CPT code 64463: Paravertebral block, thoracic continuous infusion2026 Medicare rate & RVUs in Nevada

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 Nevada, Medicare pays $263.51 for 64463 in the office and $75.60 when it’s performed in a hospital or facility.

$263.51Office (non-facility)
$75.60Hospital or facility
−0.3%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 Nevada
  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 Nevada 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. Nevada pays $263.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

64463 in Nevada vs other payment areas
  1. Nevada · this page$263.51
  2. Los Angeles, CA · California$301.00+$37.49
  3. Washington, DC area · District of Columbia$303.22+$39.71
  4. Miami, FL · Florida$280.45+$16.94
  5. Chicago, IL · Illinois$272.54+$9.03
  6. Manhattan, NY · New York$303.21+$39.70
  7. Alaska · Alaska$305.51+$42.00

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

Every other payment area

64463 in every other Medicare payment locality
Payment localityOfficeFacility
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
Hanford, 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 Nevada 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

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 64463 in Nevada
ComponentRVULocality factorAdjusted
Physician work1.85× 1.0001.8500
Practice expense5.90× 1.0015.9059
Malpractice0.16× 0.8330.1333
Total RVUs7.8892
Conversion factor× 33.4009

Office rate, Nevada$263.51

Office: (1.85 × 1 + 5.9 × 1.001 + 0.16 × 0.833) × $33.4009 = $263.51

Facility: (1.85 × 1 + 0.28 × 1.001 + 0.16 × 0.833) × $33.4009 = $75.60

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 Nevada

64463 · Office / nonfacility

$263.51

Effective 2026-10-01

The base rate is $48.89 higher than on 2025-10-01, moving from $214.62 to $263.51 (22.8%).

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

    $214.62changed to$263.51

    • 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
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $226.52changed to$214.62

    • 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

    $222.83changed to$226.52

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $236.76changed to$222.83

    • 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
    • Malpractice GPCI 1.098 changed to 0.844
  5. January 1, 2023

    RVU23A

    $247.75changed to$236.76

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.02 changed to 4.90
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $233.86changed to$247.75

    • 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

    $206.69changed to$233.86

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.65 changed to 4.59
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $186.41changed to$206.69

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.08 changed to 3.65
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $163.51changed to$186.41

    • 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

    $172.51changed to$163.51

    • 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 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $169.40changed to$172.51

    • 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 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$169.40

    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$263.51$75.60RVU26D
2026-07-01$263.51$75.60RVU26C
2026-04-01$263.51$75.60RVU26B
2026-01-01$263.51$75.60RVU26A
2025-10-01$214.62$77.47RVU25D
2025-07-01$214.62$77.47RVU25C
2025-04-01$214.62$77.47RVU25B
2025-01-01$214.62$77.47RVU25A
2024-10-01$226.52$79.39RVU24D
2024-07-01$226.52$79.39RVU24C
2024-04-01$226.52$79.39RVU24B
2024-03-09$226.52$79.39RVU24AR
2024-01-01$222.83$78.10RVU24A
2023-10-01$236.76$82.57RVU23D
2023-07-01$236.76$82.57RVU23C
2023-04-01$236.76$82.57RVU23B
2023-01-01$236.76$82.57RVU23A
2022-10-01$247.75$86.14RVU22D
2022-07-01$247.75$86.14RVU22C
2022-04-01$247.75$86.14RVU22B
2022-01-01$247.75$86.14RVU22A
2021-10-01$233.86$85.91RVU21D
2021-07-01$233.86$85.91RVU21C
2021-04-01$233.86$85.91RVU21B
2021-01-01$233.86$85.91RVU21A
2020-10-01$206.69$87.23RVU20D
2020-07-01$206.69$87.23RVU20C
2020-04-01$206.69$87.23RVU20B
2020-01-01$206.69$87.23RVU20A
2019-10-01$186.41$87.09RVU19D
2019-07-01$186.41$87.09RVU19C
2019-04-01$186.41$87.09RVU19B
2019-01-01$186.41$87.09RVU19A
2018-10-01$163.51$88.82RVU18D
2018-07-01$163.51$88.82RVU18C
2018-04-01$163.51$88.82RVU18B
2018-01-01$163.51$88.82RVU18AR1
2017-10-01$172.51$92.72RVU17D
2017-07-01$172.51$92.72RVU17C
2017-04-01$172.51$92.72RVU17B
2017-01-01$172.51$92.72RVU17A
2016-10-01$169.40$87.36RVU16D
2016-07-01$169.40$87.36RVU16C
2016-04-01$169.40$87.36RVU16B
2016-01-01$169.40$87.36RVU16A
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 Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

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 NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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