No office rate
Choose 64445 for a single-injection sciatic block. Choose 64446 when a catheter provides continuous infusion at the sciatic nerve.
On this page
CMS RVU26D · Effective 2026-10-01
64445 Sciatic nerve block Medicare reimbursement rates
Reports a single-injection anesthetic or steroid block of the sciatic nerve, commonly used for perioperative anesthesia or pain relief. Compare 64445 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 64445?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$153.59–$230.35
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $76.76 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 64445 pays more and less
109 payment localities
$153.59 to $230.35
Anesthesia and nerve blocks
About 64445: Single-injection sciatic nerve block
Reports a single-injection anesthetic or steroid block of the sciatic nerve, commonly used for perioperative anesthesia or pain relief.
This service is a single-injection block targeting the sciatic nerve, using an anesthetic agent and/or steroid. Anesthesiologists and pain physicians commonly perform it for perioperative anesthesia or postoperative pain relief, including for procedures involving the lower extremity. It may be performed in a facility or office setting. Image guidance, when used, is included in the service.
Select this code for a single injection at the sciatic nerve; use the continuous-infusion catheter code when that is the service performed. Document the indication, nerve targeted, laterality, medication, technique, and whether a catheter was placed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 64445
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.36 · 26%
- Practice expense (office) RVU3.68 · 71%
- Malpractice RVU0.15 · 3%
106.9K
Medicare services in 2024 · #536 by national volume
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.
64445 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$120.13–$175.46
64445 targets the sciatic nerve; 64447 targets the femoral nerve. Select the code for the nerve actually blocked.
No office rate
64448 describes a continuous-infusion catheter block of the femoral nerve. It is not the code for a single-injection sciatic block.
See how rates vary across the country
64445 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$153.59
$206.98
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $201.80 | 1 |
| AL | $155.81 | 1 |
| AR | $153.59 | 1 |
| AZ | $168.82 | 1 |
| CA | $183.60–$230.35 | 29 |
| CO | $180.67 | 1 |
| CT | $184.78 | 1 |
| DC | $198.25 | 1 |
| DE | $171.60 | 1 |
| FL | $170.46–$186.05 | 3 |
| GA | $161.04–$176.46 | 2 |
| GU | $188.08 | 1 |
| HI | $188.08 | 1 |
| IA | $159.88 | 1 |
| ID | $160.88 | 1 |
| IL | $165.48–$180.86 | 4 |
| IN | $161.80 | 1 |
| KS | $159.07 | 1 |
| KY | $159.28 | 1 |
| LA | $159.00–$166.78 | 2 |
| MA | $179.57–$198.51 | 2 |
| MD | $174.87–$198.25 | 3 |
| ME | $161.62–$170.40 | 2 |
| MI | $163.30–$172.49 | 2 |
| MN | $173.39 | 1 |
| MO | $156.26–$167.46 | 3 |
| MS | $154.96 | 1 |
| MT | $173.34 | 1 |
| NC | $163.31 | 1 |
| ND | $170.37 | 1 |
| NE | $160.77 | 1 |
| NH | $177.76 | 1 |
| NJ | $186.96–$196.22 | 2 |
| NM | $164.16 | 1 |
| NV | $172.64 | 1 |
| NY | $165.72–$203.78 | 5 |
| OH | $162.70 | 1 |
| OK | $159.08 | 1 |
| OR | $171.37–$186.44 | 2 |
| PA | $163.00–$180.17 | 2 |
| PR | $174.63 | 1 |
| RI | $177.73 | 1 |
| SC | $163.26 | 1 |
| SD | $170.02 | 1 |
| TN | $159.85 | 1 |
| TX | $161.93–$180.00 | 8 |
| UT | $165.46 | 1 |
| VA | $169.79–$198.25 | 2 |
| VI | $174.63 | 1 |
| VT | $169.65 | 1 |
| WA | $179.26–$202.61 | 2 |
| WI | $164.72 | 1 |
| WV | $159.41 | 1 |
| WY | $172.05 | 1 |
Compare 64445 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $155.81 | Facility $62.00 |
| Alaska* | Office $201.80 | Facility $87.62 |
| Arizona | Office $168.82 | Facility $64.93 |
| Arkansas | Office $153.59 | Facility $61.49 |
| Atlanta | Office $176.46 | Facility $67.53 |
| Austin | Office $180.00 | Facility $66.56 |
| Bakersfield | Office $184.05 | Facility $66.54 |
| Baltimore/Surr. Cntys | Office $184.24 | Facility $69.19 |
| Beaumont | Office $161.93 | Facility $64.37 |
| Brazoria | Office $171.51 | Facility $65.25 |
| Chicago | Office $180.77 | Facility $73.02 |
| Chico | Office $183.60 | Facility $66.09 |
| Colorado | Office $180.67 | Facility $66.59 |
| Connecticut | Office $184.78 | Facility $69.30 |
| Dallas | Office $172.56 | Facility $65.77 |
| Dc + Md/Va Suburbs | Office $198.25 | Facility $71.95 |
| Delaware | Office $171.60 | Facility $65.67 |
| Detroit | Office $172.49 | Facility $69.02 |
| East St. Louis | Office $168.60 | Facility $69.96 |
| El Centro | Office $183.62 | Facility $66.11 |
| Fort Lauderdale | Office $179.00 | Facility $70.39 |
| Fort Worth | Office $171.39 | Facility $65.68 |
| Fresno | Office $183.60 | Facility $66.09 |
| Galveston | Office $171.99 | Facility $65.53 |
| Hanford-Corcoran | Office $183.60 | Facility $66.09 |
| Hawaii, Guam | Office $188.08 | Facility $66.18 |
| Houston | Office $174.74 | Facility $68.27 |
| Idaho | Office $160.88 | Facility $62.24 |
| Indiana | Office $161.80 | Facility $62.41 |
| Iowa | Office $159.88 | Facility $61.78 |
| Kansas | Office $159.07 | Facility $62.14 |
| Kentucky | Office $159.28 | Facility $63.97 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $196.02 | Facility $69.19 |
| Madera | Office $183.60 | Facility $66.09 |
| Manhattan | Office $199.11 | Facility $74.52 |
| Merced | Office $183.60 | Facility $66.09 |
| Metropolitan Boston | Office $198.51 | Facility $70.49 |
| Metropolitan Kansas City | Office $165.74 | Facility $65.06 |
| Metropolitan Philadelphia | Office $180.17 | Facility $68.56 |
| Metropolitan St. Louis | Office $167.46 | Facility $65.39 |
| Miami | Office $186.05 | Facility $74.44 |
| Minnesota | Office $173.39 | Facility $63.06 |
| Mississippi | Office $154.96 | Facility $62.64 |
| Modesto | Office $183.60 | Facility $66.09 |
| Montana** | Office $173.34 | Facility $66.12 |
| Napa | Office $212.83 | Facility $71.52 |
| Nebraska | Office $160.77 | Facility $61.81 |
| Nevada** | Office $172.64 | Facility $65.31 |
| New Hampshire | Office $177.76 | Facility $66.15 |
| New Mexico | Office $164.16 | Facility $65.84 |
| New Orleans | Office $166.78 | Facility $65.89 |
| North Carolina | Office $163.31 | Facility $63.27 |
| North Dakota** | Office $170.37 | Facility $63.16 |
| Northern Nj | Office $196.22 | Facility $71.85 |
| Nyc Suburbs/Long Island | Office $203.78 | Facility $76.30 |
| Ohio | Office $162.70 | Facility $64.81 |
| Oklahoma | Office $159.08 | Facility $63.34 |
| Oxnard-Thousand Oaks-Ventura | Office $195.10 | Facility $68.37 |
| Portland | Office $186.44 | Facility $67.32 |
| Poughkpsie/N Nyc Suburbs | Office $188.12 | Facility $70.72 |
| Puerto Rico | Office $174.63 | Facility $66.23 |
| Queens | Office $200.84 | Facility $74.11 |
| Redding | Office $183.60 | Facility $66.09 |
| Rest Of California | Office $183.60 | Facility $66.09 |
| Rest Of Florida | Office $170.46 | Facility $67.96 |
| Rest Of Georgia | Office $161.04 | Facility $65.40 |
| Rest Of Illinois | Office $165.48 | Facility $67.59 |
| Rest Of Louisiana | Office $159.00 | Facility $64.12 |
| Rest Of Maine | Office $161.62 | Facility $62.98 |
| Rest Of Maryland | Office $174.87 | Facility $66.37 |
| Rest Of Massachusetts | Office $179.57 | Facility $66.68 |
| Rest Of Michigan | Office $163.30 | Facility $65.41 |
| Rest Of Missouri | Office $156.26 | Facility $63.84 |
| Rest Of New Jersey | Office $186.96 | Facility $69.88 |
| Rest Of New York | Office $165.72 | Facility $63.86 |
| Rest Of Oregon | Office $171.37 | Facility $64.58 |
| Rest Of Pennsylvania | Office $163.00 | Facility $64.57 |
| Rest Of Texas | Office $166.60 | Facility $64.85 |
| Rest Of Washington | Office $179.26 | Facility $66.36 |
| Rhode Island | Office $177.73 | Facility $66.97 |
| Riverside-San Bernardino-Ontario | Office $185.23 | Facility $67.72 |
| Sacramento-Roseville-Folsom | Office $192.70 | Facility $68.00 |
| Salinas | Office $191.98 | Facility $67.71 |
| San Diego-Chula Vista-Carlsbad | Office $196.51 | Facility $68.28 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $225.35 | Facility $74.18 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $225.18 | Facility $74.00 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $230.35 | Facility $75.74 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $229.65 | Facility $75.05 |
| San Luis Obispo-Paso Robles | Office $188.88 | Facility $66.76 |
| Santa Cruz-Watsonville | Office $198.41 | Facility $68.14 |
| Santa Maria-Santa Barbara | Office $192.70 | Facility $67.69 |
| Santa Rosa-Petaluma | Office $200.41 | Facility $68.75 |
| Seattle (King Cnty) | Office $202.61 | Facility $71.05 |
| South Carolina | Office $163.26 | Facility $64.19 |
| South Dakota** | Office $170.02 | Facility $62.81 |
| Southern Maine | Office $170.40 | Facility $64.14 |
| Stockton | Office $183.60 | Facility $66.09 |
| Suburban Chicago | Office $180.86 | Facility $70.74 |
| Tennessee | Office $159.85 | Facility $62.39 |
| Utah | Office $165.46 | Facility $64.68 |
| Vallejo | Office $212.59 | Facility $71.28 |
| Vermont | Office $169.65 | Facility $63.50 |
| Virgin Islands | Office $174.63 | Facility $66.23 |
| Virginia | Office $169.79 | Facility $64.39 |
| Visalia | Office $183.60 | Facility $66.09 |
| West Virginia | Office $159.41 | Facility $66.24 |
| Wisconsin | Office $164.72 | Facility $62.01 |
| Wyoming** | Office $172.05 | Facility $64.83 |
| Yuba City | Office $183.60 | Facility $66.09 |
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64445 billing questions
How does 64445 differ from 64446?
64445 is for a single-injection sciatic nerve block. Use 64446 when the sciatic nerve is treated with a continuous-infusion catheter.
Is imaging guidance separately reportable?
Imaging guidance, when performed for this block, is included in 64445. Do not separately report guidance for the same block.
How is a bilateral block reported?
CMS identifies 64445 as a bilateral procedure; modifier 50 is paid at 150%. Document the block on each side.
What happens when 64445 is performed with another procedure?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 64445. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,10564425,,Njx aa&/strd ii ih nerves,A,,0.98,2.55,,0.42,,0.09,3.62,1.49,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10664430,,Njx aa&/strd pudendal nerve,A,,0.98,1.78,,0.37,,0.11,2.87,1.46,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10764435,,Njx aa&/strd paracrv nrv,A,,0.73,1.39,,0.30,,0.13,2.25,1.16,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10864445,,Njx aa&/strd sciatic nrv img,A,,1.36,3.68,,0.47,,0.15,5.19,1.98,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10964446,,Njx aa&/strd sc nrv nfs img,A,,1.71,0.26,NA,0.26,,0.15,2.12,2.12,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11064447,,Njx aa&/strd femoral nrv img,A,,1.31,2.59,,0.39,,0.12,4.02,1.82,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11164448,,Njx aa&/strd fem nrv nfs img,A,,1.64,0.25,NA,0.25,,0.14,2.03,2.03,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00