CPT code 64454: Genicular nerve block, anesthetic or steroid injection2026 Medicare rate & RVUs

Medicare pays $234.81 for 64454 nationally in the office and $73.15 in a hospital or facility. Local office rates run $207.18–$318.25.

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

What 64454 covers

A clinician injects anesthetic, steroid, or both near sensory branches supplying the knee. This service is commonly used to evaluate or relieve knee pain, including pain associated with osteoarthritis, and may help assess a patient’s response before considering genicular nerve destruction. It is performed in office or facility settings; imaging guidance, when used, is included in the service.

Report 64454 for the genicular nerve branch injection rather than counting each needle placement or branch as a separate service. Documentation should identify the treated side and branches, the indication, medications administered, and guidance used when applicable. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 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.

Where 64454 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

64454 rates by state

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

How the 64454 rate is calculated

Each of 64454’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 64454

The CMS indicators that decide how 64454 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

64454 compared with similar codes

How to choose

64624Genicular nerve ablationThree or more branches

64454 is for anesthetic and/or steroid injection of genicular branches; 64624 is for neurolytic destruction of those branches.

64450Nerve blockOther peripheral nerve or branch

Use 64454 for the specifically identified genicular nerve branches. 64450 describes injection of another peripheral nerve or branch not represented by a more specific code.

20610Joint injectionMajor joint or bursa, no ultrasound

64454 targets sensory nerve branches supplying the knee. 20610 targets the major joint space, such as for an intra-articular knee injection.

Codes related to 64454

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

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