CPT code 64463: Paravertebral block, thoracic continuous infusion2026 Medicare rate & RVUs in Metropolitan Boston, MA

Reports a thoracic paravertebral block using a catheter for continuous anesthetic infusion, commonly to provide perioperative pain control after chest or breast surgery.

CMS RVU26DEffective Oct 1, 2026One payment locality815 Medicare services in 2024

In Metropolitan Boston, MA, Medicare pays $304.38 for 64463 in the office and $80.25 when it’s performed in a hospital or facility.

$304.38Office (non-facility)
$80.25Hospital or facility
+15.2%vs the national office rate ($264.20)

Check a contract rate as a % of Medicare · 64463 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 64463 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Metropolitan Boston, MA
  2. What 64463 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 64463 covers

Code 64463 reports a thoracic paravertebral block performed with a catheter for continuous anesthetic infusion. The catheter delivers medication near the thoracic spinal nerves beside the vertebral column. Anesthesiologists and pain medicine physicians commonly perform the block for perioperative analgesia, including after thoracotomy or breast surgery, in an operating room or other procedural setting. Imaging guidance, when used for the block, is included.

Select this code for the continuous catheter technique rather than a single-injection thoracic block. Document the thoracic site, laterality, catheter technique, and plan for continuous infusion. The service 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 at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 Metropolitan Boston, MA compares for 64463

Across 109 of 109 payment localities, the office rate for 64463 runs from $233.82 in Arkansas to $355.62 in San Benito County, CA. Metropolitan Boston, MA pays $304.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

64463 in Metropolitan Boston, MA vs other payment areas
  1. Metropolitan Boston, MA · this page$304.38
  2. Rest of Massachusetts · Massachusetts$274.55−$29.83
  3. Los Angeles, CA · California$301.00−$3.38
  4. Washington, DC area · District of Columbia$303.22−$1.16
  5. Miami, FL · Florida$280.45−$23.93
  6. Chicago, IL · Illinois$272.54−$31.84
  7. Manhattan, NY · New York$303.21−$1.17

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

Every other payment area

64463 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$305.51$105.59
AlabamaAlabama$237.25$73.00
ArkansasArkansas$233.82$72.58
ArizonaArizona$257.32$75.43
Bakersfield, CACalifornia$282.20$76.47
Chico, CACalifornia$281.69$75.96
El Centro, CACalifornia$281.72$75.98
Fresno, CACalifornia$281.69$75.96

64463 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.

$233.82

$318.66

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

View every state and territory as a table
64463 office rate range by state
State / territoryOffice rate rangeLocalities
AK$305.511
AL$237.251
AR$233.821
AZ$257.321
CA$281.69–$355.6229
CO$276.381
CT$281.731
DC$303.221
DE$261.611
FL$258.22–$280.453
GA$243.94–$268.612
GU$288.951
HI$288.951
IA$244.231
ID$245.621
IL$250.07–$274.084
IN$247.071
KS$242.631
KY$241.871
LA$241.31–$253.302
MA$274.55–$304.382
MD$266.75–$303.223
ME$246.42–$260.462
MI$247.75–$260.972
MN$266.151
MO$236.87–$254.753
MS$235.411
MT$264.191
NC$249.071
ND$261.031
NE$245.701
NH$271.611
NJ$285.32–$299.992
NM$248.921
NV$263.511
NY$252.76–$309.985
OH$247.101
OK$241.921
OR$261.83–$285.702
PA$247.75–$274.422
PR$266.291
RI$271.301
SC$248.421
SD$260.651
TN$243.791
TX$246.09–$275.158
UT$251.831
VA$259.28–$303.222
VI$266.291
VT$259.591
WA$274.17–$311.052
WI$252.231
WV$240.691
WY$262.811

See 64463 in every payment locality

How the 64463 rate is calculated

Each of 64463’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 · 64463

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.85

1.85 RVUs× 1.000 GPCI

Practice expense5.90

5.90 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

7.9100

Conversion factor

$33.4009

Medicare rate

$264.20

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

The exact Metropolitan Boston, MA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,119

Code
64463
Physician work
1.85
Practice expense
5.90
Malpractice
0.16

GPCI2026.csv

62

Locality
Metropolitan Boston, MA
Physician work
1.041
Practice expense
1.194
Malpractice
0.890
Office calculation for 64463 in Metropolitan Boston, MA
ComponentRVULocality factorAdjusted
Physician work1.85× 1.0411.9259
Practice expense5.90× 1.1947.0446
Malpractice0.16× 0.8900.1424
Total RVUs9.1128
Conversion factor× 33.4009

Office rate, Metropolitan Boston, MA$304.38

Office: (1.85 × 1.041 + 5.9 × 1.194 + 0.16 × 0.89) × $33.4009 = $304.38

Facility: (1.85 × 1.041 + 0.28 × 1.194 + 0.16 × 0.89) × $33.4009 = $80.25

Open 64463 in the RVU calculator

Payment rules and modifiers for 64463

The CMS indicators that decide how 64463 is paid alongside other services.

CMS payment indicators · 64463

Paravertebral block, thoracic continuous infusion

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

64463 without 50 · national office

$264.20

Paravertebral block, thoracic continuous infusion

64463-50 · Bilateral: 150%

$396.30

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 64463 has changed in Metropolitan Boston, MA

64463 · Office / nonfacility

$304.38

Effective 2026-10-01

The base rate is $57.61 higher than on 2025-10-01, moving from $246.77 to $304.38 (23.3%).

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

    $246.77changed to$304.38

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.90 changed to 1.85
    • Practice expense RVU 4.60 changed to 5.90
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.197 changed to 1.194
    • Malpractice GPCI 0.894 changed to 0.890

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $260.73changed to$246.77

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.77 changed to 4.60

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $256.47changed to$260.73

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $271.54changed to$256.47

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.90 changed to 4.77
    • Malpractice RVU 0.17 changed to 0.16
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.200 changed to 1.197
    • Malpractice GPCI 0.868 changed to 0.894
  5. January 1, 2023

    RVU23A

    $282.92changed to$271.54

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.02 changed to 4.90
    • Work GPCI 1.049 changed to 1.045
    • Practice expense GPCI 1.203 changed to 1.200
    • Malpractice GPCI 0.842 changed to 0.868

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $266.62changed to$282.92

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.59 changed to 5.02
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $233.42changed to$266.62

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.65 changed to 4.59
    • Work GPCI 1.041 changed to 1.049
    • Practice expense GPCI 1.191 changed to 1.203
    • Malpractice GPCI 0.952 changed to 0.842

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $207.34changed to$233.42

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.08 changed to 3.65
    • Work GPCI 1.033 changed to 1.041
    • Practice expense GPCI 1.179 changed to 1.191
    • Malpractice GPCI 1.061 changed to 0.952

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $180.80changed to$207.34

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.46 changed to 3.08

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $186.14changed to$180.80

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.63 changed to 2.46
    • Malpractice RVU 0.19 changed to 0.15
    • Work GPCI 1.025 changed to 1.033
    • Practice expense GPCI 1.171 changed to 1.179
    • Malpractice GPCI 0.839 changed to 1.061

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $178.93changed to$186.14

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.81 changed to 1.90
    • Practice expense RVU 2.64 changed to 2.63
    • Malpractice RVU 0.14 changed to 0.19
    • Work GPCI 1.017 changed to 1.025
    • Practice expense GPCI 1.163 changed to 1.171
    • Malpractice GPCI 0.617 changed to 0.839

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$178.93

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$304.38$80.25RVU26D
2026-07-01$304.38$80.25RVU26C
2026-04-01$304.38$80.25RVU26B
2026-01-01$304.38$80.25RVU26A
2025-10-01$246.77$82.61RVU25D
2025-07-01$246.77$82.61RVU25C
2025-04-01$246.77$82.61RVU25B
2025-01-01$246.77$82.61RVU25A
2024-10-01$260.73$84.61RVU24D
2024-07-01$260.73$84.61RVU24C
2024-04-01$260.73$84.61RVU24B
2024-03-09$260.73$84.61RVU24AR
2024-01-01$256.47$83.23RVU24A
2023-10-01$271.54$86.52RVU23D
2023-07-01$271.54$86.52RVU23C
2023-04-01$271.54$86.52RVU23B
2023-01-01$271.54$86.52RVU23A
2022-10-01$282.92$88.50RVU22D
2022-07-01$282.92$88.50RVU22C
2022-04-01$282.92$88.50RVU22B
2022-01-01$282.92$88.50RVU22A
2021-10-01$266.62$88.64RVU21D
2021-07-01$266.62$88.64RVU21C
2021-04-01$266.62$88.64RVU21B
2021-01-01$266.62$88.64RVU21A
2020-10-01$233.42$91.15RVU20D
2020-07-01$233.42$91.15RVU20C
2020-04-01$233.42$91.15RVU20B
2020-01-01$233.42$91.15RVU20A
2019-10-01$207.34$92.19RVU19D
2019-07-01$207.34$92.19RVU19C
2019-04-01$207.34$92.19RVU19B
2019-01-01$207.34$92.19RVU19A
2018-10-01$180.80$94.21RVU18D
2018-07-01$180.80$94.21RVU18C
2018-04-01$180.80$94.21RVU18B
2018-01-01$180.80$94.21RVU18AR1
2017-10-01$186.14$95.79RVU17D
2017-07-01$186.14$95.79RVU17C
2017-04-01$186.14$95.79RVU17B
2017-01-01$186.14$95.79RVU17A
2016-10-01$178.93$88.15RVU16D
2016-07-01$178.93$88.15RVU16C
2016-04-01$178.93$88.15RVU16B
2016-01-01$178.93$88.15RVU16A
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 64463 for an earlier date of service

Where the Metropolitan Boston, MA rate applies

Metropolitan Boston, MA is a Medicare payment area, not a city. Our Census mapping connects it to 60 cities and communities in Massachusetts. Some span more than one payment area; confirm with the service ZIP.

  • Boston
  • Arlington
  • Ayer
  • Bellingham
  • Belmont
  • Braintree Town
  • Brookline
  • Burlington

Browse all communities in Massachusetts

64463 billing questions

How does 64463 differ from 64461?

64463 is for a thoracic paravertebral block using a catheter for continuous infusion. 64461 describes a single-injection thoracic paravertebral block.

Can imaging guidance be billed separately?

Imaging guidance, when used for the block, is included in 64463.

How is a bilateral block reported?

CMS identifies 64463 as a bilateral procedure; modifier 50 is paid at 150%. Document the treated sides.

What documentation supports choosing 64463?

Document the thoracic paravertebral location, laterality, catheter technique, and that the catheter is intended for continuous infusion. A single-injection technique points to a different code.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 64463. Co-surgeons and team surgery are not permitted.

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 64463PPRRVU2026_Oct_nonQPP.csv, line 7,119 (RVU26D)
Geographic factors for Metropolitan Boston, MAGPCI2026.csv, line 62 (RVU26D)

Open CMS sourceHow we calculate rates

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