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

Reports anesthetic and/or steroid injection of genicular nerve branches for knee pain, including imaging guidance when performed.

CMS RVU26DEffective Oct 1, 2026One payment locality55.6K Medicare services in 2024

In Utah, Medicare pays $223.50 for 64454 in the office and $71.54 when it’s performed in a hospital or facility.

$223.50Office (non-facility)
$71.54Hospital or facility
−4.8%vs the national office rate ($234.81)

Check a contract rate as a % of Medicare · 64454 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 64454 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 64454 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 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.

How Utah compares for 64454

Across 109 of 109 payment localities, the office rate for 64454 runs from $207.18 in Arkansas to $318.25 in San Benito County, CA. Utah pays $223.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

64454 in Utah vs other payment areas
  1. Utah · this page$223.50
  2. Los Angeles, CA · California$268.51+$45.01
  3. Washington, DC area · District of Columbia$270.19+$46.69
  4. Miami, FL · Florida$248.87+$25.37
  5. Chicago, IL · Illinois$241.68+$18.18
  6. Manhattan, NY · New York$269.84+$46.34
  7. Alaska · Alaska$269.34+$45.84

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

Every other payment area

64454 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$210.29$68.84
ArkansasArkansas$207.18$68.31
ArizonaArizona$228.57$71.92
Bakersfield, CACalifornia$251.43$74.25
Chico, CACalifornia$251.01$73.83
El Centro, CACalifornia$251.03$73.86
Fresno, CACalifornia$251.01$73.83
Hanford, CACalifornia$251.01$73.83

64454 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.

$207.18

$284.63

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

View every state and territory as a table
64454 office rate range by state
State / territoryOffice rate rangeLocalities
AK$269.341
AL$210.291
AR$207.181
AZ$228.571
CA$251.01–$318.2529
CO$246.041
CT$250.651
DC$270.191
DE$232.441
FL$229.03–$248.873
GA$216.09–$238.732
GU$257.781
HI$257.781
IA$216.801
ID$218.041
IL$221.50–$243.394
IN$219.361
KS$215.281
KY$214.341
LA$213.81–$224.722
MA$244.31–$271.482
MD$237.12–$270.193
ME$218.68–$231.582
MI$219.62–$231.452
MN$237.001
MO$209.71–$226.133
MS$208.511
MT$234.801
NC$221.111
ND$232.231
NE$218.171
NH$241.691
NJ$253.86–$267.182
NM$220.661
NV$234.261
NY$224.47–$275.915
OH$219.091
OK$214.471
OR$232.79–$254.582
PA$219.72–$243.962
PR$236.731
RI$241.251
SC$220.401
SD$231.931
TN$216.321
TX$218.21–$244.918
UT$223.501
VA$230.45–$270.192
VI$236.731
VT$230.851
WA$244.01–$277.582
WI$224.201
WV$212.961
WY$233.681

See 64454 in every payment locality

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.

How the rate is built · 64454

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.48

1.48 RVUs× 1.000 GPCI

Practice expense5.42

5.42 RVUs× 1.000 GPCI

Malpractice0.13

0.13 RVUs× 1.000 GPCI

Adjusted RVUs

7.0300

Conversion factor

$33.4009

Medicare rate

$234.81

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,115

Code
64454
Physician work
1.48
Practice expense
5.42
Malpractice
0.13

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 64454 in Utah
ComponentRVULocality factorAdjusted
Physician work1.48× 1.0001.4800
Practice expense5.42× 0.9405.0948
Malpractice0.13× 0.8980.1167
Total RVUs6.6915
Conversion factor× 33.4009

Office rate, Utah$223.50

Office: (1.48 × 1 + 5.42 × 0.94 + 0.13 × 0.898) × $33.4009 = $223.50

Facility: (1.48 × 1 + 0.58 × 0.94 + 0.13 × 0.898) × $33.4009 = $71.54

Open 64454 in the RVU calculator

Payment rules and modifiers for 64454

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

CMS payment indicators · 64454

Genicular nerve block, anesthetic or steroid injection

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

64454 without 50 · national office

$234.81

Genicular nerve block, anesthetic or steroid injection

64454-50 · Bilateral: 150%

$352.22

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 64454 has changed in Utah

64454 · Office / nonfacility

$223.50

Effective 2026-10-01

The base rate is $22.85 higher than on 2025-10-01, moving from $200.65 to $223.50 (11.4%).

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

    $200.65changed to$223.50

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.52 changed to 1.48
    • Practice expense RVU 4.87 changed to 5.42
    • Malpractice RVU 0.15 changed to 0.13
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $210.22changed to$200.65

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.00 changed to 4.87
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $206.79changed to$210.22

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $211.25changed to$206.79

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.96 changed to 5.00
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930
  5. January 1, 2023

    RVU23A

    $217.91changed to$211.25

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.05 changed to 4.96
    • Malpractice RVU 0.17 changed to 0.14
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $214.03changed to$217.91

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.89 changed to 5.05
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $206.07changed to$214.03

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.38 changed to 4.89
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    No ratechanged to$206.07

    Held through RVU20B, RVU20C, RVU20D.

  9. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$223.50$71.54RVU26D
2026-07-01$223.50$71.54RVU26C
2026-04-01$223.50$71.54RVU26B
2026-01-01$223.50$71.54RVU26A
2025-10-01$200.65$77.82RVU25D
2025-07-01$200.65$77.82RVU25C
2025-04-01$200.65$77.82RVU25B
2025-01-01$200.65$77.82RVU25A
2024-10-01$210.22$79.47RVU24D
2024-07-01$210.22$79.47RVU24C
2024-04-01$210.22$79.47RVU24B
2024-03-09$210.22$79.47RVU24AR
2024-01-01$206.79$78.17RVU24A
2023-10-01$211.25$79.46RVU23D
2023-07-01$211.25$79.46RVU23C
2023-04-01$211.25$79.46RVU23B
2023-01-01$211.25$79.46RVU23A
2022-10-01$217.91$80.84RVU22D
2022-07-01$217.91$80.84RVU22C
2022-04-01$217.91$80.84RVU22B
2022-01-01$217.91$80.84RVU22A
2021-10-01$214.03$79.99RVU21D
2021-07-01$214.03$79.99RVU21C
2021-04-01$214.03$79.99RVU21B
2021-01-01$214.03$79.99RVU21A
2020-10-01$206.07$83.16RVU20D
2020-07-01$206.07$83.16RVU20C
2020-04-01$206.07$83.16RVU20B
2020-01-01$206.07$83.16RVU20A
2019-10-01Not in this releaseNot in this releaseRVU19D
2019-07-01Not in this releaseNot in this releaseRVU19C
2019-04-01Not in this releaseNot in this releaseRVU19B
2019-01-01Not in this releaseNot in this releaseRVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 64454 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

64454 billing questions

Should each genicular branch or needle placement be reported as a unit?

No. Report the code for the genicular nerve branch injection on the treated side rather than billing separately for each branch or needle placement.

Is imaging guidance separately reported?

No. Imaging guidance is included when performed as part of the genicular nerve branch injection.

How is bilateral treatment reported?

Use modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.

How does this differ from genicular nerve destruction?

64454 reports injection of anesthetic and/or steroid. Use 64624 when the service is neurolytic destruction of genicular nerve branches.

What documentation supports the service?

Document the knee and side treated, the genicular branches targeted, the reason for the injection, the medications administered, and imaging guidance when used.

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 64454PPRRVU2026_Oct_nonQPP.csv, line 7,115 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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