$120.13–$175.46
Use 64449 for a lumbar plexus target; use 64447 when the injection is directed specifically at the femoral nerve.
On this page
CMS RVU26D · Effective 2026-10-01
64449 Lumbar plexus block Medicare reimbursement rates
Reports injection of anesthetic and/or steroid at the lumbar plexus for regional anesthesia, perioperative analgesia, or selected pain treatment. Compare 64449 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 64449?
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
No supported rate
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 64449 pays more and less
Peripheral nerve block
About 64449: Lumbar plexus anesthetic injection
Reports injection of anesthetic and/or steroid at the lumbar plexus for regional anesthesia, perioperative analgesia, or selected pain treatment.
This service places anesthetic and/or steroid near the lumbar plexus to interrupt nerve signals from the lower extremity. Anesthesiologists and pain physicians commonly perform it in an operating room, procedure suite, or other setting where regional blocks are provided. A lumbar plexus block may support anesthesia or postoperative pain control for hip or femur procedures, or be used in selected pain-treatment plans.
Report the code when the documented target is the lumbar plexus, rather than an individual femoral or sciatic nerve. The record should identify the indication, laterality, target, and medication injected. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When performed in the same session with other procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. For bilateral service, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 64449
- 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 RVU1.24 · 69%
- Practice expense (office) RVU0.43 · 24%
- Malpractice RVU0.14 · 8%
521
Medicare services in 2024 · #3526 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.
64449 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
64448 describes a femoral nerve block delivered by continuous catheter infusion. It is not the code for a lumbar plexus injection.
$153.59–$230.35
64445 is directed at the sciatic nerve, not the lumbar plexus.
No office rate
64446 describes continuous catheter infusion at the sciatic nerve; 64449 identifies the lumbar plexus target.
See how rates vary across the country
64449 · 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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 64449 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 Unavailable | Facility $56.63 |
| Alaska* | Office Unavailable | Facility $80.00 |
| Arizona | Office Unavailable | Facility $59.34 |
| Arkansas | Office Unavailable | Facility $56.16 |
| Atlanta | Office Unavailable | Facility $61.75 |
| Austin | Office Unavailable | Facility $60.84 |
| Bakersfield | Office Unavailable | Facility $60.79 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $63.27 |
| Beaumont | Office Unavailable | Facility $58.83 |
| Brazoria | Office Unavailable | Facility $59.63 |
| Chicago | Office Unavailable | Facility $66.87 |
| Chico | Office Unavailable | Facility $60.37 |
| Colorado | Office Unavailable | Facility $60.85 |
| Connecticut | Office Unavailable | Facility $63.37 |
| Dallas | Office Unavailable | Facility $60.11 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $65.78 |
| Delaware | Office Unavailable | Facility $60.02 |
| Detroit | Office Unavailable | Facility $63.16 |
| East St. Louis | Office Unavailable | Facility $64.05 |
| El Centro | Office Unavailable | Facility $60.39 |
| Fort Lauderdale | Office Unavailable | Facility $64.42 |
| Fort Worth | Office Unavailable | Facility $60.02 |
| Fresno | Office Unavailable | Facility $60.37 |
| Galveston | Office Unavailable | Facility $59.88 |
| Hanford-Corcoran | Office Unavailable | Facility $60.37 |
| Hawaii, Guam | Office Unavailable | Facility $60.45 |
| Houston | Office Unavailable | Facility $62.44 |
| Idaho | Office Unavailable | Facility $56.84 |
| Indiana | Office Unavailable | Facility $57.00 |
| Iowa | Office Unavailable | Facility $56.42 |
| Kansas | Office Unavailable | Facility $56.76 |
| Kentucky | Office Unavailable | Facility $58.46 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $63.21 |
| Madera | Office Unavailable | Facility $60.37 |
| Manhattan | Office Unavailable | Facility $68.17 |
| Merced | Office Unavailable | Facility $60.37 |
| Metropolitan Boston | Office Unavailable | Facility $64.43 |
| Metropolitan Kansas City | Office Unavailable | Facility $59.47 |
| Metropolitan Philadelphia | Office Unavailable | Facility $62.69 |
| Metropolitan St. Louis | Office Unavailable | Facility $59.78 |
| Miami | Office Unavailable | Facility $68.19 |
| Minnesota | Office Unavailable | Facility $57.58 |
| Mississippi | Office Unavailable | Facility $57.24 |
| Modesto | Office Unavailable | Facility $60.37 |
| Montana** | Office Unavailable | Facility $60.45 |
| Napa | Office Unavailable | Facility $65.33 |
| Nebraska | Office Unavailable | Facility $56.44 |
| Nevada** | Office Unavailable | Facility $59.69 |
| New Hampshire | Office Unavailable | Facility $60.46 |
| New Mexico | Office Unavailable | Facility $60.20 |
| New Orleans | Office Unavailable | Facility $60.24 |
| North Carolina | Office Unavailable | Facility $57.81 |
| North Dakota** | Office Unavailable | Facility $57.68 |
| Northern Nj | Office Unavailable | Facility $65.68 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $69.83 |
| Ohio | Office Unavailable | Facility $59.24 |
| Oklahoma | Office Unavailable | Facility $57.88 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $62.47 |
| Portland | Office Unavailable | Facility $61.52 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $64.67 |
| Puerto Rico | Office Unavailable | Facility $60.54 |
| Queens | Office Unavailable | Facility $67.79 |
| Redding | Office Unavailable | Facility $60.37 |
| Rest Of California | Office Unavailable | Facility $60.37 |
| Rest Of Florida | Office Unavailable | Facility $62.18 |
| Rest Of Georgia | Office Unavailable | Facility $59.80 |
| Rest Of Illinois | Office Unavailable | Facility $61.84 |
| Rest Of Louisiana | Office Unavailable | Facility $58.61 |
| Rest Of Maine | Office Unavailable | Facility $57.54 |
| Rest Of Maryland | Office Unavailable | Facility $60.66 |
| Rest Of Massachusetts | Office Unavailable | Facility $60.93 |
| Rest Of Michigan | Office Unavailable | Facility $59.81 |
| Rest Of Missouri | Office Unavailable | Facility $58.35 |
| Rest Of New Jersey | Office Unavailable | Facility $63.89 |
| Rest Of New York | Office Unavailable | Facility $58.35 |
| Rest Of Oregon | Office Unavailable | Facility $59.01 |
| Rest Of Pennsylvania | Office Unavailable | Facility $59.02 |
| Rest Of Texas | Office Unavailable | Facility $59.27 |
| Rest Of Washington | Office Unavailable | Facility $60.64 |
| Rhode Island | Office Unavailable | Facility $61.21 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $61.89 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $62.12 |
| Salinas | Office Unavailable | Facility $61.85 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $62.37 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $67.75 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $67.59 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $69.19 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $68.54 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $60.99 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $62.24 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $61.83 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $62.80 |
| Seattle (King Cnty) | Office Unavailable | Facility $64.93 |
| South Carolina | Office Unavailable | Facility $58.66 |
| South Dakota** | Office Unavailable | Facility $57.35 |
| Southern Maine | Office Unavailable | Facility $58.60 |
| Stockton | Office Unavailable | Facility $60.37 |
| Suburban Chicago | Office Unavailable | Facility $64.74 |
| Tennessee | Office Unavailable | Facility $56.98 |
| Utah | Office Unavailable | Facility $59.12 |
| Vallejo | Office Unavailable | Facility $65.10 |
| Vermont | Office Unavailable | Facility $58.00 |
| Virgin Islands | Office Unavailable | Facility $60.54 |
| Virginia | Office Unavailable | Facility $58.84 |
| Visalia | Office Unavailable | Facility $60.37 |
| West Virginia | Office Unavailable | Facility $60.59 |
| Wisconsin | Office Unavailable | Facility $56.62 |
| Wyoming** | Office Unavailable | Facility $59.24 |
| Yuba City | Office Unavailable | Facility $60.37 |
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64449 billing questions
How is this code distinguished from a femoral nerve block?
Use this code when the documented injection targets the lumbar plexus. A block directed at the femoral nerve is reported with the femoral nerve code instead.
Does the code include same-day preoperative and postoperative care?
Yes. It has a 0-day global period, and same-day preoperative and postoperative care is included.
How is bilateral lumbar plexus injection reported?
Report bilateral service with modifier 50. CMS pays the bilateral procedure at 150%.
What happens when this is performed with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported for this procedure?
Assistant-at-surgery services are not paid. 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.
7,10964446,,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
7,11264449,,Njx aa&/strd lmbr plex nfs,A,,1.24,0.43,NA,0.43,,0.14,1.81,1.81,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11364450,,Njx aa&/strd other pn/branch,A,,0.73,1.62,,0.35,,0.07,2.42,1.15,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11464451,,Njx aa&/strd nrv nrvtg si jt,A,,1.48,5.61,,0.55,,0.14,7.23,2.17,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11564454,,Njx aa&/strd gnclr nrv brnch,A,,1.48,5.42,,0.58,,0.13,7.03,2.19,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00