CPT code 64486: TAP block, unilateral injection2026 Medicare rate & RVUs in Ohio
A unilateral transversus abdominis plane block by injection provides abdominal wall analgesia, commonly for pain control after abdominal surgery.
In Ohio, Medicare pays $118.35 for 64486 in the office and $47.90 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Ohio 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. Ohio pays $118.35. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Ohio · this page$118.35
- Los Angeles, CA · California$141.46+$23.11
- Washington, DC area · District of Columbia$142.90+$24.55
- Miami, FL · Florida$133.61+$15.26
- Chicago, IL · Illinois$130.17+$11.82
- Manhattan, NY · New York$143.38+$25.03
- Alaska · Alaska$149.20+$30.85
Other areas in Ohio first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $132.87 | $48.31 |
| Merced, CACalifornia | $132.87 | $48.31 |
| Modesto, CACalifornia | $132.87 | $48.31 |
| Napa, CACalifornia | $153.12 | $51.43 |
| Oxnard, CACalifornia | $140.75 | $49.55 |
| Redding, CACalifornia | $132.87 | $48.31 |
| Rest of CaliforniaCalifornia | $132.87 | $48.31 |
| Riverside, CACalifornia | $133.87 | $49.30 |
| Sacramento, CACalifornia | $139.21 | $49.48 |
| Salinas, CACalifornia | $138.68 | $49.26 |
| San Diego, CACalifornia | $141.75 | $49.47 |
| Marin County, CACalifornia | $161.91 | $53.12 |
| San Francisco, CACalifornia | $161.81 | $53.02 |
| San Benito County, CACalifornia | $165.40 | $54.14 |
| Santa Clara County, CACalifornia | $164.98 | $53.72 |
| San Luis Obispo, CACalifornia | $136.46 | $48.58 |
| Santa Cruz, CACalifornia | $142.97 | $49.22 |
| Santa Maria, CACalifornia | $139.15 | $49.18 |
| Santa Rosa, CACalifornia | $144.40 | $49.66 |
| Stockton, CACalifornia | $132.87 | $48.31 |
| Vallejo, CACalifornia | $152.98 | $51.29 |
| Visalia, CACalifornia | $132.87 | $48.31 |
| Yuba City, CACalifornia | $132.87 | $48.31 |
| ColoradoColorado | $130.74 | $48.65 |
| ConnecticutConnecticut | $133.43 | $50.33 |
| DelawareDelaware | $124.48 | $48.25 |
| Fort Lauderdale, FLFlorida | $129.10 | $50.94 |
| Rest of FloridaFlorida | $123.43 | $49.66 |
| Atlanta, GAGeorgia | $127.64 | $49.25 |
| Rest of GeorgiaGeorgia | $117.15 | $48.32 |
| Hawaii, Guam, HIHawaii | $135.76 | $48.04 |
| IowaIowa | $116.68 | $46.08 |
| IdahoIdaho | $117.32 | $46.34 |
| East St. Louis, ILIllinois | $121.96 | $50.97 |
| Rest of IllinoisIllinois | $120.02 | $49.57 |
| Suburban Chicago, ILIllinois | $130.44 | $51.20 |
| IndianaIndiana | $117.95 | $46.42 |
| KansasKansas | $116.08 | $46.33 |
| KentuckyKentucky | $116.06 | $47.47 |
| New Orleans, LALouisiana | $121.07 | $48.47 |
| Rest of LouisianaLouisiana | $115.86 | $47.58 |
| Metropolitan Boston, MAMassachusetts | $143.06 | $50.93 |
| Rest of MassachusettsMassachusetts | $130.03 | $48.78 |
| Baltimore area, MDMaryland | $133.02 | $50.23 |
| Rest of MarylandMaryland | $126.73 | $48.65 |
| Rest of MaineMaine | $117.77 | $46.79 |
| Southern Maine, MEMaine | $123.73 | $47.26 |
| Detroit, MIMichigan | $124.73 | $50.27 |
| Rest of MichiganMichigan | $118.71 | $48.27 |
| MinnesotaMinnesota | $125.89 | $46.50 |
| Metropolitan Kansas City, MOMissouri | $120.42 | $47.98 |
| Metropolitan St. Louis, MOMissouri | $121.59 | $48.13 |
| Rest of MissouriMissouri | $113.99 | $47.48 |
| MississippiMississippi | $113.20 | $46.76 |
| MontanaMontana | $125.58 | $48.43 |
| North CarolinaNorth Carolina | $118.91 | $46.92 |
| North DakotaNorth Dakota | $123.80 | $46.65 |
| NebraskaNebraska | $117.29 | $46.07 |
| New HampshireNew Hampshire | $128.64 | $48.32 |
| Northern New JerseyNew Jersey | $141.61 | $52.11 |
| Rest of New JerseyNew Jersey | $135.12 | $50.87 |
| New MexicoNew Mexico | $119.26 | $48.51 |
| NevadaNevada | $125.17 | $47.94 |
| NYC suburbs and Long Island, NYNew York | $146.45 | $54.71 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $135.91 | $51.42 |
| Queens, NYNew York | $144.61 | $53.42 |
| Rest of New YorkNew York | $120.52 | $47.22 |
| OklahomaOklahoma | $115.98 | $47.08 |
| Portland, OROregon | $134.71 | $48.99 |
| Rest of OregonOregon | $124.36 | $47.51 |
| Metropolitan Philadelphia, PAPennsylvania | $130.29 | $49.98 |
| Rest of PennsylvaniaPennsylvania | $118.57 | $47.75 |
| Puerto RicoPuerto Rico | $126.46 | $48.46 |
| Rhode IslandRhode Island | $128.76 | $49.06 |
| South CarolinaSouth Carolina | $118.79 | $47.50 |
| South DakotaSouth Dakota | $123.59 | $46.44 |
| TennesseeTennessee | $116.60 | $46.46 |
| Austin, TXTexas | $130.17 | $48.53 |
| Beaumont, TXTexas | $117.86 | $47.65 |
| Brazoria, TXTexas | $124.49 | $48.03 |
| Dallas, TXTexas | $125.18 | $48.33 |
| Fort Worth, TXTexas | $124.38 | $48.31 |
| Galveston, TXTexas | $124.80 | $48.18 |
| Houston, TXTexas | $126.45 | $49.83 |
| Rest of TexasTexas | $121.04 | $47.82 |
| UtahUtah | $120.27 | $47.74 |
| VirginiaVirginia | $123.28 | $47.44 |
| Virgin Islands, VIUnited States Virgin Islands | $126.46 | $48.46 |
| VermontVermont | $123.27 | $46.88 |
| Rest of WashingtonWashington | $129.80 | $48.56 |
| King County, WAWashington | $145.95 | $51.28 |
| WisconsinWisconsin | $120.00 | $46.08 |
| West VirginiaWest Virginia | $115.94 | $48.90 |
| WyomingWyoming | $124.81 | $47.65 |
64486 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.
$112.36
$149.20
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $149.20 | 1 |
| AL | $113.84 | 1 |
| AR | $112.36 | 1 |
| AZ | $122.57 | 1 |
| CA | $132.87–$165.40 | 29 |
| CO | $130.74 | 1 |
| CT | $133.43 | 1 |
| DC | $142.90 | 1 |
| DE | $124.48 | 1 |
| FL | $123.43–$133.61 | 3 |
| GA | $117.15–$127.64 | 2 |
| GU | $135.76 | 1 |
| HI | $135.76 | 1 |
| IA | $116.68 | 1 |
| ID | $117.32 | 1 |
| IL | $120.02–$130.44 | 4 |
| IN | $117.95 | 1 |
| KS | $116.08 | 1 |
| KY | $116.06 | 1 |
| LA | $115.86–$121.07 | 2 |
| MA | $130.03–$143.06 | 2 |
| MD | $126.73–$142.90 | 3 |
| ME | $117.77–$123.73 | 2 |
| MI | $118.71–$124.73 | 2 |
| MN | $125.89 | 1 |
| MO | $113.99–$121.59 | 3 |
| MS | $113.20 | 1 |
| MT | $125.58 | 1 |
| NC | $118.91 | 1 |
| ND | $123.80 | 1 |
| NE | $117.29 | 1 |
| NH | $128.64 | 1 |
| NJ | $135.12–$141.61 | 2 |
| NM | $119.26 | 1 |
| NV | $125.17 | 1 |
| NY | $120.52–$146.45 | 5 |
| OH | $118.35 | 1 |
| OK | $115.98 | 1 |
| OR | $124.36–$134.71 | 2 |
| PA | $118.57–$130.29 | 2 |
| PR | $126.46 | 1 |
| RI | $128.76 | 1 |
| SC | $118.79 | 1 |
| SD | $123.59 | 1 |
| TN | $116.60 | 1 |
| TX | $117.86–$130.17 | 8 |
| UT | $120.27 | 1 |
| VA | $123.28–$142.90 | 2 |
| VI | $126.46 | 1 |
| VT | $123.27 | 1 |
| WA | $129.80–$145.95 | 2 |
| WI | $120.00 | 1 |
| WV | $115.94 | 1 |
| WY | $124.81 | 1 |
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
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 Ohio 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
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.17 | × 1.000 | 1.1700 |
| Practice expense | 2.50 | × 0.913 | 2.2825 |
| Malpractice | 0.09 | × 1.008 | 0.0907 |
| Total RVUs | 3.5432 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Ohio$118.35
Office: (1.17 × 1 + 2.5 × 0.913 + 0.09 × 1.008) × $33.4009 = $118.35
Facility: (1.17 × 1 + 0.19 × 0.913 + 0.09 × 1.008) × $33.4009 = $47.90
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
| 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
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).
How 64486 has changed in Ohio
64486 · Office / nonfacility
$118.35
Effective 2026-10-01
The base rate is $18.44 higher than on 2025-10-01, moving from $99.91 to $118.35 (18.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$99.91changed to$118.35
- 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 0.911 changed to 0.913
- Malpractice GPCI 1.033 changed to 1.008
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$105.49changed to$99.91
- 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.
March 9, 2024
RVU24AR
$103.77changed to$105.49
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$108.19changed to$103.77
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.98 changed to 1.96
- Practice expense GPCI 0.912 changed to 0.911
- Malpractice GPCI 1.063 changed to 1.033
January 1, 2023
RVU23A
$110.67changed to$108.19
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.913 changed to 0.912
- Malpractice GPCI 1.094 changed to 1.063
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$111.59changed to$110.67
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$109.11changed to$111.59
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.79 changed to 1.98
- Practice expense GPCI 0.915 changed to 0.913
- Malpractice GPCI 1.049 changed to 1.094
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$107.23changed to$109.11
- 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 0.917 changed to 0.915
- Malpractice GPCI 1.005 changed to 1.049
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$114.10changed to$107.23
- 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.
January 1, 2018
RVU18AR1
$117.81changed to$114.10
- 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 0.918 changed to 0.917
- Malpractice GPCI 0.999 changed to 1.005
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$120.40changed to$117.81
- 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
- Malpractice GPCI 0.993 changed to 0.999
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$120.46changed to$120.40
- 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.
July 1, 2015
RVU15C
$119.86changed to$120.46
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
No ratechanged to$119.86
Held through RVU15B.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $118.35 | $47.90 | RVU26D |
| 2026-07-01 | $118.35 | $47.90 | RVU26C |
| 2026-04-01 | $118.35 | $47.90 | RVU26B |
| 2026-01-01 | $118.35 | $47.90 | RVU26A |
| 2025-10-01 | $99.91 | $49.52 | RVU25D |
| 2025-07-01 | $99.91 | $49.52 | RVU25C |
| 2025-04-01 | $99.91 | $49.52 | RVU25B |
| 2025-01-01 | $99.91 | $49.52 | RVU25A |
| 2024-10-01 | $105.49 | $53.64 | RVU24D |
| 2024-07-01 | $105.49 | $53.64 | RVU24C |
| 2024-04-01 | $105.49 | $53.64 | RVU24B |
| 2024-03-09 | $105.49 | $53.64 | RVU24AR |
| 2024-01-01 | $103.77 | $52.76 | RVU24A |
| 2023-10-01 | $108.19 | $54.73 | RVU23D |
| 2023-07-01 | $108.19 | $54.73 | RVU23C |
| 2023-04-01 | $108.19 | $54.73 | RVU23B |
| 2023-01-01 | $108.19 | $54.73 | RVU23A |
| 2022-10-01 | $110.67 | $56.01 | RVU22D |
| 2022-07-01 | $110.67 | $56.01 | RVU22C |
| 2022-04-01 | $110.67 | $56.01 | RVU22B |
| 2022-01-01 | $110.67 | $56.01 | RVU22A |
| 2021-10-01 | $111.59 | $56.48 | RVU21D |
| 2021-07-01 | $111.59 | $56.48 | RVU21C |
| 2021-04-01 | $111.59 | $56.48 | RVU21B |
| 2021-01-01 | $111.59 | $56.48 | RVU21A |
| 2020-10-01 | $109.11 | $57.92 | RVU20D |
| 2020-07-01 | $109.11 | $57.92 | RVU20C |
| 2020-04-01 | $109.11 | $57.92 | RVU20B |
| 2020-01-01 | $109.11 | $57.92 | RVU20A |
| 2019-10-01 | $107.23 | $57.32 | RVU19D |
| 2019-07-01 | $107.23 | $57.32 | RVU19C |
| 2019-04-01 | $107.23 | $57.32 | RVU19B |
| 2019-01-01 | $107.23 | $57.32 | RVU19A |
| 2018-10-01 | $114.10 | $60.95 | RVU18D |
| 2018-07-01 | $114.10 | $60.95 | RVU18C |
| 2018-04-01 | $114.10 | $60.95 | RVU18B |
| 2018-01-01 | $114.10 | $60.95 | RVU18AR1 |
| 2017-10-01 | $117.81 | $63.12 | RVU17D |
| 2017-07-01 | $117.81 | $63.12 | RVU17C |
| 2017-04-01 | $117.81 | $63.12 | RVU17B |
| 2017-01-01 | $117.81 | $63.12 | RVU17A |
| 2016-10-01 | $120.40 | $63.87 | RVU16D |
| 2016-07-01 | $120.40 | $63.87 | RVU16C |
| 2016-04-01 | $120.40 | $63.87 | RVU16B |
| 2016-01-01 | $120.40 | $63.87 | RVU16A |
| 2015-10-01 | $120.46 | $63.72 | RVU15D |
| 2015-07-01 | $120.46 | $63.72 | RVU15C |
| 2015-04-01 | $119.86 | $63.40 | RVU15B |
| 2015-01-01 | $119.86 | $63.40 | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Ohio rate applies
Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Ada
- Adamsville
- Addyston
- Adelphi
- Adena
- Ai
- Akron
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
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