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

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, 2026One payment locality357.1K Medicare services in 2024

In Houston, TX, Medicare pays $135.52 for 64447 in the office and $62.56 when it’s performed in a hospital or facility.

$135.52Office (non-facility)
$62.56Hospital or facility
+0.9%vs the national office rate ($134.27)

Check a contract rate as a % of Medicare · 64447 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 64447 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 64447 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 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.

How Houston, TX compares for 64447

Across 109 of 109 payment localities, the office rate for 64447 runs from $120.13 in Arkansas to $175.46 in San Benito County, CA. Houston, TX pays $135.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

64447 in Houston, TX vs other payment areas
  1. Houston, TX · this page$135.52
  2. Austin, TX · Texas$138.92+$3.40
  3. Beaumont, TX · Texas$126.20−$9.32
  4. Brazoria, TX · Texas$132.96−$2.56
  5. Dallas, TX · Texas$133.75−$1.77
  6. Fort Worth, TX · Texas$132.94−$2.58
  7. Galveston, TX · Texas$133.33−$2.19

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

Every other payment area

64447 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$129.47$59.74
Los Angeles, CACalifornia$150.55$63.62
Washington, DC areaDistrict of Columbia$152.49$65.92
Miami, FLFlorida$143.95$67.45
Chicago, ILIllinois$140.20$66.35
Manhattan, NYNew York$153.44$68.05
AlaskaAlaska$159.97$81.71
AlabamaAlabama$121.72$57.42

64447 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.

$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

See 64447 in every payment locality

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.

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,110

Code
64447
Physician work
1.31
Practice expense
2.59
Malpractice
0.12

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 64447 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.31× 1.0081.3205
Practice expense2.59× 0.9932.5719
Malpractice0.12× 1.3760.1651
Total RVUs4.0575
Conversion factor× 33.4009

Office rate, Houston, TX$135.52

Office: (1.31 × 1.008 + 2.59 × 0.993 + 0.12 × 1.376) × $33.4009 = $135.52

Facility: (1.31 × 1.008 + 0.39 × 0.993 + 0.12 × 1.376) × $33.4009 = $62.56

Open 64447 in the RVU calculator

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

Codes related to 64447

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

Codes related to 64447
CodeHow it relatesOffice range, Houston, TX
Same family
64448Femoral nerve block, continuous catheter infusionFemoral nerve catheter service for continuous infusion, rather than a single-injection block.No office rate
Often billed with
64445Sciatic nerve block, single injectionA separately performed single-injection sciatic block may accompany femoral blockade when both nerve territories need coverage.$174.74
64446Sciatic nerve block, continuous catheter infusionContinuous sciatic nerve infusion may accompany a femoral block when both nerve territories need coverage.No office rate

How 64447 has changed in Houston, TX

64447 · Office / nonfacility

$135.52

Effective 2026-10-01

The base rate is $20.43 higher than on 2025-10-01, moving from $115.09 to $135.52 (17.8%).

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

    $115.09changed to$135.52

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.34 changed to 1.31
    • Practice expense RVU 2.01 changed to 2.59
    • Malpractice RVU 0.13 changed to 0.12
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $118.17changed to$115.09

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.03 changed to 2.01
    • Malpractice RVU 0.11 changed to 0.13

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $116.24changed to$118.17

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $120.65changed to$116.24

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $93.37changed to$120.65

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.10 changed to 1.34
    • Practice expense RVU 1.44 changed to 2.03
    • Malpractice RVU 0.09 changed to 0.11
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $94.50changed to$93.37

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.45 changed to 1.44

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $93.04changed to$94.50

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.34 changed to 1.45
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $126.30changed to$93.04

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.50 changed to 1.10
    • Practice expense RVU 1.84 changed to 1.34
    • Malpractice RVU 0.12 changed to 0.09
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $126.16changed to$126.30

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $122.72changed to$126.16

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.76 changed to 1.84
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $123.30changed to$122.72

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.79 changed to 1.76
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $123.03changed to$123.30

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.77 changed to 1.79

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $122.41changed to$123.03

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $120.77changed to$122.41

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.74 changed to 1.77
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $121.77changed to$120.77

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.96 changed to 1.74
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $121.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$135.52$62.56RVU26D
2026-07-01$135.52$62.56RVU26C
2026-04-01$135.52$62.56RVU26B
2026-01-01$135.52$62.56RVU26A
2025-10-01$115.09$63.83RVU25D
2025-07-01$115.09$63.83RVU25C
2025-04-01$115.09$63.83RVU25B
2025-01-01$115.09$63.83RVU25A
2024-10-01$118.17$64.41RVU24D
2024-07-01$118.17$64.41RVU24C
2024-04-01$118.17$64.41RVU24B
2024-03-09$118.17$64.41RVU24AR
2024-01-01$116.24$63.36RVU24A
2023-10-01$120.65$64.87RVU23D
2023-07-01$120.65$64.87RVU23C
2023-04-01$120.65$64.87RVU23B
2023-01-01$120.65$64.87RVU23A
2022-10-01$93.37$54.55RVU22D
2022-07-01$93.37$54.55RVU22C
2022-04-01$93.37$54.55RVU22B
2022-01-01$93.37$54.55RVU22A
2021-10-01$94.50$55.00RVU21D
2021-07-01$94.50$55.00RVU21C
2021-04-01$94.50$55.00RVU21B
2021-01-01$94.50$55.00RVU21A
2020-10-01$93.04$56.23RVU20D
2020-07-01$93.04$56.23RVU20C
2020-04-01$93.04$56.23RVU20B
2020-01-01$93.04$56.23RVU20A
2019-10-01$126.30$69.76RVU19D
2019-07-01$126.30$69.76RVU19C
2019-04-01$126.30$69.76RVU19B
2019-01-01$126.30$69.76RVU19A
2018-10-01$126.16$69.69RVU18D
2018-07-01$126.16$69.69RVU18C
2018-04-01$126.16$69.69RVU18B
2018-01-01$126.16$69.69RVU18AR1
2017-10-01$122.72$69.12RVU17D
2017-07-01$122.72$69.12RVU17C
2017-04-01$122.72$69.12RVU17B
2017-01-01$122.72$69.12RVU17A
2016-10-01$123.30$68.92RVU16D
2016-07-01$123.30$68.92RVU16C
2016-04-01$123.30$68.92RVU16B
2016-01-01$123.30$68.92RVU16A
2015-10-01$123.03$68.80RVU15D
2015-07-01$123.03$68.80RVU15C
2015-04-01$122.41$68.46RVU15B
2015-01-01$122.41$68.46RVU15A
2014-10-01$120.77$68.26RVU14D
2014-07-01$120.77$68.26RVU14C
2014-04-01$120.77$68.26RVU14B
2014-01-01$120.77$68.26RVU14A
2013-10-01$121.77$65.18RVU13D
2013-07-01$121.77$65.18RVU13C
2013-04-01$121.77$65.18RVU13B
2013-01-01$121.77$65.18RVU13AR

Price 64447 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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