CPT code 64489: TAP block, bilateral continuous infusion2026 Medicare rate & RVUs in West Virginia
Reports a bilateral transversus abdominis plane block with continuous catheter infusion for abdominal wall analgesia, commonly around abdominal surgery.
In West Virginia, Medicare pays $360.63 for 64489 in the office and $71.83 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 64489 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 64489 covers
A transversus abdominis plane (TAP) block places local anesthetic in the fascial plane of the abdominal wall to provide analgesia. This code describes the block on both sides with continuous infusion through catheters; catheter insertion is included when performed. Anesthesia professionals commonly place these blocks around abdominal operations to support postoperative pain control, often in a hospital or surgical facility.
Choose this code when the service is bilateral and uses continuous catheter infusion, rather than a single injection. Document the block sites, bilateral service, catheter placement when performed, and the infusion plan. CMS assigns the code a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. The code is priced as bilateral, so modifier 50 does not increase payment. CMS does not pay an assistant at surgery and does not permit co-surgeon or team-surgery payment for this code.
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 West Virginia compares for 64489
Across 109 of 109 payment localities, the office rate for 64489 runs from $352.63 in Arkansas to $557.84 in San Benito County, CA. West Virginia pays $360.63. The RVUs are the same everywhere; the geographic indexes change the dollars.
- West Virginia · this page$360.63
- Los Angeles, CA · California$466.21+$105.58
- Washington, DC area · District of Columbia$467.50+$106.87
- Miami, FL · Florida$424.79+$64.16
- Chicago, IL · Illinois$411.74+$51.11
- Manhattan, NY · New York$464.99+$104.36
- Alaska · Alaska$451.62+$90.99
Other areas in West Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $358.35 | $67.55 |
| ArkansasArkansas | $352.63 | $67.16 |
| ArizonaArizona | $391.86 | $69.82 |
| Bakersfield, CACalifornia | $435.01 | $70.77 |
| Chico, CACalifornia | $434.53 | $70.29 |
| El Centro, CACalifornia | $434.56 | $70.31 |
| Fresno, CACalifornia | $434.53 | $70.29 |
| Hanford, CACalifornia | $434.53 | $70.29 |
| Madera, CACalifornia | $434.53 | $70.29 |
| Merced, CACalifornia | $434.53 | $70.29 |
| Modesto, CACalifornia | $434.53 | $70.29 |
| Napa, CACalifornia | $512.73 | $74.70 |
| Oxnard, CACalifornia | $464.93 | $72.10 |
| Redding, CACalifornia | $434.53 | $70.29 |
| Rest of CaliforniaCalifornia | $434.53 | $70.29 |
| Riverside, CACalifornia | $436.18 | $71.94 |
| Sacramento, CACalifornia | $458.47 | $71.96 |
| Salinas, CACalifornia | $456.82 | $71.64 |
| San Diego, CACalifornia | $469.41 | $71.93 |
| Marin County, CACalifornia | $545.68 | $77.09 |
| San Francisco, CACalifornia | $545.51 | $76.92 |
| San Benito County, CACalifornia | $557.84 | $78.61 |
| Santa Clara County, CACalifornia | $557.14 | $77.91 |
| San Luis Obispo, CACalifornia | $449.20 | $70.66 |
| Santa Cruz, CACalifornia | $475.34 | $71.55 |
| Santa Maria, CACalifornia | $459.03 | $71.53 |
| Santa Rosa, CACalifornia | $480.29 | $72.18 |
| Stockton, CACalifornia | $434.53 | $70.29 |
| Vallejo, CACalifornia | $512.48 | $74.46 |
| Visalia, CACalifornia | $434.53 | $70.29 |
| Yuba City, CACalifornia | $434.53 | $70.29 |
| ColoradoColorado | $424.56 | $70.95 |
| ConnecticutConnecticut | $431.60 | $73.67 |
| DelawareDelaware | $398.84 | $70.49 |
| Fort Lauderdale, FLFlorida | $411.63 | $74.97 |
| Rest of FloridaFlorida | $390.66 | $72.95 |
| Atlanta, GAGeorgia | $409.78 | $72.13 |
| Rest of GeorgiaGeorgia | $367.28 | $70.83 |
| Hawaii, Guam, HIHawaii | $447.76 | $69.89 |
| IowaIowa | $371.14 | $67.05 |
| IdahoIdaho | $373.23 | $67.47 |
| East St. Louis, ILIllinois | $380.95 | $75.20 |
| Rest of IllinoisIllinois | $376.30 | $72.88 |
| Suburban Chicago, ILIllinois | $416.62 | $75.31 |
| IndianaIndiana | $375.68 | $67.60 |
| KansasKansas | $367.93 | $67.49 |
| KentuckyKentucky | $364.87 | $69.42 |
| New Orleans, LALouisiana | $383.71 | $70.98 |
| Rest of LouisianaLouisiana | $363.72 | $69.60 |
| Metropolitan Boston, MAMassachusetts | $471.10 | $74.29 |
| Rest of MassachusettsMassachusetts | $421.12 | $71.17 |
| Baltimore area, MDMaryland | $430.14 | $73.55 |
| Rest of MarylandMaryland | $407.40 | $71.07 |
| Rest of MaineMaine | $373.97 | $68.22 |
| Southern Maine, MEMaine | $398.23 | $68.88 |
| Detroit, MIMichigan | $394.65 | $73.94 |
| Rest of MichiganMichigan | $374.13 | $70.70 |
| MinnesotaMinnesota | $409.51 | $67.53 |
| Metropolitan Kansas City, MOMissouri | $382.23 | $70.16 |
| Metropolitan St. Louis, MOMissouri | $386.79 | $70.40 |
| Rest of MissouriMissouri | $355.96 | $69.48 |
| MississippiMississippi | $354.44 | $68.30 |
| MontanaMontana | $403.14 | $70.80 |
| North CarolinaNorth Carolina | $378.49 | $68.42 |
| North DakotaNorth Dakota | $400.17 | $67.83 |
| NebraskaNebraska | $373.77 | $67.02 |
| New HampshireNew Hampshire | $416.50 | $70.54 |
| Northern New JerseyNew Jersey | $461.65 | $76.14 |
| Rest of New JerseyNew Jersey | $437.29 | $74.38 |
| New MexicoNew Mexico | $375.85 | $71.10 |
| NevadaNevada | $402.65 | $69.98 |
| NYC suburbs and Long Island, NYNew York | $475.55 | $80.40 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $439.17 | $75.26 |
| Queens, NYNew York | $471.08 | $78.26 |
| Rest of New YorkNew York | $384.61 | $68.89 |
| OhioOhio | $373.52 | $70.09 |
| OklahomaOklahoma | $365.54 | $68.76 |
| Portland, OROregon | $440.63 | $71.41 |
| Rest of OregonOregon | $400.30 | $69.29 |
| Metropolitan Philadelphia, PAPennsylvania | $419.13 | $73.16 |
| Rest of PennsylvaniaPennsylvania | $374.91 | $69.82 |
| Puerto RicoPuerto Rico | $406.82 | $70.83 |
| Rhode IslandRhode Island | $414.95 | $71.64 |
| South CarolinaSouth Carolina | $376.48 | $69.40 |
| South DakotaSouth Dakota | $399.82 | $67.48 |
| TennesseeTennessee | $369.80 | $67.70 |
| Austin, TXTexas | $422.47 | $70.86 |
| Beaumont, TXTexas | $372.10 | $69.67 |
| Brazoria, TXTexas | $399.43 | $70.09 |
| Dallas, TXTexas | $401.59 | $70.58 |
| Fort Worth, TXTexas | $398.24 | $70.56 |
| Galveston, TXTexas | $400.36 | $70.34 |
| Houston, TXTexas | $403.10 | $73.09 |
| Rest of TexasTexas | $385.27 | $69.88 |
| UtahUtah | $382.18 | $69.78 |
| VirginiaVirginia | $395.88 | $69.19 |
| Virgin Islands, VIUnited States Virgin Islands | $406.82 | $70.83 |
| VermontVermont | $397.26 | $68.25 |
| Rest of WashingtonWashington | $420.77 | $70.82 |
| King County, WAWashington | $482.50 | $74.72 |
| WisconsinWisconsin | $385.36 | $66.98 |
| WyomingWyoming | $401.85 | $69.51 |
64489 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.
$352.63
$496.19
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 | $451.62 | 1 |
| AL | $358.35 | 1 |
| AR | $352.63 | 1 |
| AZ | $391.86 | 1 |
| CA | $434.53–$557.84 | 29 |
| CO | $424.56 | 1 |
| CT | $431.60 | 1 |
| DC | $467.50 | 1 |
| DE | $398.84 | 1 |
| FL | $390.66–$424.79 | 3 |
| GA | $367.28–$409.78 | 2 |
| GU | $447.76 | 1 |
| HI | $447.76 | 1 |
| IA | $371.14 | 1 |
| ID | $373.23 | 1 |
| IL | $376.30–$416.62 | 4 |
| IN | $375.68 | 1 |
| KS | $367.93 | 1 |
| KY | $364.87 | 1 |
| LA | $363.72–$383.71 | 2 |
| MA | $421.12–$471.10 | 2 |
| MD | $407.40–$467.50 | 3 |
| ME | $373.97–$398.23 | 2 |
| MI | $374.13–$394.65 | 2 |
| MN | $409.51 | 1 |
| MO | $355.96–$386.79 | 3 |
| MS | $354.44 | 1 |
| MT | $403.14 | 1 |
| NC | $378.49 | 1 |
| ND | $400.17 | 1 |
| NE | $373.77 | 1 |
| NH | $416.50 | 1 |
| NJ | $437.29–$461.65 | 2 |
| NM | $375.85 | 1 |
| NV | $402.65 | 1 |
| NY | $384.61–$475.55 | 5 |
| OH | $373.52 | 1 |
| OK | $365.54 | 1 |
| OR | $400.30–$440.63 | 2 |
| PA | $374.91–$419.13 | 2 |
| PR | $406.82 | 1 |
| RI | $414.95 | 1 |
| SC | $376.48 | 1 |
| SD | $399.82 | 1 |
| TN | $369.80 | 1 |
| TX | $372.10–$422.47 | 8 |
| UT | $382.18 | 1 |
| VA | $395.88–$467.50 | 2 |
| VI | $406.82 | 1 |
| VT | $397.26 | 1 |
| WA | $420.77–$482.50 | 2 |
| WI | $385.36 | 1 |
| WV | $360.63 | 1 |
| WY | $401.85 | 1 |
How the 64489 rate is calculated
Each of 64489’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 · 64489
RVUs × geographic indexes × conversion factor
Work1.71
1.71 RVUs× 1.000 GPCI
Practice expense10.21
10.21 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
12.0700
Conversion factor
$33.4009
Medicare rate
$403.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact West Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,133
- Code
- 64489
- Physician work
- 1.71
- Practice expense
- 10.21
- Malpractice
- 0.15
GPCI2026.csv
110
- Locality
- West Virginia
- Physician work
- 1.000
- Practice expense
- 0.869
- Malpractice
- 1.431
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.71 | × 1.000 | 1.7100 |
| Practice expense | 10.21 | × 0.869 | 8.8725 |
| Malpractice | 0.15 | × 1.431 | 0.2147 |
| Total RVUs | 10.7971 | ||
| Conversion factor | × 33.4009 | ||
Office rate, West Virginia$360.63
Office: (1.71 × 1 + 10.21 × 0.869 + 0.15 × 1.431) × $33.4009 = $360.63
Facility: (1.71 × 1 + 0.26 × 0.869 + 0.15 × 1.431) × $33.4009 = $71.83
Payment rules and modifiers for 64489
The CMS indicators that decide how 64489 is paid alongside other services.
CMS payment indicators · 64489
TAP block, bilateral continuous infusion
| 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
64489 without 51 · national office
$403.15
TAP block, bilateral continuous infusion
64489-51 · Second procedure: 50%
$201.58
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%).
How 64489 has changed in West Virginia
64489 · Office / nonfacility
$360.63
Effective 2026-10-01
The base rate is $72.11 higher than on 2025-10-01, moving from $288.52 to $360.63 (25.0%).
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
$288.52changed to$360.63
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.75 changed to 1.71
- Practice expense RVU 8.07 changed to 10.21
- Malpractice RVU 0.16 changed to 0.15
- Practice expense GPCI 0.862 changed to 0.869
- Malpractice GPCI 1.333 changed to 1.431
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$307.89changed to$288.52
- Conversion factor 33.2875 changed to 32.3465
- Work RVU 1.80 changed to 1.75
- Practice expense RVU 8.41 changed to 8.07
- Malpractice RVU 0.15 changed to 0.16
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$302.86changed to$307.89
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$320.96changed to$302.86
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.67 changed to 8.41
- Malpractice RVU 0.17 changed to 0.15
- Practice expense GPCI 0.860 changed to 0.862
- Malpractice GPCI 1.266 changed to 1.333
January 1, 2023
RVU23A
$331.76changed to$320.96
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.88 changed to 8.67
- Malpractice RVU 0.14 changed to 0.17
- Practice expense GPCI 0.858 changed to 0.860
- Malpractice GPCI 1.198 changed to 1.266
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$306.19changed to$331.76
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 7.92 changed to 8.88
- Malpractice RVU 0.15 changed to 0.14
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$258.24changed to$306.19
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 6.06 changed to 7.92
- Malpractice RVU 0.13 changed to 0.15
- Practice expense GPCI 0.857 changed to 0.858
- Malpractice GPCI 1.247 changed to 1.198
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$216.88changed to$258.24
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 4.71 changed to 6.06
- Malpractice RVU 0.14 changed to 0.13
- Malpractice GPCI 1.296 changed to 1.247
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$171.60changed to$216.88
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.25 changed to 4.71
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$165.92changed to$171.60
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.12 changed to 3.25
- Practice expense GPCI 0.847 changed to 0.857
- Malpractice GPCI 1.289 changed to 1.296
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$195.43changed to$165.92
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 4.10 changed to 3.12
- Malpractice RVU 0.18 changed to 0.14
- Practice expense GPCI 0.836 changed to 0.847
- Malpractice GPCI 1.282 changed to 1.289
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$194.16changed to$195.43
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 4.08 changed to 4.10
- Malpractice RVU 0.15 changed to 0.18
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$193.19changed to$194.16
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
No ratechanged to$193.19
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 | $360.63 | $71.83 | RVU26D |
| 2026-07-01 | $360.63 | $71.83 | RVU26C |
| 2026-04-01 | $360.63 | $71.83 | RVU26B |
| 2026-01-01 | $360.63 | $71.83 | RVU26A |
| 2025-10-01 | $288.52 | $72.71 | RVU25D |
| 2025-07-01 | $288.52 | $72.71 | RVU25C |
| 2025-04-01 | $288.52 | $72.71 | RVU25B |
| 2025-01-01 | $288.52 | $72.71 | RVU25A |
| 2024-10-01 | $307.89 | $76.04 | RVU24D |
| 2024-07-01 | $307.89 | $76.04 | RVU24C |
| 2024-04-01 | $307.89 | $76.04 | RVU24B |
| 2024-03-09 | $307.89 | $76.04 | RVU24AR |
| 2024-01-01 | $302.86 | $74.80 | RVU24A |
| 2023-10-01 | $320.96 | $78.20 | RVU23D |
| 2023-07-01 | $320.96 | $78.20 | RVU23C |
| 2023-04-01 | $320.96 | $78.20 | RVU23B |
| 2023-01-01 | $320.96 | $78.20 | RVU23A |
| 2022-10-01 | $331.76 | $77.60 | RVU22D |
| 2022-07-01 | $331.76 | $77.60 | RVU22C |
| 2022-04-01 | $331.76 | $77.60 | RVU22B |
| 2022-01-01 | $331.76 | $77.60 | RVU22A |
| 2021-10-01 | $306.19 | $78.66 | RVU21D |
| 2021-07-01 | $306.19 | $78.66 | RVU21C |
| 2021-04-01 | $306.19 | $78.66 | RVU21B |
| 2021-01-01 | $306.19 | $78.66 | RVU21A |
| 2020-10-01 | $258.24 | $80.71 | RVU20D |
| 2020-07-01 | $258.24 | $80.71 | RVU20C |
| 2020-04-01 | $258.24 | $80.71 | RVU20B |
| 2020-01-01 | $258.24 | $80.71 | RVU20A |
| 2019-10-01 | $216.88 | $81.60 | RVU19D |
| 2019-07-01 | $216.88 | $81.60 | RVU19C |
| 2019-04-01 | $216.88 | $81.60 | RVU19B |
| 2019-01-01 | $216.88 | $81.60 | RVU19A |
| 2018-10-01 | $171.60 | $81.82 | RVU18D |
| 2018-07-01 | $171.60 | $81.82 | RVU18C |
| 2018-04-01 | $171.60 | $81.82 | RVU18B |
| 2018-01-01 | $171.60 | $81.82 | RVU18AR1 |
| 2017-10-01 | $165.92 | $80.80 | RVU17D |
| 2017-07-01 | $165.92 | $80.80 | RVU17C |
| 2017-04-01 | $165.92 | $80.80 | RVU17B |
| 2017-01-01 | $165.92 | $80.80 | RVU17A |
| 2016-10-01 | $195.43 | $90.97 | RVU16D |
| 2016-07-01 | $195.43 | $90.97 | RVU16C |
| 2016-04-01 | $195.43 | $90.97 | RVU16B |
| 2016-01-01 | $195.43 | $90.97 | RVU16A |
| 2015-10-01 | $194.16 | $89.61 | RVU15D |
| 2015-07-01 | $194.16 | $89.61 | RVU15C |
| 2015-04-01 | $193.19 | $89.17 | RVU15B |
| 2015-01-01 | $193.19 | $89.17 | 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 West Virginia rate applies
West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.
- Accoville
- Addison (Webster Springs)
- Adrian
- Albright
- Alderson
- Alum Creek
- Amherstdale
- Anawalt
64489 billing questions
How does 64489 differ from 64488?
64489 is for bilateral TAP blocks delivered by continuous catheter infusion. 64488 describes bilateral TAP blocks by injection.
Can modifier 50 be added?
No. The code is already priced as bilateral, and modifier 50 does not increase payment.
What documentation supports continuous infusion?
Record that the block was performed on both sides and document catheter placement when performed and the plan for continuous infusion.
Does the code include catheter insertion?
Catheter insertion is included when performed as part of the bilateral TAP block with continuous infusion.
How does the multiple-procedure reduction work?
For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
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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