CPT code 64451: SI nerve block, image-guided nerve injection2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $278.04 for 64451 in the office and $78.95 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 64451 nationwide

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

What 64451 covers

This service is an injection of anesthetic, steroid, or both around nerves that carry sensation from the sacroiliac joint. Clinicians commonly target the L5 dorsal ramus and sacral lateral branches when evaluating or treating suspected SI-joint pain. Pain medicine physicians, anesthesiologists, and physiatrists may perform it in an office or outpatient facility, using fluoroscopy or CT to guide needle placement.

Report the code when the target is the nerves supplying the SI joint, rather than the joint space itself. The record should identify the side and nerve targets, document image guidance, and describe the injectate and clinical indication. Needle placement and imaging guidance are included. The procedure has a 0-day global period, so same-day preoperative and postoperative care are included. For bilateral services, modifier 50 is paid at 150%. In the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. 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 Washington, DC area compares for 64451

Across 109 of 109 payment localities, the office rate for 64451 runs from $212.80 in Arkansas to $327.58 in San Benito County, CA. Washington, DC area pays $278.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

64451 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 64451 in every payment locality

How the 64451 rate is calculated

Each of 64451’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.

Payment rules and modifiers for 64451

The CMS indicators that decide how 64451 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

Codes related to 64451

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

How 64451 has changed in Washington, DC area

Price 64451 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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

Open CMS sourceHow we calculate rates