CPT code 64468: Thoracic block, bilateral injection2026 Medicare rate & RVUs in Louisiana
Reports bilateral injection of anesthetic into thoracic fascial planes for chest-wall analgesia, commonly around breast or other thoracic surgery.
Medicare pays $152.06–$158.83 for 64468 in the office in Louisiana, from Rest of Louisiana to New Orleans, LA. 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 64468 covers
This code covers injection of anesthetic into thoracic fascial planes on both sides for regional analgesia. Anesthesiologists and acute-pain specialists commonly perform the block around breast or other thoracic surgery to manage chest-wall pain. It describes injections, not delivery through a catheter for continuous infusion; imaging guidance, when performed, is included in the block service.
Report one unit for the bilateral block, with documentation identifying the sites and both sides treated, the anesthetic injected, and the clinical purpose. The 0-day global period includes same-day preoperative and postoperative care. When this block is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. The code is priced as bilateral, so modifier 50 does not increase payment. 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.
Where 64468 pays more and less in Louisiana
| Payment locality | Office | Facility |
|---|---|---|
| New Orleans, LA | $158.83 | $68.31 |
| Rest of Louisiana | $152.06 | $66.93 |
How the 64468 rate is calculated
Each of 64468’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 · 64468
RVUs × geographic indexes × conversion factor
Work1.63
1.63 RVUs× 1.000 GPCI
Practice expense3.14
3.14 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
4.9200
Conversion factor
$33.4009
Medicare rate
$164.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64468
The CMS indicators that decide how 64468 is paid alongside other services.
CMS payment indicators · 64468
Thoracic block, bilateral 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) | 2 | Already bilateral by definition: paid once at 100%. |
| 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 51 · payment effect
With and without the modifier
64468 without 51 · national office
$164.33
Thoracic block, bilateral injection
64468-51 · Second procedure: 50%
$82.17
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
64468 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64466Thoracic blockUnilateral injection
- Use 64468 when the thoracic fascial plane injections are bilateral; use 64466 when they are unilateral.
- 64469Thoracic plane blockBilateral continuous catheter
- Use 64468 for bilateral injections; 64469 describes bilateral delivery by continuous infusion.
- 64461Paravertebral blockThoracic, single site
- 64461 describes a thoracic paravertebral block, not a thoracic fascial plane injection.
64468 billing questions
How does 64468 differ from 64466?
64468 describes injection treatment on both sides. 64466 describes the corresponding unilateral injection service.
How does 64468 differ from 64469?
Both describe bilateral thoracic fascial plane blocks, but 64468 is for injections and 64469 is for continuous infusion.
Should modifier 50 be appended?
The code is already priced as bilateral, and modifier 50 does not increase payment. Document that the block was performed on both sides.
Can imaging guidance be billed separately?
Imaging guidance, when performed, is included in the thoracic fascial plane block service.
What documentation supports reporting 64468?
Document the thoracic fascial plane sites, bilateral treatment, anesthetic injected, and reason for the block, such as perioperative chest-wall analgesia.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction. The 0-day global period includes same-day preoperative and postoperative care.
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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