CPT code 64451: SI nerve block, image-guided nerve injection2026 Medicare rate & RVUs in New Mexico
Report this code for an image-guided anesthetic or steroid injection targeting nerves that innervate the sacroiliac joint, such as for suspected SI-joint pain.
In New Mexico, Medicare pays $226.88 for 64451 in the office and $71.90 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.
On this page 11 sections
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 New Mexico 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. New Mexico pays $226.88. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$226.88
- Los Angeles, CA · California$276.23+$49.35
- Washington, DC area · District of Columbia$278.04+$51.16
- Miami, FL · Florida$256.32+$29.44
- Chicago, IL · Illinois$248.83+$21.95
- Manhattan, NY · New York$277.75+$50.87
- Alaska · Alaska$276.29+$49.41
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $216.04 | $68.15 |
| ArkansasArkansas | $212.80 | $67.62 |
| ArizonaArizona | $235.01 | $71.24 |
| Bakersfield, CACalifornia | $258.59 | $73.35 |
| Chico, CACalifornia | $258.15 | $72.91 |
| El Centro, CACalifornia | $258.17 | $72.94 |
| Fresno, CACalifornia | $258.15 | $72.91 |
| Hanford, CACalifornia | $258.15 | $72.91 |
| Madera, CACalifornia | $258.15 | $72.91 |
| Merced, CACalifornia | $258.15 | $72.91 |
| Modesto, CACalifornia | $258.15 | $72.91 |
| Napa, CACalifornia | $301.89 | $79.14 |
| Oxnard, CACalifornia | $275.21 | $75.44 |
| Redding, CACalifornia | $258.15 | $72.91 |
| Rest of CaliforniaCalifornia | $258.15 | $72.91 |
| Riverside, CACalifornia | $259.68 | $74.45 |
| Sacramento, CACalifornia | $271.64 | $75.08 |
| Salinas, CACalifornia | $270.64 | $74.76 |
| San Diego, CACalifornia | $277.56 | $75.42 |
| Marin County, CACalifornia | $320.48 | $82.18 |
| San Francisco, CACalifornia | $320.32 | $82.02 |
| San Benito County, CACalifornia | $327.58 | $83.87 |
| Santa Clara County, CACalifornia | $326.93 | $83.22 |
| San Luis Obispo, CACalifornia | $266.20 | $73.70 |
| Santa Cruz, CACalifornia | $280.64 | $75.30 |
| Santa Maria, CACalifornia | $271.81 | $74.74 |
| Santa Rosa, CACalifornia | $283.52 | $75.98 |
| Stockton, CACalifornia | $258.15 | $72.91 |
| Vallejo, CACalifornia | $301.66 | $78.91 |
| Visalia, CACalifornia | $258.15 | $72.91 |
| Yuba City, CACalifornia | $258.15 | $72.91 |
| ColoradoColorado | $253.05 | $73.22 |
| ConnecticutConnecticut | $257.89 | $75.87 |
| DelawareDelaware | $239.01 | $72.03 |
| Fort Lauderdale, FLFlorida | $247.70 | $76.50 |
| Rest of FloridaFlorida | $235.60 | $74.02 |
| Atlanta, GAGeorgia | $245.57 | $73.86 |
| Rest of GeorgiaGeorgia | $222.15 | $71.39 |
| Hawaii, Guam, HIHawaii | $265.19 | $73.03 |
| IowaIowa | $222.74 | $68.10 |
| IdahoIdaho | $224.03 | $68.55 |
| East St. Louis, ILIllinois | $231.24 | $75.75 |
| Rest of IllinoisIllinois | $227.82 | $73.51 |
| Suburban Chicago, ILIllinois | $250.50 | $76.93 |
| IndianaIndiana | $225.41 | $68.74 |
| KansasKansas | $221.18 | $68.40 |
| KentuckyKentucky | $220.29 | $70.04 |
| New Orleans, LALouisiana | $231.07 | $72.03 |
| Rest of LouisianaLouisiana | $219.74 | $70.17 |
| Metropolitan Boston, MAMassachusetts | $279.35 | $77.56 |
| Rest of MassachusettsMassachusetts | $251.26 | $73.30 |
| Baltimore area, MDMaryland | $257.07 | $75.72 |
| Rest of MarylandMaryland | $243.85 | $72.81 |
| Rest of MaineMaine | $224.73 | $69.24 |
| Southern Maine, MEMaine | $238.08 | $70.59 |
| Detroit, MIMichigan | $238.14 | $75.04 |
| Rest of MichiganMichigan | $225.79 | $71.48 |
| MinnesotaMinnesota | $243.63 | $69.72 |
| Metropolitan Kansas City, MOMissouri | $229.95 | $71.25 |
| Metropolitan St. Louis, MOMissouri | $232.50 | $71.61 |
| Rest of MissouriMissouri | $215.51 | $69.82 |
| MississippiMississippi | $214.22 | $68.71 |
| MontanaMontana | $241.48 | $72.47 |
| North CarolinaNorth Carolina | $227.25 | $69.56 |
| North DakotaNorth Dakota | $238.71 | $69.70 |
| NebraskaNebraska | $224.15 | $68.16 |
| New HampshireNew Hampshire | $248.59 | $72.65 |
| Northern New JerseyNew Jersey | $274.90 | $78.85 |
| Rest of New JerseyNew Jersey | $261.16 | $76.60 |
| NevadaNevada | $240.89 | $71.72 |
| NYC suburbs and Long Island, NYNew York | $284.07 | $83.12 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $262.50 | $77.43 |
| Queens, NYNew York | $280.82 | $81.05 |
| Rest of New YorkNew York | $230.73 | $70.17 |
| OhioOhio | $225.22 | $70.92 |
| OklahomaOklahoma | $220.40 | $69.47 |
| Portland, OROregon | $261.88 | $74.11 |
| Rest of OregonOregon | $239.35 | $71.02 |
| Metropolitan Philadelphia, PAPennsylvania | $250.96 | $75.03 |
| Rest of PennsylvaniaPennsylvania | $225.87 | $70.72 |
| Puerto RicoPuerto Rico | $243.48 | $72.61 |
| Rhode IslandRhode Island | $248.11 | $73.52 |
| South CarolinaSouth Carolina | $226.55 | $70.38 |
| South DakotaSouth Dakota | $238.38 | $69.38 |
| TennesseeTennessee | $222.27 | $68.64 |
| Austin, TXTexas | $251.92 | $73.11 |
| Beaumont, TXTexas | $224.29 | $70.49 |
| Brazoria, TXTexas | $239.17 | $71.68 |
| Dallas, TXTexas | $240.52 | $72.19 |
| Fort Worth, TXTexas | $238.71 | $72.06 |
| Galveston, TXTexas | $239.77 | $71.94 |
| Houston, TXTexas | $242.33 | $74.51 |
| Rest of TexasTexas | $231.48 | $71.09 |
| UtahUtah | $229.77 | $70.90 |
| VirginiaVirginia | $236.93 | $70.79 |
| Virgin Islands, VIUnited States Virgin Islands | $243.48 | $72.61 |
| VermontVermont | $237.30 | $69.99 |
| Rest of WashingtonWashington | $250.94 | $72.98 |
| King County, WAWashington | $285.64 | $78.27 |
| WisconsinWisconsin | $230.38 | $68.47 |
| West VirginiaWest Virginia | $218.96 | $72.09 |
| WyomingWyoming | $240.27 | $71.26 |
64451 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.
$212.80
$292.87
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $276.29 | 1 |
| AL | $216.04 | 1 |
| AR | $212.80 | 1 |
| AZ | $235.01 | 1 |
| CA | $258.15–$327.58 | 29 |
| CO | $253.05 | 1 |
| CT | $257.89 | 1 |
| DC | $278.04 | 1 |
| DE | $239.01 | 1 |
| FL | $235.60–$256.32 | 3 |
| GA | $222.15–$245.57 | 2 |
| GU | $265.19 | 1 |
| HI | $265.19 | 1 |
| IA | $222.74 | 1 |
| ID | $224.03 | 1 |
| IL | $227.82–$250.50 | 4 |
| IN | $225.41 | 1 |
| KS | $221.18 | 1 |
| KY | $220.29 | 1 |
| LA | $219.74–$231.07 | 2 |
| MA | $251.26–$279.35 | 2 |
| MD | $243.85–$278.04 | 3 |
| ME | $224.73–$238.08 | 2 |
| MI | $225.79–$238.14 | 2 |
| MN | $243.63 | 1 |
| MO | $215.51–$232.50 | 3 |
| MS | $214.22 | 1 |
| MT | $241.48 | 1 |
| NC | $227.25 | 1 |
| ND | $238.71 | 1 |
| NE | $224.15 | 1 |
| NH | $248.59 | 1 |
| NJ | $261.16–$274.90 | 2 |
| NM | $226.88 | 1 |
| NV | $240.89 | 1 |
| NY | $230.73–$284.07 | 5 |
| OH | $225.22 | 1 |
| OK | $220.40 | 1 |
| OR | $239.35–$261.88 | 2 |
| PA | $225.87–$250.96 | 2 |
| PR | $243.48 | 1 |
| RI | $248.11 | 1 |
| SC | $226.55 | 1 |
| SD | $238.38 | 1 |
| TN | $222.27 | 1 |
| TX | $224.29–$251.92 | 8 |
| UT | $229.77 | 1 |
| VA | $236.93–$278.04 | 2 |
| VI | $243.48 | 1 |
| VT | $237.30 | 1 |
| WA | $250.94–$285.64 | 2 |
| WI | $230.38 | 1 |
| WV | $218.96 | 1 |
| WY | $240.27 | 1 |
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.
How the rate is built · 64451
RVUs × geographic indexes × conversion factor
Work1.48
1.48 RVUs× 1.000 GPCI
Practice expense5.61
5.61 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
7.2300
Conversion factor
$33.4009
Medicare rate
$241.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,114
- Code
- 64451
- Physician work
- 1.48
- Practice expense
- 5.61
- Malpractice
- 0.14
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.48 | × 1.000 | 1.4800 |
| Practice expense | 5.61 | × 0.917 | 5.1444 |
| Malpractice | 0.14 | × 1.201 | 0.1681 |
| Total RVUs | 6.7925 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$226.88
Office: (1.48 × 1 + 5.61 × 0.917 + 0.14 × 1.201) × $33.4009 = $226.88
Facility: (1.48 × 1 + 0.55 × 0.917 + 0.14 × 1.201) × $33.4009 = $71.90
Payment rules and modifiers for 64451
The CMS indicators that decide how 64451 is paid alongside other services.
CMS payment indicators · 64451
SI nerve block, image-guided nerve injection
| 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
64451 without 50 · national office
$241.49
SI nerve block, image-guided nerve injection
64451-50 · Bilateral: 150%
$362.24
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).
How 64451 has changed in New Mexico
64451 · Office / nonfacility
$226.88
Effective 2026-10-01
The base rate is $23.71 higher than on 2025-10-01, moving from $203.17 to $226.88 (11.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$203.17changed to$226.88
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.52 changed to 1.48
- Practice expense RVU 5.05 changed to 5.61
- Malpractice RVU 0.15 changed to 0.14
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$212.62changed to$203.17
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 5.18 changed to 5.05
- Malpractice RVU 0.14 changed to 0.15
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$209.15changed to$212.62
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$214.78changed to$209.15
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.16 changed to 5.18
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$221.66changed to$214.78
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 5.27 changed to 5.16
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$212.65changed to$221.66
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 4.91 changed to 5.27
- Malpractice RVU 0.15 changed to 0.14
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$202.95changed to$212.65
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 4.32 changed to 4.91
- Practice expense GPCI 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged to$202.95
Held through RVU20B, RVU20C, RVU20D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $226.88 | $71.90 | RVU26D |
| 2026-07-01 | $226.88 | $71.90 | RVU26C |
| 2026-04-01 | $226.88 | $71.90 | RVU26B |
| 2026-01-01 | $226.88 | $71.90 | RVU26A |
| 2025-10-01 | $203.17 | $78.06 | RVU25D |
| 2025-07-01 | $203.17 | $78.06 | RVU25C |
| 2025-04-01 | $203.17 | $78.06 | RVU25B |
| 2025-01-01 | $203.17 | $78.06 | RVU25A |
| 2024-10-01 | $212.62 | $79.33 | RVU24D |
| 2024-07-01 | $212.62 | $79.33 | RVU24C |
| 2024-04-01 | $212.62 | $79.33 | RVU24B |
| 2024-03-09 | $212.62 | $79.33 | RVU24AR |
| 2024-01-01 | $209.15 | $78.04 | RVU24A |
| 2023-10-01 | $214.78 | $79.98 | RVU23D |
| 2023-07-01 | $214.78 | $79.98 | RVU23C |
| 2023-04-01 | $214.78 | $79.98 | RVU23B |
| 2023-01-01 | $214.78 | $79.98 | RVU23A |
| 2022-10-01 | $221.66 | $80.89 | RVU22D |
| 2022-07-01 | $221.66 | $80.89 | RVU22C |
| 2022-04-01 | $221.66 | $80.89 | RVU22B |
| 2022-01-01 | $221.66 | $80.89 | RVU22A |
| 2021-10-01 | $212.65 | $78.84 | RVU21D |
| 2021-07-01 | $212.65 | $78.84 | RVU21C |
| 2021-04-01 | $212.65 | $78.84 | RVU21B |
| 2021-01-01 | $212.65 | $78.84 | RVU21A |
| 2020-10-01 | $202.95 | $81.71 | RVU20D |
| 2020-07-01 | $202.95 | $81.71 | RVU20C |
| 2020-04-01 | $202.95 | $81.71 | RVU20B |
| 2020-01-01 | $202.95 | $81.71 | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
64451 billing questions
How is this different from an SI-joint injection?
This code is for injections targeting nerves that innervate the SI joint. Code 27096 is for an injection into the SI-joint space.
Is image guidance separately reported?
No. The service includes fluoroscopic or CT guidance and needle placement.
Can I report this for both sides?
Yes. Report bilateral work with modifier 50; CMS pays the bilateral procedure at 150%.
How does the multiple-procedure reduction affect same-session services?
CMS pays the highest-valued procedure in full and reduces the other procedures to 50% when performed in the same session.
What documentation supports reporting this code?
Document the SI-innervating nerve targets, laterality, image guidance, injectate, and reason for the injection. The record should make clear that the target is neural, not the joint space.
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
Fee sheets · Coming soon
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