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CPT code 64486: TAP block, unilateral injection2026 Medicare rate & RVUs in Idaho

A unilateral transversus abdominis plane block by injection provides abdominal wall analgesia, commonly for pain control after abdominal surgery.

CMS RVU26DEffective Oct 1, 2026One payment locality6.9K Medicare services in 2024

In Idaho, Medicare pays $117.32 for 64486 in the office and $46.34 when it’s performed in a hospital or facility.

$117.32Office (non-facility)
$46.34Hospital or facility
−6.6%vs the national office rate ($125.59)

Check a contract rate as a % of Medicare · 64486 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 64486 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Idaho
  2. What 64486 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 64486 covers

This service places local anesthetic into the plane between abdominal wall muscle layers to reduce pain from the abdominal wall on one side. Anesthesiologists, pain physicians, and other qualified clinicians commonly perform the block for perioperative analgesia, including after abdominal operations. The service covers injection rather than delivery through a catheter for continuous infusion; imaging guidance, when used, is included in the block service.

Report 64486 for the unilateral injection service, documenting the side, block site, medication, and clinical purpose. A catheter-based continuous infusion is reported with 64487, while bilateral injection has its own code, 64488. 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 lists bilateral modifier 50 payment at 150%; 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.

How Idaho compares for 64486

Across 109 of 109 payment localities, the office rate for 64486 runs from $112.36 in Arkansas to $165.40 in San Benito County, CA. Idaho pays $117.32. The RVUs are the same everywhere; the geographic indexes change the dollars.

64486 in Idaho vs other payment areas
  1. Idaho · this page$117.32
  2. Los Angeles, CA · California$141.46+$24.14
  3. Washington, DC area · District of Columbia$142.90+$25.58
  4. Miami, FL · Florida$133.61+$16.29
  5. Chicago, IL · Illinois$130.17+$12.85
  6. Manhattan, NY · New York$143.38+$26.06
  7. Alaska · Alaska$149.20+$31.88

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

Every other payment area

64486 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$113.84$46.33
ArkansasArkansas$112.36$46.08
ArizonaArizona$122.57$47.80
Bakersfield, CACalifornia$133.17$48.61
Chico, CACalifornia$132.87$48.31
El Centro, CACalifornia$132.89$48.33
Fresno, CACalifornia$132.87$48.31
Hanford, CACalifornia$132.87$48.31

64486 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$112.36

$149.20

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

View every state and territory as a table
64486 office rate range by state
State / territoryOffice rate rangeLocalities
AK$149.201
AL$113.841
AR$112.361
AZ$122.571
CA$132.87–$165.4029
CO$130.741
CT$133.431
DC$142.901
DE$124.481
FL$123.43–$133.613
GA$117.15–$127.642
GU$135.761
HI$135.761
IA$116.681
ID$117.321
IL$120.02–$130.444
IN$117.951
KS$116.081
KY$116.061
LA$115.86–$121.072
MA$130.03–$143.062
MD$126.73–$142.903
ME$117.77–$123.732
MI$118.71–$124.732
MN$125.891
MO$113.99–$121.593
MS$113.201
MT$125.581
NC$118.911
ND$123.801
NE$117.291
NH$128.641
NJ$135.12–$141.612
NM$119.261
NV$125.171
NY$120.52–$146.455
OH$118.351
OK$115.981
OR$124.36–$134.712
PA$118.57–$130.292
PR$126.461
RI$128.761
SC$118.791
SD$123.591
TN$116.601
TX$117.86–$130.178
UT$120.271
VA$123.28–$142.902
VI$126.461
VT$123.271
WA$129.80–$145.952
WI$120.001
WV$115.941
WY$124.811

See 64486 in every payment locality

How the 64486 rate is calculated

Each of 64486’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 · 64486

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.17

1.17 RVUs× 1.000 GPCI

Practice expense2.50

2.50 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

3.7600

Conversion factor

$33.4009

Medicare rate

$125.59

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

The exact Idaho inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,130

Code
64486
Physician work
1.17
Practice expense
2.50
Malpractice
0.09

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Office calculation for 64486 in Idaho
ComponentRVULocality factorAdjusted
Physician work1.17× 1.0001.1700
Practice expense2.50× 0.9202.3000
Malpractice0.09× 0.4730.0426
Total RVUs3.5126
Conversion factor× 33.4009

Office rate, Idaho$117.32

Office: (1.17 × 1 + 2.5 × 0.92 + 0.09 × 0.473) × $33.4009 = $117.32

Facility: (1.17 × 1 + 0.19 × 0.92 + 0.09 × 0.473) × $33.4009 = $46.34

Open 64486 in the RVU calculator

Payment rules and modifiers for 64486

The CMS indicators that decide how 64486 is paid alongside other services.

CMS payment indicators · 64486

TAP block, unilateral 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

64486 without 50 · national office

$125.59

TAP block, unilateral injection

64486-50 · Bilateral: 150%

$188.39

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

Codes related to 64486

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 64486
CodeHow it relatesOffice range, Idaho
Same family
64487TAP block, unilateral, continuous infusionUnilateral TAP block by catheter-based continuous infusion rather than injection.$227.85
64488TAP block, bilateral, injection techniqueBilateral TAP block by injection.$137.69
64489TAP block, bilateral continuous infusionBilateral TAP block by catheter-based continuous infusion.$373.23

How 64486 has changed in Idaho

64486 · Office / nonfacility

$117.32

Effective 2026-10-01

The base rate is $19.45 higher than on 2025-10-01, moving from $97.87 to $117.32 (19.9%).

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

    $97.87changed to$117.32

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.20 changed to 1.17
    • Practice expense RVU 1.96 changed to 2.50
    • Malpractice RVU 0.10 changed to 0.09
    • Practice expense GPCI 0.908 changed to 0.920
    • Malpractice GPCI 0.461 changed to 0.473

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $103.20changed to$97.87

    • Conversion factor 33.2875 changed to 32.3465
    • Work RVU 1.27 changed to 1.20
    • Malpractice RVU 0.11 changed to 0.10

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $101.52changed to$103.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $104.59changed to$101.52

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.98 changed to 1.96
    • Practice expense GPCI 0.893 changed to 0.908
    • Malpractice GPCI 0.439 changed to 0.461

  5. January 1, 2023

    RVU23A

    $105.63changed to$104.59

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 0.877 changed to 0.893
    • Malpractice GPCI 0.416 changed to 0.439

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $106.50changed to$105.63

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $105.17changed to$106.50

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.79 changed to 1.98
    • Practice expense GPCI 0.890 changed to 0.877
    • Malpractice GPCI 0.464 changed to 0.416

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $104.50changed to$105.17

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.75 changed to 1.79
    • Malpractice RVU 0.10 changed to 0.11
    • Practice expense GPCI 0.902 changed to 0.890
    • Malpractice GPCI 0.512 changed to 0.464

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $110.93changed to$104.50

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.94 changed to 1.75
    • Malpractice RVU 0.12 changed to 0.10

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $114.03changed to$110.93

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.04 changed to 1.94
    • Malpractice RVU 0.14 changed to 0.12
    • Practice expense GPCI 0.900 changed to 0.902
    • Malpractice GPCI 0.510 changed to 0.512

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $116.78changed to$114.03

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.15 changed to 2.04
    • Malpractice RVU 0.12 changed to 0.14
    • Practice expense GPCI 0.898 changed to 0.900
    • Malpractice GPCI 0.508 changed to 0.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $117.16changed to$116.78

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.16 changed to 2.15
    • Malpractice RVU 0.10 changed to 0.12

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $116.58changed to$117.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    No ratechanged to$116.58

    Held through RVU15B.

  15. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$117.32$46.34RVU26D
2026-07-01$117.32$46.34RVU26C
2026-04-01$117.32$46.34RVU26B
2026-01-01$117.32$46.34RVU26A
2025-10-01$97.87$47.65RVU25D
2025-07-01$97.87$47.65RVU25C
2025-04-01$97.87$47.65RVU25B
2025-01-01$97.87$47.65RVU25A
2024-10-01$103.20$51.52RVU24D
2024-07-01$103.20$51.52RVU24C
2024-04-01$103.20$51.52RVU24B
2024-03-09$103.20$51.52RVU24AR
2024-01-01$101.52$50.68RVU24A
2023-10-01$104.59$52.24RVU23D
2023-07-01$104.59$52.24RVU23C
2023-04-01$104.59$52.24RVU23B
2023-01-01$104.59$52.24RVU23A
2022-10-01$105.63$53.12RVU22D
2022-07-01$105.63$53.12RVU22C
2022-04-01$105.63$53.12RVU22B
2022-01-01$105.63$53.12RVU22A
2021-10-01$106.50$53.56RVU21D
2021-07-01$106.50$53.56RVU21C
2021-04-01$106.50$53.56RVU21B
2021-01-01$106.50$53.56RVU21A
2020-10-01$105.17$55.38RVU20D
2020-07-01$105.17$55.38RVU20C
2020-04-01$105.17$55.38RVU20B
2020-01-01$105.17$55.38RVU20A
2019-10-01$104.50$55.42RVU19D
2019-07-01$104.50$55.42RVU19C
2019-04-01$104.50$55.42RVU19B
2019-01-01$104.50$55.42RVU19A
2018-10-01$110.93$58.65RVU18D
2018-07-01$110.93$58.65RVU18C
2018-04-01$110.93$58.65RVU18B
2018-01-01$110.93$58.65RVU18AR1
2017-10-01$114.03$60.42RVU17D
2017-07-01$114.03$60.42RVU17C
2017-04-01$114.03$60.42RVU17B
2017-01-01$114.03$60.42RVU17A
2016-10-01$116.78$61.48RVU16D
2016-07-01$116.78$61.48RVU16C
2016-04-01$116.78$61.48RVU16B
2016-01-01$116.78$61.48RVU16A
2015-10-01$117.16$61.66RVU15D
2015-07-01$117.16$61.66RVU15C
2015-04-01$116.58$61.35RVU15B
2015-01-01$116.58$61.35RVU15A
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 64486 for an earlier date of service

Where the Idaho rate applies

Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Acequia
  • Albion
  • American Falls
  • Ammon
  • Arbon Valley
  • Arco
  • Arimo

Browse all communities in Idaho

64486 billing questions

When should 64486 be chosen instead of 64487?

Use 64486 for a unilateral TAP block delivered by injection. Use 64487 when the service uses a catheter for continuous infusion.

How is a bilateral injection block reported?

Code 64488 specifically describes bilateral TAP block by injection. CMS lists modifier 50 payment at 150% for a bilateral procedure; follow the applicable reporting convention for the service and claim.

Is ultrasound guidance separately reported?

Imaging guidance, when performed for this block, is included in the service rather than separately reported as guidance for the TAP block.

What documentation supports 64486?

Document the unilateral side, injection site, medication, and reason for the block. The record should also support that the service was an injection rather than catheter-based continuous infusion.

Are same-day preoperative and postoperative visits separately included?

The 0-day global period includes same-day preoperative and postoperative care for this procedure.

Can an assistant or co-surgeon be billed for this block?

CMS restricts assistant-at-surgery payment for 64486. 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 64486PPRRVU2026_Oct_nonQPP.csv, line 7,130 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)

Open CMS sourceHow we calculate rates

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