Billing code 64450: Nerve blockMedicare rate & RVUs
Report 64450 for an anesthetic and/or steroid injection targeting a peripheral nerve or branch that does not have a more specific code.
Medicare pays $80.83 for 64450 nationally in the office and $38.41 in a hospital or facility. Local office rates run $72.07–$106.34.
Medicare rate · 64450
Nerve block
Swap in your local Medicare rate.
- Work RVUs
- 0.73
- Total RVUs
- 2.42
- Global days
- 000
National rate · 2026
$80.83
Office setting, before claim adjustments.
See every locality for 64450 → · 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
What 64450 covers
A clinician injects anesthetic, steroid, or both around a peripheral nerve or branch not identified by a more specific nerve-block code. The block may be used to reduce pain or help evaluate whether a particular nerve is contributing to symptoms. Pain physicians, anesthesiologists, surgeons, and other clinicians may perform it in an office, outpatient procedure area, or hospital. The documented target must be the nerve or branch actually treated; this code is not a substitute for a code that names the nerve or anatomic target.
Report the service based on the documented nerve, indication, laterality, and injectate. The record should identify the target and support the clinical purpose of the block; for a diagnostic block, document the patient’s response when assessed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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 64450 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$72.07 to $106.34
109 of 109 payment localities
64450 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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.
$72.07
$95.85
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 | $95.49 | 1 |
| AL | $73.05 | 1 |
| AR | $72.07 | 1 |
| AZ | $78.82 | 1 |
| CA | $85.35–$106.34 | 29 |
| CO | $84.07 | 1 |
| CT | $85.98 | 1 |
| DC | $92.04 | 1 |
| DE | $80.07 | 1 |
| FL | $79.63–$86.62 | 3 |
| GA | $75.44–$82.24 | 2 |
| GU | $87.26 | 1 |
| HI | $87.26 | 1 |
| IA | $74.82 | 1 |
| ID | $75.27 | 1 |
| IL | $77.44–$84.30 | 4 |
| IN | $75.68 | 1 |
| KS | $74.48 | 1 |
| KY | $74.63 | 1 |
| LA | $74.51–$77.96 | 2 |
| MA | $83.61–$92.07 | 2 |
| MD | $81.53–$92.04 | 3 |
| ME | $75.62–$79.48 | 2 |
| MI | $76.42–$80.54 | 2 |
| MN | $80.75 | 1 |
| MO | $73.30–$78.24 | 3 |
| MS | $72.70 | 1 |
| MT | $80.83 | 1 |
| NC | $76.36 | 1 |
| ND | $79.44 | 1 |
| NE | $75.21 | 1 |
| NH | $82.76 | 1 |
| NJ | $87.01–$91.18 | 2 |
| NM | $76.81 | 1 |
| NV | $80.49 | 1 |
| NY | $77.43–$94.62 | 5 |
| OH | $76.14 | 1 |
| OK | $74.52 | 1 |
| OR | $79.92–$86.63 | 2 |
| PA | $76.26–$83.94 | 2 |
| PR | $81.39 | 1 |
| RI | $82.83 | 1 |
| SC | $76.37 | 1 |
| SD | $79.28 | 1 |
| TN | $74.82 | 1 |
| TX | $75.79–$83.75 | 8 |
| UT | $77.35 | 1 |
| VA | $79.22–$92.04 | 2 |
| VI | $81.39 | 1 |
| VT | $79.13 | 1 |
| WA | $83.46–$93.90 | 2 |
| WI | $76.94 | 1 |
| WV | $74.75 | 1 |
| WY | $80.22 | 1 |
How the 64450 rate is calculated
Each of 64450’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 · 64450
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.73Practice expense 1.62Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64450
The CMS indicators that decide how 64450 is paid alongside other services.
CMS payment indicators · 64450
Nerve block
| 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
64450 without 50 · national office
$80.83
Nerve block
64450-50 · Bilateral: 150%
$121.25
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).
64450 compared with similar codes
Compare codes
64450 vs 64420 vs 64425 vs 64430 vs 64455: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64420Intercostal block
- 64420 identifies an intercostal nerve block. Use 64450 for another peripheral nerve or branch without a more specific code.
- 64425Nerve block
- 64425 is specific to the ilioinguinal or iliohypogastric nerves; 64450 is for a different peripheral nerve or branch not specifically named by a code.
- 64430Nerve block
- 64430 identifies a pudendal nerve block. Report 64450 only when the target is another peripheral nerve or branch without a more specific code.
- 64455Nerve injection
- 64455 is specific to a plantar common digital nerve injection. Use 64450 for a different peripheral nerve or branch not covered by a more specific code.
64450 billing questions
When should 64450 be chosen instead of a code for a named nerve?
Use 64450 when the treated peripheral nerve or branch does not have a more specific code. For a nerve with its own code, report that code rather than using 64450 as a general substitute.
What should the procedure note identify?
Document the nerve or branch treated, the clinical indication, laterality, and the anesthetic and/or steroid injected. For a diagnostic block, record the response when it is assessed.
How is a bilateral service reported?
Use modifier 50 for a bilateral procedure; CMS pays it at 150%.
How does the multiple-procedure reduction affect 64450?
When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.
Can an assistant, co-surgeon, or surgical team be billed for this procedure?
Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted for this code.
Are same-day preoperative and postoperative services included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
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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