Billing code 64488: TAP blockMedicare rate & RVUs
Bilateral transversus abdominis plane block by injection provides abdominal wall regional analgesia, commonly for perioperative pain control using an injection technique.
Medicare pays $147.63 for 64488 nationally in the office and $56.78 in a hospital or facility. Local office rates run $131.89–$194.06.
Medicare rate · 64488
TAP block
Swap in your local Medicare rate.
- Work RVUs
- 1.37
- Total RVUs
- 4.42
- Global days
- 000
National rate · 2026
$147.63
Office setting, before claim adjustments.
See every locality for 64488 → · 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 64488 covers
A transversus abdominis plane (TAP) block places local anesthetic in the tissue plane between abdominal wall muscles to reduce sensation from the anterior abdominal wall. An anesthesiologist, pain physician, or other qualified clinician may perform the block, often with ultrasound guidance, for perioperative pain control around abdominal surgery. This code identifies a bilateral block delivered by injection rather than through a catheter for continuous infusion.
Report the code when the documented service is a bilateral TAP injection; the record should support the block’s purpose, bilateral performance, and injection technique. Medicare prices the code as bilateral, so modifier 50 does not increase payment. The procedure has a 0-day global period, which includes same-day preoperative and postoperative care. When performed in the same session as other procedures, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant at surgery for this service; 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 64488 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
$131.89 to $194.06
109 of 109 payment localities
64488 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.
$131.89
$175.07
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 | $175.07 | 1 |
| AL | $133.66 | 1 |
| AR | $131.89 | 1 |
| AZ | $144.02 | 1 |
| CA | $155.95–$194.06 | 29 |
| CO | $153.57 | 1 |
| CT | $156.92 | 1 |
| DC | $167.98 | 1 |
| DE | $146.28 | 1 |
| FL | $145.34–$157.77 | 3 |
| GA | $137.83–$150.14 | 2 |
| GU | $159.35 | 1 |
| HI | $159.35 | 1 |
| IA | $136.90 | 1 |
| ID | $137.69 | 1 |
| IL | $141.37–$153.69 | 4 |
| IN | $138.43 | 1 |
| KS | $136.25 | 1 |
| KY | $136.43 | 1 |
| LA | $136.21–$142.40 | 2 |
| MA | $152.74–$168.05 | 2 |
| MD | $148.94–$167.98 | 3 |
| ME | $138.29–$145.27 | 2 |
| MI | $139.63–$146.96 | 2 |
| MN | $147.65 | 1 |
| MO | $134.02–$142.94 | 3 |
| MS | $132.98 | 1 |
| MT | $147.62 | 1 |
| NC | $139.63 | 1 |
| ND | $145.25 | 1 |
| NE | $137.60 | 1 |
| NH | $151.14 | 1 |
| NJ | $158.85–$166.45 | 2 |
| NM | $140.31 | 1 |
| NV | $147.06 | 1 |
| NY | $141.55–$172.49 | 5 |
| OH | $139.15 | 1 |
| OK | $136.27 | 1 |
| OR | $146.05–$158.20 | 2 |
| PA | $139.39–$153.24 | 2 |
| PR | $148.65 | 1 |
| RI | $151.30 | 1 |
| SC | $139.59 | 1 |
| SD | $144.97 | 1 |
| TN | $136.87 | 1 |
| TX | $138.54–$152.94 | 8 |
| UT | $141.35 | 1 |
| VA | $144.79–$167.98 | 2 |
| VI | $148.65 | 1 |
| VT | $144.67 | 1 |
| WA | $152.46–$171.40 | 2 |
| WI | $140.75 | 1 |
| WV | $136.54 | 1 |
| WY | $146.59 | 1 |
How the 64488 rate is calculated
Each of 64488’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 · 64488
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.37Practice expense 2.93Malpractice 0.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64488
The CMS indicators that decide how 64488 is paid alongside other services.
CMS payment indicators · 64488
TAP 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) | 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
64488 without 51 · national office
$147.63
TAP block
64488-51 · Second procedure: 50%
$73.82
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%).
64488 compared with similar codes
Compare codes
64488 vs 64486 vs 64487 vs 64489: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64486TAP block
- Both describe TAP blocks by injection, but 64486 is unilateral and 64488 is bilateral.
- 64487TAP block
- 64487 is a unilateral continuous-infusion service involving a catheter; 64488 is a bilateral injection service.
- 64489TAP block
- Both are bilateral TAP services. Choose 64488 for injection(s) and 64489 for continuous infusion by catheter.
64488 billing questions
When should this code be chosen over 64486?
Use 64488 for a bilateral TAP block by injection. Code 64486 describes the unilateral injection service.
Is this code for a catheter-based continuous infusion?
No. It represents bilateral injection(s); 64489 is the related bilateral code for continuous infusion by catheter.
Should modifier 50 be appended?
No. Medicare prices 64488 as bilateral, and modifier 50 does not increase payment.
What should the documentation identify?
Document the TAP block, that it was performed bilaterally, and that the technique was injection rather than continuous catheter infusion.
How is it paid when other procedures occur in the same session?
The highest-valued procedure is paid in full and the other procedures are paid at 50%. Same-day preoperative and postoperative care is included in this code’s 0-day global period.
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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