CPT code 64448: Femoral nerve block, continuous catheter infusion2026 Medicare rate & RVUs in Guam
Reports a femoral nerve block delivered through a catheter for continuous infusion, commonly used to provide postoperative analgesia after knee or lower-extremity surgery.
CMS doesn’t publish an office rate for 64448 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 64448 covers
This service places a catheter by the femoral nerve and delivers anesthetic continuously for regional pain control. Anesthesiologists and pain physicians commonly perform it around knee or other lower-extremity surgery, often in a hospital or ambulatory surgery setting. The service differs from a one-time femoral nerve injection because the catheter supports ongoing infusion; imaging guidance is included in the code when performed.
Report the service when the record supports femoral nerve targeting, catheter placement, and a continuous infusion plan. Document the indication, laterality, procedure details, and infusion regimen. The code has 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%. Assistant-at-surgery services are not paid; 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.
64448 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $66.98 |
How the 64448 rate is calculated
Each of 64448’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 · 64448
RVUs × geographic indexes × conversion factor
Work1.64
1.64 RVUs× 1.000 GPCI
Practice expense0.25
0.25 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
2.0300
Conversion factor
$33.4009
Medicare rate
$67.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64448
The CMS indicators that decide how 64448 is paid alongside other services.
CMS payment indicators · 64448
Femoral 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
64448 without 50 · national facility
$67.80
Femoral nerve block, continuous catheter infusion
64448-50 · Bilateral: 150%
$101.70
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).
64448 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64447Femoral nerve blockSingle injection
- Choose 64448 when the femoral nerve catheter is used for continuous infusion; choose 64447 for a single-injection femoral nerve block.
- 64446Sciatic nerve blockContinuous catheter infusion
- Both involve continuous catheter infusion, but 64446 targets the sciatic nerve and 64448 targets the femoral nerve.
- 64449Lumbar plexus blockAnesthetic or steroid injection
- 64449 is the continuous catheter service for the lumbar plexus; 64448 is directed to the femoral nerve.
64448 billing questions
How does this differ from 64447?
64448 is for a femoral nerve catheter with continuous infusion. 64447 is the corresponding femoral nerve service for a single injection rather than a continuous catheter infusion.
Is catheter placement separately reported?
Catheter placement is part of this service. The documentation should show placement and the plan for continuous infusion.
Can modifier 50 be used for bilateral treatment?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document treatment on both sides.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the 0-day global period.
What happens when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and the other procedures are paid at 50% under the standard multiple procedure reduction.
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
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