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

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 King County, WA, Medicare pays $93.90 for 64450 in the office and $41.86 when it’s performed in a hospital or facility.

$93.90Office (non-facility)
$41.86Hospital or facility
+16.2%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 King County, WA
  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 King County, WA 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. King County, WA pays $93.90. The RVUs are the same everywhere; the geographic indexes change the dollars.

64450 in King County, WA vs other payment areas
  1. King County, WA · this page$93.90
  2. Rest of Washington · Washington$83.46−$10.44
  3. Los Angeles, CA · California$90.95−$2.95
  4. Washington, DC area · District of Columbia$92.04−$1.86
  5. Miami, FL · Florida$86.62−$7.28
  6. Chicago, IL · Illinois$84.30−$9.60
  7. Manhattan, NY · New York$92.53−$1.37

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

Every other payment area

64450 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$95.49$50.31
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

64450 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.

$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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 64450 in King County, WA
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0500.7665
Practice expense1.62× 1.2271.9877
Malpractice0.07× 0.8170.0572
Total RVUs2.8114
Conversion factor× 33.4009

Office rate, King County, WA$93.90

Office: (0.73 × 1.05 + 1.62 × 1.227 + 0.07 × 0.817) × $33.4009 = $93.90

Facility: (0.73 × 1.05 + 0.35 × 1.227 + 0.07 × 0.817) × $33.4009 = $41.86

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

Codes related to 64450

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

Codes related to 64450
CodeHow it relatesOffice range, King County, WA
Used instead
64420Intercostal block, single nerveUse for an intercostal nerve block rather than the unspecified peripheral-nerve code.$122.48
64425Nerve block, ilioinguinal and iliohypogastricUse for an ilioinguinal or iliohypogastric nerve block.$141.33
64430Nerve block, pudendal nerveUse when the treated nerve is the pudendal nerve.$110.32
64454Genicular nerve block, anesthetic or steroid injectionUse for injection of genicular nerve branches.$277.58
64455Nerve injection, plantar common digital nerveUse for injection targeting a plantar common digital nerve.$56.20

How 64450 has changed in King County, WA

64450 · Office / nonfacility

$93.90

Effective 2026-10-01

The base rate is $11.42 higher than on 2025-10-01, moving from $82.48 to $93.90 (13.8%).

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

    $82.48changed to$93.90

    • 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
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $86.26changed to$82.48

    • 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

    $84.85changed to$86.26

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $86.29changed to$84.85

    • 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
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $87.98changed to$86.29

    • 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
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $89.96changed to$87.98

    • 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

    $87.26changed to$89.96

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.34 changed to 1.45
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $86.69changed to$87.26

    • 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
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $90.31changed to$86.69

    • 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

    $89.30changed to$90.31

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.45 changed to 1.46
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $88.73changed to$89.30

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $89.46changed to$88.73

    • 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

    $89.02changed to$89.46

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $88.75changed to$89.02

    • 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 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $89.45changed to$88.75

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.58 changed to 1.45
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $89.45

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$93.90$41.86RVU26D
2026-07-01$93.90$41.86RVU26C
2026-04-01$93.90$41.86RVU26B
2026-01-01$93.90$41.86RVU26A
2025-10-01$82.48$43.81RVU25D
2025-07-01$82.48$43.81RVU25C
2025-04-01$82.48$43.81RVU25B
2025-01-01$82.48$43.81RVU25A
2024-10-01$86.26$45.25RVU24D
2024-07-01$86.26$45.25RVU24C
2024-04-01$86.26$45.25RVU24B
2024-03-09$86.26$45.25RVU24AR
2024-01-01$84.85$44.51RVU24A
2023-10-01$86.29$45.39RVU23D
2023-07-01$86.29$45.39RVU23C
2023-04-01$86.29$45.39RVU23B
2023-01-01$86.29$45.39RVU23A
2022-10-01$87.98$45.83RVU22D
2022-07-01$87.98$45.83RVU22C
2022-04-01$87.98$45.83RVU22B
2022-01-01$87.98$45.83RVU22A
2021-10-01$89.96$46.21RVU21D
2021-07-01$89.96$46.21RVU21C
2021-04-01$89.96$46.21RVU21B
2021-01-01$89.96$46.21RVU21A
2020-10-01$87.26$47.15RVU20D
2020-07-01$87.26$47.15RVU20C
2020-04-01$87.26$47.15RVU20B
2020-01-01$87.26$47.15RVU20A
2019-10-01$86.69$49.11RVU19D
2019-07-01$86.69$49.11RVU19C
2019-04-01$86.69$49.11RVU19B
2019-01-01$86.69$49.11RVU19A
2018-10-01$90.31$49.88RVU18D
2018-07-01$90.31$49.88RVU18C
2018-04-01$90.31$49.88RVU18B
2018-01-01$90.31$49.88RVU18AR1
2017-10-01$89.30$49.24RVU17D
2017-07-01$89.30$49.24RVU17C
2017-04-01$89.30$49.24RVU17B
2017-01-01$89.30$49.24RVU17A
2016-10-01$88.73$49.03RVU16D
2016-07-01$88.73$49.03RVU16C
2016-04-01$88.73$49.03RVU16B
2016-01-01$88.73$49.03RVU16A
2015-10-01$89.46$49.21RVU15D
2015-07-01$89.46$49.21RVU15C
2015-04-01$89.02$48.96RVU15B
2015-01-01$89.02$48.96RVU15A
2014-10-01$88.75$49.62RVU14D
2014-07-01$88.75$49.62RVU14C
2014-04-01$88.75$49.62RVU14B
2014-01-01$88.75$49.62RVU14A
2013-10-01$89.45$48.19RVU13D
2013-07-01$89.45$48.19RVU13C
2013-04-01$89.45$48.19RVU13B
2013-01-01$89.45$48.19RVU13AR

Price 64450 for an earlier date of service

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
  • 64450 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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