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Billing code 64448: Femoral nerve blockMedicare rate & RVUs

Reports a femoral nerve block delivered through a catheter for continuous infusion, commonly used to provide postoperative analgesia after knee or lower-extremity surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities23.5K Medicare services in 2024

Medicare pays $67.80 for 64448 nationally in a facility.

Medicare rate · 64448

Femoral nerve block

Swap in your local Medicare rate.

Work RVUs
1.64
Total RVUs
2.03
Global days
000

National rate · 2026

$67.80

Facility setting, before claim adjustments.

See every locality for 64448 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 64448 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 64448 covers

This service places a catheter by the femoral nerve and delivers anesthetic continuously for regional pain control. Anesthesiologists and pain physicians commonly perform it around knee or other lower-extremity surgery, often in a hospital or ambulatory surgery setting. The service differs from a one-time femoral nerve injection because the catheter supports ongoing infusion; imaging guidance is included in the code when performed.

Report the service when the record supports femoral nerve targeting, catheter placement, and a continuous infusion plan. Document the indication, laterality, procedure details, and infusion regimen. The code has 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%. Assistant-at-surgery services are not paid; 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 64448 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

64448 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$64.73
Alaska*Unavailable$93.64
ArizonaUnavailable$66.87
ArkansasUnavailable$64.36
AtlantaUnavailable$69.04
AustinUnavailable$67.86
BakersfieldUnavailable$67.82
Baltimore/Surr. CntysUnavailable$70.40
BeaumontUnavailable$66.72
BrazoriaUnavailable$67.14

64448 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
64448 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 64448 rate is calculated

Each of 64448’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 · 64448

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.64Practice expense 0.25Malpractice 0.14

2.0300 adjusted RVUs×$33.4009 conversion factor=$67.80

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 64448

The CMS indicators that decide how 64448 is paid alongside other services.

CMS payment indicators · 64448

Femoral nerve block

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

64448 without 50 · national facility

$67.80

Femoral nerve block

64448-50 · Bilateral: 150%

$101.70

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

64448 compared with similar codes

Compare codes

64448 vs 64447 vs 64446 vs 64449: national Medicare rates

Swap in your local Medicare rate.

  • 64448
    Femoral nerve block · 1.64 wRVU
    —
  • 64447
    Femoral nerve block · 1.31 wRVU
    $134.27
  • 64446
    Sciatic nerve block · 1.71 wRVU
    —
  • 64449
    Lumbar plexus block · 1.24 wRVU
    —

How to choose

64447Femoral nerve block
Choose 64448 when the femoral nerve catheter is used for continuous infusion; choose 64447 for a single-injection femoral nerve block.
64446Sciatic nerve block
Both involve continuous catheter infusion, but 64446 targets the sciatic nerve and 64448 targets the femoral nerve.
64449Lumbar plexus block
64449 is the continuous catheter service for the lumbar plexus; 64448 is directed to the femoral nerve.

Codes related to 64448

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

Codes related to 64448
CodeHow it relatesNational office range
Used instead
64447Femoral nerve blockFemoral nerve block by single injection rather than continuous catheter infusion.$120.13–$175.46
64446Sciatic nerve blockContinuous catheter block targeting the sciatic nerve rather than the femoral nerve.No office rate
64449Lumbar plexus blockContinuous catheter block targeting the lumbar plexus rather than the femoral nerve.No office rate

64448 billing questions

How does this differ from 64447?

64448 is for a femoral nerve catheter with continuous infusion. 64447 is the corresponding femoral nerve service for a single injection rather than a continuous catheter infusion.

Is catheter placement separately reported?

Catheter placement is part of this service. The documentation should show placement and the plan for continuous infusion.

Can modifier 50 be used for bilateral treatment?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document treatment on both sides.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the 0-day global period.

What happens when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and the other procedures are paid at 50% under the standard multiple procedure 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
RVUs for 64448PPRRVU2026_Oct_nonQPP.csv, line 7,111 (RVU26D)

Open CMS sourceHow we calculate rates

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