CPT code 64446: Sciatic nerve block, continuous catheter infusion2026 Medicare rate & RVUs in King County, WA
Reports a sciatic nerve block delivered through a catheter for continuous infusion, commonly for ongoing lower-extremity analgesia after surgery.
In King County, WA, Medicare pays $74.72 for 64446 in a facility. There’s no office rate.
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.
On this page 11 sections
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 King County, WA 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. King County, WA pays $74.72. The RVUs are the same everywhere; the geographic indexes change the dollars.
- King County, WA · this page$74.72
- Rest of Washington · Washington$70.82−$3.90
- Los Angeles, CA · California$73.06−$1.66
- Washington, DC area · District of Columbia$76.01+$1.29
- Miami, FL · Florida$78.83+$4.11
- Chicago, IL · Illinois$77.74+$3.02
- Manhattan, NY · New York$78.81+$4.09
Other areas in Washington first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | — | $97.68 |
| AlabamaAlabama | — | $67.55 |
| 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 |
| Merced, CACalifornia | — | $70.29 |
| Modesto, CACalifornia | — | $70.29 |
| Napa, CACalifornia | — | $74.70 |
| Oxnard, CACalifornia | — | $72.10 |
| Redding, CACalifornia | — | $70.29 |
| Rest of CaliforniaCalifornia | — | $70.29 |
| Riverside, CACalifornia | — | $71.94 |
| Sacramento, CACalifornia | — | $71.96 |
| Salinas, CACalifornia | — | $71.64 |
| San Diego, CACalifornia | — | $71.93 |
| Marin County, CACalifornia | — | $77.09 |
| San Francisco, CACalifornia | — | $76.92 |
| San Benito County, CACalifornia | — | $78.61 |
| Santa Clara County, CACalifornia | — | $77.91 |
| San Luis Obispo, CACalifornia | — | $70.66 |
| Santa Cruz, CACalifornia | — | $71.55 |
| Santa Maria, CACalifornia | — | $71.53 |
| Santa Rosa, CACalifornia | — | $72.18 |
| Stockton, CACalifornia | — | $70.29 |
| Vallejo, CACalifornia | — | $74.46 |
| Visalia, CACalifornia | — | $70.29 |
| Yuba City, CACalifornia | — | $70.29 |
| ColoradoColorado | — | $70.95 |
| ConnecticutConnecticut | — | $73.67 |
| DelawareDelaware | — | $70.49 |
| Fort Lauderdale, FLFlorida | — | $74.97 |
| Rest of FloridaFlorida | — | $72.95 |
| Atlanta, GAGeorgia | — | $72.13 |
| Rest of GeorgiaGeorgia | — | $70.83 |
| Hawaii, Guam, HIHawaii | — | $69.89 |
| IowaIowa | — | $67.05 |
| IdahoIdaho | — | $67.47 |
| East St. Louis, ILIllinois | — | $75.20 |
| Rest of IllinoisIllinois | — | $72.88 |
| Suburban Chicago, ILIllinois | — | $75.31 |
| IndianaIndiana | — | $67.60 |
| KansasKansas | — | $67.49 |
| KentuckyKentucky | — | $69.42 |
| New Orleans, LALouisiana | — | $70.98 |
| Rest of LouisianaLouisiana | — | $69.60 |
| Metropolitan Boston, MAMassachusetts | — | $74.29 |
| Rest of MassachusettsMassachusetts | — | $71.17 |
| Baltimore area, MDMaryland | — | $73.55 |
| Rest of MarylandMaryland | — | $71.07 |
| Rest of MaineMaine | — | $68.22 |
| Southern Maine, MEMaine | — | $68.88 |
| Detroit, MIMichigan | — | $73.94 |
| Rest of MichiganMichigan | — | $70.70 |
| MinnesotaMinnesota | — | $67.53 |
| Metropolitan Kansas City, MOMissouri | — | $70.16 |
| Metropolitan St. Louis, MOMissouri | — | $70.40 |
| Rest of MissouriMissouri | — | $69.48 |
| MississippiMississippi | — | $68.30 |
| MontanaMontana | — | $70.80 |
| North CarolinaNorth Carolina | — | $68.42 |
| North DakotaNorth Dakota | — | $67.83 |
| NebraskaNebraska | — | $67.02 |
| New HampshireNew Hampshire | — | $70.54 |
| Northern New JerseyNew Jersey | — | $76.14 |
| Rest of New JerseyNew Jersey | — | $74.38 |
| New MexicoNew Mexico | — | $71.10 |
| NevadaNevada | — | $69.98 |
| NYC suburbs and Long Island, NYNew York | — | $80.40 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $75.26 |
| Queens, NYNew York | — | $78.26 |
| Rest of New YorkNew York | — | $68.89 |
| OhioOhio | — | $70.09 |
| OklahomaOklahoma | — | $68.76 |
| Portland, OROregon | — | $71.41 |
| Rest of OregonOregon | — | $69.29 |
| Metropolitan Philadelphia, PAPennsylvania | — | $73.16 |
| Rest of PennsylvaniaPennsylvania | — | $69.82 |
| Puerto RicoPuerto Rico | — | $70.83 |
| Rhode IslandRhode Island | — | $71.64 |
| South CarolinaSouth Carolina | — | $69.40 |
| South DakotaSouth Dakota | — | $67.48 |
| TennesseeTennessee | — | $67.70 |
| Austin, TXTexas | — | $70.86 |
| Beaumont, TXTexas | — | $69.67 |
| Brazoria, TXTexas | — | $70.09 |
| Dallas, TXTexas | — | $70.58 |
| Fort Worth, TXTexas | — | $70.56 |
| Galveston, TXTexas | — | $70.34 |
| Houston, TXTexas | — | $73.09 |
| Rest of TexasTexas | — | $69.88 |
| UtahUtah | — | $69.78 |
| VirginiaVirginia | — | $69.19 |
| Virgin Islands, VIUnited States Virgin Islands | — | $70.83 |
| VermontVermont | — | $68.25 |
| WisconsinWisconsin | — | $66.98 |
| West VirginiaWest Virginia | — | $71.83 |
| WyomingWyoming | — | $69.51 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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 King County, WA 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
108
- Locality
- King County, WA
- Physician work
- 1.050
- Practice expense
- 1.227
- Malpractice
- 0.817
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.71 | × 1.050 | 1.7955 |
| Practice expense | 0.26 | × 1.227 | 0.3190 |
| Malpractice | 0.15 | × 0.817 | 0.1225 |
| Total RVUs | 2.2371 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, King County, WA$74.72
Facility: (1.71 × 1.05 + 0.26 × 1.227 + 0.15 × 0.817) × $33.4009 = $74.72
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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).
How 64446 has changed in King County, WA
64446 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $74.72 | RVU26D |
| 2026-07-01 | Not available in this setting | $74.72 | RVU26C |
| 2026-04-01 | Not available in this setting | $74.72 | RVU26B |
| 2026-01-01 | Not available in this setting | $74.72 | RVU26A |
| 2025-10-01 | Not available in this setting | $76.87 | RVU25D |
| 2025-07-01 | Not available in this setting | $76.87 | RVU25C |
| 2025-04-01 | Not available in this setting | $76.87 | RVU25B |
| 2025-01-01 | Not available in this setting | $76.87 | RVU25A |
| 2024-10-01 | Not available in this setting | $78.42 | RVU24D |
| 2024-07-01 | Not available in this setting | $78.42 | RVU24C |
| 2024-04-01 | Not available in this setting | $78.42 | RVU24B |
| 2024-03-09 | Not available in this setting | $78.42 | RVU24AR |
| 2024-01-01 | Not available in this setting | $77.14 | RVU24A |
| 2023-10-01 | Not available in this setting | $80.22 | RVU23D |
| 2023-07-01 | Not available in this setting | $80.22 | RVU23C |
| 2023-04-01 | Not available in this setting | $80.22 | RVU23B |
| 2023-01-01 | Not available in this setting | $80.22 | RVU23A |
| 2022-10-01 | Not available in this setting | $62.04 | RVU22D |
| 2022-07-01 | Not available in this setting | $62.04 | RVU22C |
| 2022-04-01 | Not available in this setting | $62.04 | RVU22B |
| 2022-01-01 | Not available in this setting | $62.04 | RVU22A |
| 2021-10-01 | Not available in this setting | $62.56 | RVU21D |
| 2021-07-01 | Not available in this setting | $62.56 | RVU21C |
| 2021-04-01 | Not available in this setting | $62.56 | RVU21B |
| 2021-01-01 | Not available in this setting | $62.56 | RVU21A |
| 2020-10-01 | Not available in this setting | $64.13 | RVU20D |
| 2020-07-01 | Not available in this setting | $64.13 | RVU20C |
| 2020-04-01 | Not available in this setting | $64.13 | RVU20B |
| 2020-01-01 | Not available in this setting | $64.13 | RVU20A |
| 2019-10-01 | Not available in this setting | $85.32 | RVU19D |
| 2019-07-01 | Not available in this setting | $85.32 | RVU19C |
| 2019-04-01 | Not available in this setting | $85.32 | RVU19B |
| 2019-01-01 | Not available in this setting | $85.32 | RVU19A |
| 2018-10-01 | Not available in this setting | $84.81 | RVU18D |
| 2018-07-01 | Not available in this setting | $84.81 | RVU18C |
| 2018-04-01 | Not available in this setting | $84.81 | RVU18B |
| 2018-01-01 | Not available in this setting | $84.81 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $83.04 | RVU17D |
| 2017-07-01 | Not available in this setting | $83.04 | RVU17C |
| 2017-04-01 | Not available in this setting | $83.04 | RVU17B |
| 2017-01-01 | Not available in this setting | $83.04 | RVU17A |
| 2016-10-01 | Not available in this setting | $82.14 | RVU16D |
| 2016-07-01 | Not available in this setting | $82.14 | RVU16C |
| 2016-04-01 | Not available in this setting | $82.14 | RVU16B |
| 2016-01-01 | Not available in this setting | $82.14 | RVU16A |
| 2015-10-01 | Not available in this setting | $82.61 | RVU15D |
| 2015-07-01 | Not available in this setting | $82.61 | RVU15C |
| 2015-04-01 | Not available in this setting | $82.20 | RVU15B |
| 2015-01-01 | Not available in this setting | $82.20 | RVU15A |
| 2014-10-01 | Not available in this setting | $83.26 | RVU14D |
| 2014-07-01 | Not available in this setting | $83.26 | RVU14C |
| 2014-04-01 | Not available in this setting | $83.26 | RVU14B |
| 2014-01-01 | Not available in this setting | $83.26 | RVU14A |
| 2013-10-01 | Not available in this setting | $81.33 | RVU13D |
| 2013-07-01 | Not available in this setting | $81.33 | RVU13C |
| 2013-04-01 | Not available in this setting | $81.33 | RVU13B |
| 2013-01-01 | Not available in this setting | $81.33 | RVU13AR |
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
- 64446 in Auburn · multiple payment areas
- Baring
- Beaux Arts Village
- Bellevue
- Black Diamond
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
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