CPT code 64447: Femoral nerve block, single injection2026 Medicare rate & RVUs

Report this code for a single-injection femoral nerve block, with imaging guidance included when performed, for perioperative or other targeted analgesia.

CMS RVU26DEffective Oct 1, 2026109 payment localities357.1K Medicare services in 2024

Medicare pays $134.27 for 64447 nationally in the office and $60.79 in a hospital or facility. Local office rates run $120.13–$175.46.

Medicare rate · 64447

Femoral nerve block, single injection

Office or facility?

Work RVUs
1.31
Total RVUs
4.02
Global days
000

National rate · 2026

$134.27

Office setting, before claim adjustments.

See every locality for 64447 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 64447 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 64447 covers

This service is a single-injection block of the femoral nerve, commonly performed by an anesthesiologist or other qualified clinician for pain control around lower-extremity surgery, such as knee procedures. It may be performed in a preoperative area, procedure room, or facility operating setting. Imaging guidance, when used to place the injection, is included in the service. A catheter placed for continuous infusion is distinguished from this single-injection service.

Report the code when the documented target is the femoral nerve and the block is a single-injection technique. The record should identify the indication, side, nerve target, technique, and whether imaging was used. The CMS global period is zero days, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. 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.

Where 64447 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$120.13 to $175.46

$120.13$147.80$175.46
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

64447 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$121.72$57.42
Alaska$159.97$81.71
Arizona$131.01$59.81
Arkansas$120.13$57.01
Atlanta, GA$136.59$61.93
Austin, TX$138.92$61.18
Bakersfield, CA$141.84$61.30
Baltimore area, MD$142.24$63.39
Beaumont, TX$126.20$59.33
Brazoria, TX$132.96$60.14

64447 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.

$120.13

$159.97

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

View every state and territory as a table
64447 office rate range by state
State / territoryOffice rate rangeLocalities
AK$159.971
AL$121.721
AR$120.131
AZ$131.011
CA$141.46–$175.4629
CO$139.461
CT$142.651
DC$152.491
DE$133.051
FL$132.48–$143.953
GA$125.70–$136.592
GU$144.441
HI$144.441
IA$124.501
ID$125.241
IL$129.00–$140.204
IN$125.901
KS$123.981
KY$124.331
LA$124.15–$129.712
MA$138.74–$152.412
MD$135.42–$152.493
ME$125.84–$132.012
MI$127.26–$133.992
MN$133.961
MO$122.23–$130.133
MS$121.201
MT$134.261
NC$127.031
ND$131.891
NE$125.121
NH$137.321
NJ$144.37–$151.142
NM$127.901
NV$133.691
NY$128.76–$156.865
OH$126.781
OK$124.121
OR$132.74–$143.552
PA$126.96–$139.382
PR$135.161
RI$137.521
SC$127.101
SD$131.611
TN$124.541
TX$126.20–$138.928
UT$128.671
VA$131.62–$152.492
VI$135.161
VT$131.431
WA$138.47–$155.362
WI$127.861
WV$124.671
WY$133.231

How the 64447 rate is calculated

Each of 64447’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 · 64447

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.31

1.31 RVUs× 1.000 GPCI

Practice expense2.59

2.59 RVUs× 1.000 GPCI

Malpractice0.12

0.12 RVUs× 1.000 GPCI

Adjusted RVUs

4.0200

Conversion factor

$33.4009

Medicare rate

$134.27

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

Payment rules and modifiers for 64447

The CMS indicators that decide how 64447 is paid alongside other services.

CMS payment indicators · 64447

Femoral 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

64447 without 50 · national office

$134.27

Femoral nerve block, single injection

64447-50 · Bilateral: 150%

$201.41

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

64447 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 64447

    Femoral nerve block, single injection1.31 wRVU

    $134.27

  • 64448

    Femoral nerve block, continuous catheter infusion1.64 wRVU

    Not priced

  • 64445

    Sciatic nerve block, single injection1.36 wRVU

    $173.35+$39.08

  • 64446

    Sciatic nerve block, continuous catheter infusion1.71 wRVU

    Not priced

How to choose

64448Femoral nerve blockContinuous catheter infusion
64447 describes a single-injection femoral block. Choose 64448 when a femoral catheter is placed for continuous infusion.
64445Sciatic nerve blockSingle injection
64445 targets the sciatic nerve with a single injection; 64447 targets the femoral nerve. Select by the nerve actually blocked.
64446Sciatic nerve blockContinuous catheter infusion
64446 is the continuous-infusion sciatic nerve service. It differs from 64447 in both the targeted nerve and the catheter-based technique.

64447 billing questions

When should 64447 be selected instead of 64448?

Use 64447 for a single-injection femoral nerve block. Use 64448 when a catheter is placed for continuous femoral nerve infusion.

Is imaging guidance separately reported?

Imaging guidance used to perform the femoral block is included in 64447. Do not report a separate guidance service for that work.

How is a bilateral femoral block reported?

Report the bilateral procedure with modifier 50. CMS pays the bilateral service at 150%.

Can a sciatic nerve block be reported on the same date?

A sciatic block may be reported separately when it is performed to address the sciatic nerve territory as well as the femoral nerve territory. The documentation should support each distinct nerve block.

What same-session payment reduction applies?

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

Can an assistant or co-surgeon be reported for this service?

CMS does not pay an assistant at surgery for this code. 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 64447PPRRVU2026_Oct_nonQPP.csv, line 7,110 (RVU26D)

Open CMS sourceHow we calculate rates

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