CPT code 64466: Thoracic block, unilateral injection2026 Medicare rate & RVUs in Missouri
Reports a single-injection anesthetic block in a thoracic fascial plane on one side, often for chest-wall pain control around breast or thoracic surgery.
Medicare pays $129.62–$137.71 for 64466 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 64466 covers
This code describes an anesthetic injection into a fascial plane in the thoracic region on one side. An anesthesiologist or other qualified clinician may perform the block for chest-wall pain control around breast or thoracic surgery. The operative or anesthesia record should identify the side, target plane, injection technique, and clinical purpose so the service can be distinguished from a thoracic paravertebral block or a catheter infusion.
Report 64466 for the unilateral injection service, not for a continuous infusion through a catheter; the latter has a separate family code. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. CMS identifies bilateral payment at 150% with modifier 50; the family also has a separate bilateral injection code, 64468, so select the descriptor that matches the service. Assistant-at-surgery payment is restricted, and 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 64466 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$129.62 to $137.71
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $136.45 | $60.86 |
| Metropolitan St. Louis, MO | $137.71 | $61.08 |
| Rest of Missouri | $129.62 | $60.23 |
How the 64466 rate is calculated
Each of 64466’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 · 64466
RVUs × geographic indexes × conversion factor
Work1.46
1.46 RVUs× 1.000 GPCI
Practice expense2.65
2.65 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
4.2500
Conversion factor
$33.4009
Medicare rate
$141.95
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64466
The CMS indicators that decide how 64466 is paid alongside other services.
CMS payment indicators · 64466
Thoracic block, unilateral 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
64466 without 50 · national office
$141.95
Thoracic block, unilateral injection
64466-50 · Bilateral: 150%
$212.93
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).
64466 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64467Thoracic plane blockUnilateral, NFS service
- Choose 64466 for a unilateral injection; 64467 describes a unilateral block delivered as a continuous infusion through a catheter.
- 64468Thoracic blockBilateral injection
- 64468 identifies a bilateral thoracic fascial plane injection, while 64466 describes the unilateral service.
- 64461Paravertebral blockThoracic, single site
- 64461 is a thoracic paravertebral block, not an injection into a thoracic fascial plane.
64466 billing questions
How is 64466 different from 64467?
64466 is for a unilateral injection. Use 64467 for a unilateral thoracic fascial plane block performed as a continuous infusion by catheter.
How should a bilateral thoracic injection be reported?
CMS lists bilateral payment at 150% with modifier 50. The code family also has 64468 for a bilateral injection, so choose the code and modifier combination that matches the documented service and applicable CPT instructions.
Is same-day postoperative care separately included?
No. The 0-day global period includes same-day preoperative and postoperative care.
What documentation supports 64466?
Document the thoracic fascial plane targeted, the unilateral site, the injection technique, and the reason for the block. The record should support an injection rather than a catheter-based continuous infusion.
Can an assistant or co-surgeon be reported for this service?
CMS restricts assistant-at-surgery payment for 64466. 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
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