CPT code 64450: Nerve block, other peripheral nerve or branch2026 Medicare rate & RVUs in Iowa

Report 64450 for an anesthetic and/or steroid injection targeting a peripheral nerve or branch that does not have a more specific CPT code.

CMS RVU26DEffective Oct 1, 2026One payment locality387.6K Medicare services in 2024

In Iowa, Medicare pays $74.82 for 64450 in the office and $36.01 when it’s performed in a hospital or facility.

$74.82Office (non-facility)
$36.01Hospital or facility
−7.4%vs the national office rate ($80.83)

Check a contract rate as a % of Medicare · 64450 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 64450 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 64450 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 64450 covers

A clinician injects anesthetic, steroid, or both around a peripheral nerve or branch not identified by a more specific nerve-block code. The block may be used to reduce pain or help evaluate whether a particular nerve is contributing to symptoms. Pain physicians, anesthesiologists, surgeons, and other clinicians may perform it in an office, outpatient procedure area, or hospital. The documented target must be the nerve or branch actually treated; this code is not a substitute for a code that names the nerve or anatomic target.

Report the service based on the documented nerve, indication, laterality, and injectate. The record should identify the target and support the clinical purpose of the block; for a diagnostic block, document the patient’s response when assessed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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 Iowa compares for 64450

Across 109 of 109 payment localities, the office rate for 64450 runs from $72.07 in Arkansas to $106.34 in San Benito County, CA. Iowa pays $74.82. The RVUs are the same everywhere; the geographic indexes change the dollars.

64450 in Iowa vs other payment areas
  1. Iowa · this page$74.82
  2. Los Angeles, CA · California$90.95+$16.13
  3. Washington, DC area · District of Columbia$92.04+$17.22
  4. Miami, FL · Florida$86.62+$11.80
  5. Chicago, IL · Illinois$84.30+$9.48
  6. Manhattan, NY · New York$92.53+$17.71
  7. Alaska · Alaska$95.49+$20.67

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

Every other payment area

64450 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$73.05$35.94
ArkansasArkansas$72.07$35.63
ArizonaArizona$78.82$37.71
Bakersfield, CACalifornia$85.57$39.08
Chico, CACalifornia$85.35$38.86
El Centro, CACalifornia$85.37$38.87
Fresno, CACalifornia$85.35$38.86
Hanford, CACalifornia$85.35$38.86

64450 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.

$72.07

$95.85

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

View every state and territory as a table
64450 office rate range by state
State / territoryOffice rate rangeLocalities
AK$95.491
AL$73.051
AR$72.071
AZ$78.821
CA$85.35–$106.3429
CO$84.071
CT$85.981
DC$92.041
DE$80.071
FL$79.63–$86.623
GA$75.44–$82.242
GU$87.261
HI$87.261
IA$74.821
ID$75.271
IL$77.44–$84.304
IN$75.681
KS$74.481
KY$74.631
LA$74.51–$77.962
MA$83.61–$92.072
MD$81.53–$92.043
ME$75.62–$79.482
MI$76.42–$80.542
MN$80.751
MO$73.30–$78.243
MS$72.701
MT$80.831
NC$76.361
ND$79.441
NE$75.211
NH$82.761
NJ$87.01–$91.182
NM$76.811
NV$80.491
NY$77.43–$94.625
OH$76.141
OK$74.521
OR$79.92–$86.632
PA$76.26–$83.942
PR$81.391
RI$82.831
SC$76.371
SD$79.281
TN$74.821
TX$75.79–$83.758
UT$77.351
VA$79.22–$92.042
VI$81.391
VT$79.131
WA$83.46–$93.902
WI$76.941
WV$74.751
WY$80.221

See 64450 in every payment locality

How the 64450 rate is calculated

Each of 64450’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 · 64450

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.73

0.73 RVUs× 1.000 GPCI

Practice expense1.62

1.62 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

2.4200

Conversion factor

$33.4009

Medicare rate

$80.83

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,113

Code
64450
Physician work
0.73
Practice expense
1.62
Malpractice
0.07

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 64450 in Iowa
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0000.7300
Practice expense1.62× 0.9151.4823
Malpractice0.07× 0.3970.0278
Total RVUs2.2401
Conversion factor× 33.4009

Office rate, Iowa$74.82

Office: (0.73 × 1 + 1.62 × 0.915 + 0.07 × 0.397) × $33.4009 = $74.82

Facility: (0.73 × 1 + 0.35 × 0.915 + 0.07 × 0.397) × $33.4009 = $36.01

Open 64450 in the RVU calculator

Payment rules and modifiers for 64450

The CMS indicators that decide how 64450 is paid alongside other services.

CMS payment indicators · 64450

Nerve block, other peripheral nerve or branch

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

64450 without 50 · national office

$80.83

Nerve block, other peripheral nerve or branch

64450-50 · Bilateral: 150%

$121.25

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 64450 has changed in Iowa

64450 · Office / nonfacility

$74.82

Effective 2026-10-01

The base rate is $8.18 higher than on 2025-10-01, moving from $66.64 to $74.82 (12.3%).

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

    $66.64changed to$74.82

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.75 changed to 0.73
    • Practice expense RVU 1.40 changed to 1.62
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $69.49changed to$66.64

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.42 changed to 1.40
    • Malpractice RVU 0.09 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $68.36changed to$69.49

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $70.09changed to$68.36

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.41 changed to 1.42
    • Malpractice RVU 0.08 changed to 0.09
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457
  5. January 1, 2023

    RVU23A

    $71.85changed to$70.09

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.42 changed to 1.41
    • Malpractice RVU 0.09 changed to 0.08
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $73.39changed to$71.85

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.45 changed to 1.42

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $72.31changed to$73.39

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.34 changed to 1.45
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $72.88changed to$72.31

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.37 changed to 1.34
    • Malpractice RVU 0.07 changed to 0.09
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $75.74changed to$72.88

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.46 changed to 1.37

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $75.01changed to$75.74

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.45 changed to 1.46
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $74.61changed to$75.01

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $75.20changed to$74.61

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.46 changed to 1.45

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $74.82changed to$75.20

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $74.22changed to$74.82

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.45 changed to 1.46
    • Malpractice RVU 0.06 changed to 0.07
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $74.13changed to$74.22

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.58 changed to 1.45
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $74.13

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$74.82$36.01RVU26D
2026-07-01$74.82$36.01RVU26C
2026-04-01$74.82$36.01RVU26B
2026-01-01$74.82$36.01RVU26A
2025-10-01$66.64$37.70RVU25D
2025-07-01$66.64$37.70RVU25C
2025-04-01$66.64$37.70RVU25B
2025-01-01$66.64$37.70RVU25A
2024-10-01$69.49$38.80RVU24D
2024-07-01$69.49$38.80RVU24C
2024-04-01$69.49$38.80RVU24B
2024-03-09$69.49$38.80RVU24AR
2024-01-01$68.36$38.16RVU24A
2023-10-01$70.09$39.25RVU23D
2023-07-01$70.09$39.25RVU23C
2023-04-01$70.09$39.25RVU23B
2023-01-01$70.09$39.25RVU23A
2022-10-01$71.85$39.83RVU22D
2022-07-01$71.85$39.83RVU22C
2022-04-01$71.85$39.83RVU22B
2022-01-01$71.85$39.83RVU22A
2021-10-01$73.39$40.16RVU21D
2021-07-01$73.39$40.16RVU21C
2021-04-01$73.39$40.16RVU21B
2021-01-01$73.39$40.16RVU21A
2020-10-01$72.31$41.21RVU20D
2020-07-01$72.31$41.21RVU20C
2020-04-01$72.31$41.21RVU20B
2020-01-01$72.31$41.21RVU20A
2019-10-01$72.88$43.13RVU19D
2019-07-01$72.88$43.13RVU19C
2019-04-01$72.88$43.13RVU19B
2019-01-01$72.88$43.13RVU19A
2018-10-01$75.74$43.74RVU18D
2018-07-01$75.74$43.74RVU18C
2018-04-01$75.74$43.74RVU18B
2018-01-01$75.74$43.74RVU18AR1
2017-10-01$75.01$43.61RVU17D
2017-07-01$75.01$43.61RVU17C
2017-04-01$75.01$43.61RVU17B
2017-01-01$75.01$43.61RVU17A
2016-10-01$74.61$43.81RVU16D
2016-07-01$74.61$43.81RVU16C
2016-04-01$74.61$43.81RVU16B
2016-01-01$74.61$43.81RVU16A
2015-10-01$75.20$43.97RVU15D
2015-07-01$75.20$43.97RVU15C
2015-04-01$74.82$43.75RVU15B
2015-01-01$74.82$43.75RVU15A
2014-10-01$74.22$43.87RVU14D
2014-07-01$74.22$43.87RVU14C
2014-04-01$74.22$43.87RVU14B
2014-01-01$74.22$43.87RVU14A
2013-10-01$74.13$42.14RVU13D
2013-07-01$74.13$42.14RVU13C
2013-04-01$74.13$42.14RVU13B
2013-01-01$74.13$42.14RVU13AR

Price 64450 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

64450 billing questions

When should 64450 be chosen instead of a code for a named nerve?

Use 64450 when the treated peripheral nerve or branch does not have a more specific code. For a nerve with its own code, report that code rather than using 64450 as a general substitute.

What should the procedure note identify?

Document the nerve or branch treated, the clinical indication, laterality, and the anesthetic and/or steroid injected. For a diagnostic block, record the response when it is assessed.

How is a bilateral service reported?

Use modifier 50 for a bilateral procedure; CMS pays it at 150%.

How does the multiple-procedure reduction affect 64450?

When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.

Can an assistant, co-surgeon, or surgical team be billed for this procedure?

Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted for this code.

Are same-day preoperative and postoperative services included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

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 64450PPRRVU2026_Oct_nonQPP.csv, line 7,113 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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