CPT code 64446: Sciatic nerve block, continuous catheter infusion2026 Medicare rate & RVUs in Alaska

Reports a sciatic nerve block delivered through a catheter for continuous infusion, commonly for ongoing lower-extremity analgesia after surgery.

CMS RVU26DEffective Oct 1, 2026One payment locality3.3K Medicare services in 2024

In Alaska, Medicare pays $97.68 for 64446 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$97.68Hospital or facility

Check a contract rate as a % of Medicare · 64446 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 64446 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alaska
  2. What 64446 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 64446 covers

This service covers delivery of anesthetic through a catheter placed at the sciatic nerve for continuous regional analgesia. Anesthesiologists and pain physicians commonly provide it around lower-extremity surgery, such as procedures involving the foot, ankle, or lower leg. Imaging guidance, when used, is included in the service. The catheter allows medication delivery to continue beyond a single injection.

Choose this code for a continuous sciatic catheter service rather than a single-injection sciatic block. Documentation should identify the nerve and side, catheter placement, the continuous infusion plan, and any imaging used. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. 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 Alaska compares for 64446

Across 109 of 109 payment localities, the facility rate for 64446 runs from $66.98 in Wisconsin to $97.68 in Alaska. Alaska pays $97.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

64446 in Alaska vs other payment areas
  1. Alaska · this page$97.68
  2. Los Angeles, CA · California$73.06−$24.62
  3. Washington, DC area · District of Columbia$76.01−$21.67
  4. Miami, FL · Florida$78.83−$18.85
  5. Chicago, IL · Illinois$77.74−$19.94
  6. Manhattan, NY · New York$78.81−$18.87
  7. Alabama · Alabama$67.55−$30.13

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

Every other payment area

64446 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas—$67.16
ArizonaArizona—$69.82
Bakersfield, CACalifornia—$70.77
Chico, CACalifornia—$70.29
El Centro, CACalifornia—$70.31
Fresno, CACalifornia—$70.29
Hanford, CACalifornia—$70.29
Madera, CACalifornia—$70.29

64446 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.

View every state and territory as a table
64446 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 64446 in every payment locality

How the 64446 rate is calculated

Each of 64446’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 · 64446

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.71

1.71 RVUs× 1.000 GPCI

Practice expense0.26

0.26 RVUs× 1.000 GPCI

Malpractice0.15

0.15 RVUs× 1.000 GPCI

Adjusted RVUs

2.1200

Conversion factor

$33.4009

Medicare rate

$70.81

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

The exact Alaska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,109

Code
64446
Physician work
1.71
Practice expense
0.26
Malpractice
0.15

GPCI2026.csv

5

Locality
Alaska
Physician work
1.500
Practice expense
1.065
Malpractice
0.551
Facility calculation for 64446 in Alaska
ComponentRVULocality factorAdjusted
Physician work1.71× 1.5002.5650
Practice expense0.26× 1.0650.2769
Malpractice0.15× 0.5510.0827
Total RVUs2.9245
Conversion factor× 33.4009

Facility rate, Alaska$97.68

Facility: (1.71 × 1.5 + 0.26 × 1.065 + 0.15 × 0.551) × $33.4009 = $97.68

Open 64446 in the RVU calculator

Payment rules and modifiers for 64446

The CMS indicators that decide how 64446 is paid alongside other services.

CMS payment indicators · 64446

Sciatic nerve block, continuous catheter infusion

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

64446 without 50 · national facility

$70.81

Sciatic nerve block, continuous catheter infusion

64446-50 · Bilateral: 150%

$106.22

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 64446 has changed in Alaska

64446 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$97.68RVU26D
2026-07-01Not available in this setting$97.68RVU26C
2026-04-01Not available in this setting$97.68RVU26B
2026-01-01Not available in this setting$97.68RVU26A
2025-10-01Not available in this setting$99.86RVU25D
2025-07-01Not available in this setting$99.86RVU25C
2025-04-01Not available in this setting$99.86RVU25B
2025-01-01Not available in this setting$99.86RVU25A
2024-10-01Not available in this setting$102.21RVU24D
2024-07-01Not available in this setting$102.21RVU24C
2024-04-01Not available in this setting$102.21RVU24B
2024-03-09Not available in this setting$102.21RVU24AR
2024-01-01Not available in this setting$100.54RVU24A
2023-10-01Not available in this setting$105.10RVU23D
2023-07-01Not available in this setting$105.10RVU23C
2023-04-01Not available in this setting$105.10RVU23B
2023-01-01Not available in this setting$105.10RVU23A
2022-10-01Not available in this setting$82.61RVU22D
2022-07-01Not available in this setting$82.61RVU22C
2022-04-01Not available in this setting$82.61RVU22B
2022-01-01Not available in this setting$82.61RVU22A
2021-10-01Not available in this setting$83.29RVU21D
2021-07-01Not available in this setting$83.29RVU21C
2021-04-01Not available in this setting$83.29RVU21B
2021-01-01Not available in this setting$83.29RVU21A
2020-10-01Not available in this setting$85.93RVU20D
2020-07-01Not available in this setting$85.93RVU20C
2020-04-01Not available in this setting$85.93RVU20B
2020-01-01Not available in this setting$85.93RVU20A
2019-10-01Not available in this setting$114.70RVU19D
2019-07-01Not available in this setting$114.70RVU19C
2019-04-01Not available in this setting$114.70RVU19B
2019-01-01Not available in this setting$114.70RVU19A
2018-10-01Not available in this setting$114.17RVU18D
2018-07-01Not available in this setting$114.17RVU18C
2018-04-01Not available in this setting$114.17RVU18B
2018-01-01Not available in this setting$114.17RVU18AR1
2017-10-01Not available in this setting$113.38RVU17D
2017-07-01Not available in this setting$113.38RVU17C
2017-04-01Not available in this setting$113.38RVU17B
2017-01-01Not available in this setting$113.38RVU17A
2016-10-01Not available in this setting$113.46RVU16D
2016-07-01Not available in this setting$113.46RVU16C
2016-04-01Not available in this setting$113.46RVU16B
2016-01-01Not available in this setting$113.46RVU16A
2015-10-01Not available in this setting$114.13RVU15D
2015-07-01Not available in this setting$114.13RVU15C
2015-04-01Not available in this setting$113.56RVU15B
2015-01-01Not available in this setting$113.56RVU15A
2014-10-01Not available in this setting$113.31RVU14D
2014-07-01Not available in this setting$113.31RVU14C
2014-04-01Not available in this setting$113.31RVU14B
2014-01-01Not available in this setting$113.31RVU14A
2013-10-01Not available in this setting$108.59RVU13D
2013-07-01Not available in this setting$108.59RVU13C
2013-04-01Not available in this setting$108.59RVU13B
2013-01-01Not available in this setting$108.59RVU13AR

Price 64446 for an earlier date of service

Where the Alaska rate applies

Alaska is a Medicare payment area, not a city. Our Census mapping connects it to 355 cities and communities in Alaska. Some span more than one payment area; confirm with the service ZIP.

  • Adak
  • Akhiok
  • Akiachak
  • Akiak
  • Akutan
  • Alakanuk
  • Alatna
  • Alcan Border

Browse all communities in Alaska

64446 billing questions

How does 64446 differ from 64445?

64446 is for continuous anesthetic delivery through a sciatic nerve catheter. Use 64445 for a single-injection sciatic nerve block.

Can imaging guidance be reported separately?

Imaging guidance, when performed for this block, is included in 64446.

What should the procedure note identify?

Document the sciatic nerve and side, catheter placement, the continuous infusion plan, and imaging used.

How is bilateral reporting handled?

For bilateral performance, CMS specifies modifier 50, with payment at 150%.

How does CMS handle other procedures in the same session?

The highest-valued procedure is paid in full, and other procedures in the same session are paid at 50%.

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 64446PPRRVU2026_Oct_nonQPP.csv, line 7,109 (RVU26D)
Geographic factors for AlaskaGPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 64446 pays in Alaska?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 64446 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet