$174.83$75.38RVU25C
2025-04-01$174.83$75.38RVU25B
2025-01-01$174.83$75.38RVU25A
2024-10-01$183.41$77.01RVU24D
2024-07-01$183.41$77.01RVU24C
2024-04-01$183.41$77.01RVU24B
2024-03-09$183.41$77.01RVU24AR
2024-01-01$180.41$75.75RVU24A
2023-10-01$186.98$78.59RVU23D
2023-07-01$186.98$78.59RVU23C
2023-04-01$186.98$78.59RVU23B
2023-01-01$186.98$78.59RVU23A
2022-10-01$148.45$57.96RVU22D
2022-07-01$148.45$57.96RVU22C
2022-04-01$148.45$57.96RVU22B
2022-01-01$148.45$57.96RVU22A
2021-10-01$150.51$58.44RVU21D
2021-07-01$150.51$58.44RVU21C
2021-04-01$150.51$58.44RVU21B
2021-01-01$150.51$58.44RVU21A
2020-10-01$144.70$59.41RVU20D
2020-07-01$144.70$59.41RVU20C
2020-04-01$144.70$59.41RVU20B
2020-01-01$144.70$59.41RVU20A
2019-10-01$153.15$78.81RVU19D
2019-07-01$153.15$78.81RVU19C
2019-04-01$153.15$78.81RVU19B
2019-01-01$153.15$78.81RVU19A
2018-10-01$153.81$78.72RVU18D
2018-07-01$153.81$78.72RVU18C
2018-04-01$153.81$78.72RVU18B
2018-01-01$153.81$78.72RVU18AR1
2017-10-01$149.63$76.51RVU17D
2017-07-01$149.63$76.51RVU17C
2017-04-01$149.63$76.51RVU17B
2017-01-01$149.63$76.51RVU17A
2016-10-01$149.37$75.35RVU16D
2016-07-01$149.37$75.35RVU16C
2016-04-01$149.37$75.35RVU16B
2016-01-01$149.37$75.35RVU16A
2015-10-01$148.66$75.20RVU15D
2015-07-01$148.66$75.20RVU15C
2015-04-01$147.92$74.83RVU15B
2015-01-01$147.92$74.83RVU15A
2014-10-01$148.26$76.17RVU14D
2014-07-01$148.26$76.17RVU14C
2014-04-01$148.26$76.17RVU14B
2014-01-01$148.26$76.17RVU14A
2013-10-01$151.77$75.09RVU13D
2013-07-01$151.77$75.09RVU13C
2013-04-01$151.77$75.09RVU13B
2013-01-01$151.77$75.09RVU13AR

Price 64445 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 64445 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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