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CMS RVU26D · Effective 2026-10-01

64418 in Merced

Office / nonfacility

$93.59

Base rate per service

Facility setting

$47.83

Base rate per service

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.

Pain management

About 64418: Suprascapular nerve injection

Report this service for an anesthetic and/or steroid injection targeting the suprascapular nerve to evaluate or relieve shoulder pain.

The clinician places an injection at the suprascapular nerve, which supplies sensation to parts of the shoulder. Pain medicine physicians, anesthesiologists, physiatrists, and other clinicians may use the block diagnostically or therapeutically for shoulder pain, including pain associated with rotator cuff disease or glenohumeral arthritis. The injected medication may be anesthetic, steroid, or both; the service is defined by the nerve targeted, not simply by an injection into the shoulder joint.

Report 64418 when documentation identifies the suprascapular nerve as the injection target and supports the clinical indication, side, approach, and medication administered. The code has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 64418

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 RVU1.07 · 40%
  • Practice expense (office) RVU1.51 · 56%
  • Malpractice RVU0.11 · 4%

24.3K

Medicare services in 2024 · #1060 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.

64418 compared with similar codes

Office rates for Merced, from the same CMS release.

64417

Axillary nerve block

Image guidance included

$198.09

64418 identifies the suprascapular nerve as the target; 64417 targets the axillary nerve. Choose according to the nerve injected, not merely the shoulder diagnosis.

64415

Brachial plexus block

Single injection

$163.76

64415 is for a brachial plexus injection, while 64418 specifically targets the suprascapular nerve.

64450

Nerve block

Other peripheral nerve or branch

$85.35

Use 64418 for the specifically named suprascapular nerve. Use 64450 when the injected peripheral nerve or branch lacks a more specific code.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 64418 is $93.93—$0.34 higher than the $93.59 rate in Merced. Both use the same code, release and participation basis.

64418 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $93.59

  2. Bakersfield

    $93.93

    $0.34 higher than Merced

  3. Chico

    $93.59

    The same base rate than Merced

  4. El Centro

    $93.61

    $0.02 higher than Merced

  5. Fresno

    $93.59

    The same base rate than Merced

  6. Hanford-Corcoran

    $93.59

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $99.31

    $5.72 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 64418 ranges from $80.96 in Arkansas to $114.37 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 64418

    Office

    $93.59

    Facility

    $47.83

    The same base rate than Merced for the office setting.

  • Modesto

    California · 64418

    Office

    $93.59

    Facility

    $47.83

    The same base rate than Merced for the office setting.

  • Napa

    California · 64418

    Office

    $106.33

    Facility

    $51.30

    $12.74 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 64418

    Office

    $98.64

    Facility

    $49.29

    $5.05 higher than Merced for the office setting.

  • Redding

    California · 64418

    Office

    $93.59

    Facility

    $47.83

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 64418

    Office

    $93.59

    Facility

    $47.83

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 64418

    Office

    $94.79

    Facility

    $49.03

    $1.20 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 64418

    Office

    $97.65

    Facility

    $49.09

    $4.06 higher than Merced for the office setting.

  • Salinas

    California · 64418

    Office

    $97.27

    Facility

    $48.88

    $3.68 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 64418

    Office

    $99.12

    Facility

    $49.19

    $5.53 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 64418

    Office

    $111.93

    Facility

    $53.07

    $18.34 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 64418

    Office

    $111.81

    Facility

    $52.94

    $18.22 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 64418

    Office

    $114.37

    Facility

    $54.16

    $20.78 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 64418

    Office

    $113.86

    Facility

    $53.65

    $20.27 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 64418

    Office

    $95.76

    Facility

    $48.21

    $2.17 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 64418

    Office

    $99.74

    Facility

    $49.01

    $6.15 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 64418

    Office

    $97.52

    Facility

    $48.83

    $3.93 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 64418

    Office

    $100.72

    Facility

    $49.44

    $7.13 higher than Merced for the office setting.

  • Stockton

    California · 64418

    Office

    $93.59

    Facility

    $47.83

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 64418

    Office

    $106.15

    Facility

    $51.12

    $12.56 higher than Merced for the office setting.

  • Visalia

    California · 64418

    Office

    $93.59

    Facility

    $47.83

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 64418

    Office

    $93.59

    Facility

    $47.83

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 64418

    Office

    $101.17

    Facility

    $51.99

    $7.58 higher than Merced for the office setting.

  • Miami

    Florida · 64418

    Office

    $97.53

    Facility

    $54.07

    $3.94 higher than Merced for the office setting.

  • Chicago

    Illinois · 64418

    Office

    $95.11

    Facility

    $53.15

    $1.52 higher than Merced for the office setting.

  • Manhattan

    New York · 64418

    Office

    $102.46

    Facility

    $53.94

    $8.87 higher than Merced for the office setting.

  • Alaska*

    Alaska · 64418

    Office

    $109.35

    Facility

    $64.88

    $15.76 higher than Merced for the office setting.

  • Alabama

    Alabama · 64418

    Office

    $81.95

    Facility

    $45.42

    $11.64 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 64418

    Office

    $80.96

    Facility

    $45.09

    $12.63 lower than Merced for the office setting.

  • Arizona

    Arizona · 64418

    Office

    $87.76

    Facility

    $47.30

    $5.83 lower than Merced for the office setting.

  • Colorado

    Colorado · 64418

    Office

    $92.70

    Facility

    $48.28

    $0.89 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 64418

    Office

    $95.22

    Facility

    $50.25

    $1.63 higher than Merced for the office setting.

  • Delaware

    Delaware · 64418

    Office

    $89.05

    Facility

    $47.80

    $4.54 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 64418

    Office

    $93.47

    Facility

    $51.18

    $0.12 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 64418

    Office

    $89.48

    Facility

    $49.56

    $4.11 lower than Merced for the office setting.

  • Atlanta

    Georgia · 64418

    Office

    $91.50

    Facility

    $49.08

    $2.09 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 64418

    Office

    $85.11

    Facility

    $47.86

    $8.48 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 64418

    Office

    $95.21

    Facility

    $47.74

    $1.62 higher than Merced for the office setting.

  • Iowa

    Iowa · 64418

    Office

    $83.35

    Facility

    $45.14

    $10.24 lower than Merced for the office setting.

  • Idaho

    Idaho · 64418

    Office

    $83.88

    Facility

    $45.47

    $9.71 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 64418

    Office

    $89.54

    Facility

    $51.13

    $4.05 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 64418

    Office

    $87.53

    Facility

    $49.41

    $6.06 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 64418

    Office

    $94.30

    Facility

    $51.42

    $0.71 higher than Merced for the office setting.

  • Indiana

    Indiana · 64418

    Office

    $84.28

    Facility

    $45.57

    $9.31 lower than Merced for the office setting.

  • Kansas

    Kansas · 64418

    Office

    $83.18

    Facility

    $45.44

    $10.41 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 64418

    Office

    $83.94

    Facility

    $46.82

    $9.65 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 64418

    Office

    $87.37

    Facility

    $48.08

    $6.22 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 64418

    Office

    $83.89

    Facility

    $46.94

    $9.70 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 64418

    Office

    $100.69

    Facility

    $50.84

    $7.10 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 64418

    Office

    $92.35

    Facility

    $48.38

    $1.24 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 64418

    Office

    $94.97

    Facility

    $50.17

    $1.38 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 64418

    Office

    $90.51

    Facility

    $48.26

    $3.08 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 64418

    Office

    $84.42

    Facility

    $46.01

    $9.17 lower than Merced for the office setting.

  • Southern Maine

    Maine · 64418

    Office

    $88.04

    Facility

    $46.66

    $5.55 lower than Merced for the office setting.

  • Detroit

    Michigan · 64418

    Office

    $90.60

    Facility

    $50.31

    $2.99 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 64418

    Office

    $85.93

    Facility

    $47.82

    $7.66 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 64418

    Office

    $88.72

    Facility

    $45.76

    $4.87 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 64418

    Office

    $86.69

    Facility

    $47.48

    $6.90 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 64418

    Office

    $87.43

    Facility

    $47.69

    $6.16 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 64418

    Office

    $82.79

    Facility

    $46.80

    $10.80 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 64418

    Office

    $81.88

    Facility

    $45.93

    $11.71 lower than Merced for the office setting.

  • Montana**

    Montana · 64418

    Office

    $89.84

    Facility

    $48.09

    $3.75 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 64418

    Office

    $85.14

    Facility

    $46.19

    $8.45 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 64418

    Office

    $87.67

    Facility

    $45.91

    $5.92 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 64418

    Office

    $83.68

    Facility

    $45.14

    $9.91 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 64418

    Office

    $91.46

    Facility

    $47.99

    $2.13 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 64418

    Office

    $100.42

    Facility

    $51.99

    $6.83 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 64418

    Office

    $96.27

    Facility

    $50.68

    $2.68 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 64418

    Office

    $86.40

    Facility

    $48.11

    $7.19 lower than Merced for the office setting.

  • Nevada**

    Nevada · 64418

    Office

    $89.29

    Facility

    $47.49

    $4.30 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 64418

    Office

    $104.82

    Facility

    $55.17

    $11.23 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 64418

    Office

    $97.02

    Facility

    $51.30

    $3.43 higher than Merced for the office setting.

  • Queens

    New York · 64418

    Office

    $102.94

    Facility

    $53.59

    $9.35 higher than Merced for the office setting.

  • Rest Of New York

    New York · 64418

    Office

    $86.24

    Facility

    $46.57

    $7.35 lower than Merced for the office setting.

  • Ohio

    Ohio · 64418

    Office

    $85.49

    Facility

    $47.37

    $8.10 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 64418

    Office

    $83.63

    Facility

    $46.35

    $9.96 lower than Merced for the office setting.

  • Portland

    Oregon · 64418

    Office

    $95.08

    Facility

    $48.69

    $1.49 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 64418

    Office

    $88.56

    Facility

    $46.97

    $5.03 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 64418

    Office

    $93.27

    Facility

    $49.81

    $0.32 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 64418

    Office

    $85.51

    Facility

    $47.18

    $8.08 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 64418

    Office

    $90.35

    Facility

    $48.14

    $3.24 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 64418

    Office

    $91.80

    Facility

    $48.67

    $1.79 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 64418

    Office

    $85.46

    Facility

    $46.89

    $8.13 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 64418

    Office

    $87.41

    Facility

    $45.66

    $6.18 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 64418

    Office

    $83.56

    Facility

    $45.61

    $10.03 lower than Merced for the office setting.

  • Austin

    Texas · 64418

    Office

    $92.43

    Facility

    $48.25

    $1.16 lower than Merced for the office setting.

  • Beaumont

    Texas · 64418

    Office

    $85.05

    Facility

    $47.05

    $8.54 lower than Merced for the office setting.

  • Brazoria

    Texas · 64418

    Office

    $88.87

    Facility

    $47.50

    $4.72 lower than Merced for the office setting.

  • Dallas

    Texas · 64418

    Office

    $89.45

    Facility

    $47.86

    $4.14 lower than Merced for the office setting.

  • Fort Worth

    Texas · 64418

    Office

    $88.99

    Facility

    $47.82

    $4.60 lower than Merced for the office setting.

  • Galveston

    Texas · 64418

    Office

    $89.15

    Facility

    $47.69

    $4.44 lower than Merced for the office setting.

  • Houston

    Texas · 64418

    Office

    $91.16

    Facility

    $49.70

    $2.43 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 64418

    Office

    $86.92

    Facility

    $47.30

    $6.67 lower than Merced for the office setting.

  • Utah

    Utah · 64418

    Office

    $86.45

    Facility

    $47.20

    $7.14 lower than Merced for the office setting.

  • Virginia

    Virginia · 64418

    Office

    $87.91

    Facility

    $46.87

    $5.68 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 64418

    Office

    $90.35

    Facility

    $48.14

    $3.24 lower than Merced for the office setting.

  • Vermont

    Vermont · 64418

    Office

    $87.53

    Facility

    $46.20

    $6.06 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 64418

    Office

    $92.11

    Facility

    $48.14

    $1.48 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 64418

    Office

    $102.41

    Facility

    $51.18

    $8.82 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 64418

    Office

    $85.19

    Facility

    $45.19

    $8.40 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 64418

    Office

    $84.82

    Facility

    $48.54

    $8.77 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 64418

    Office

    $88.89

    Facility

    $47.14

    $4.70 lower than Merced for the office setting.

See how rates vary across the country

64418 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$80.96

$109.35

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$109.351
AL$81.951
AR$80.961
AZ$87.761
CA$93.59–$114.3729
CO$92.701
CT$95.221
DC$101.171
DE$89.051
FL$89.48–$97.533
GA$85.11–$91.502
GU$95.211
HI$95.211
IA$83.351
ID$83.881
IL$87.53–$95.114
IN$84.281
KS$83.181
KY$83.941
LA$83.89–$87.372
MA$92.35–$100.692
MD$90.51–$101.173
ME$84.42–$88.042
MI$85.93–$90.602
MN$88.721
MO$82.79–$87.433
MS$81.881
MT$89.841
NC$85.141
ND$87.671
NE$83.681
NH$91.461
NJ$96.27–$100.422
NM$86.401
NV$89.291
NY$86.24–$104.825
OH$85.491
OK$83.631
OR$88.56–$95.082
PA$85.51–$93.272
PR$90.351
RI$91.801
SC$85.461
SD$87.411
TN$83.561
TX$85.05–$92.438
UT$86.451
VA$87.91–$101.172
VI$90.351
VT$87.531
WA$92.11–$102.412
WI$85.191
WV$84.821
WY$88.891

Explore 64418 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 64418 in Merced, the physician’s office rate is $93.59 and the facility-setting rate is $47.83: a difference of $45.76.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 64418 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$102.95

$93.59 × 110% = $102.95

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64418 in Merced.

PPRRVU2026_Oct_nonQPP.csv

7,102

Code
64418
Physician work
1.07
Practice expense
1.51
Malpractice
0.11

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 64418 in Merced
ComponentRVULocality factorAdjusted
Physician work1.07× 1.0171.0882
Practice expense1.51× 1.0961.6550
Malpractice0.11× 0.5360.0590
Total RVUs2.8021
Conversion factor× 33.4009

Office / nonfacility rate, Merced$93.59

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 64418 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.071.017
Practice expense1.511.096
Malpractice0.110.536

(1.07 × 1.017 + 1.51 × 1.096 + 0.11 × 0.536) × $33.4009 = $93.59

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.071.017
Practice expense0.261.096
Malpractice0.110.536

(1.07 × 1.017 + 0.26 × 1.096 + 0.11 × 0.536) × $33.4009 = $47.83

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

64418 · Office / nonfacility

$93.59

Effective 2026-10-01

The base rate is $7.43 higher than on 2025-10-01, moving from $86.16 to $93.59 (8.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $86.16changed to$93.59

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.10 changed to 1.07
    • Practice expense RVU 1.35 changed to 1.51
    • Malpractice RVU 0.13 changed to 0.11
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $86.16

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$93.59$47.83RVU26D
2026-07-01$93.59$47.83RVU26C
2026-04-01$93.59$47.83RVU26B
2026-01-01$93.59$47.83RVU26A
2025-10-01$86.16$53.64RVU25D
2025-07-01$86.16$53.64RVU25C
2025-04-01$86.16$53.64RVU25B
2025-01-01$86.16$53.64RVU25A

64418 billing questions

How is 64418 different from a shoulder joint injection?

64418 targets the suprascapular nerve. An injection placed into the shoulder joint itself is a different service and should not be selected based only on the shared shoulder-pain indication.

When should 64450 be considered instead?

Use 64418 when the suprascapular nerve is the target. Code 64450 is for an injection targeting a peripheral nerve or branch without a more specific code for that nerve.

What documentation supports reporting 64418?

Document the shoulder-pain indication, the suprascapular nerve as the target, laterality, injection approach, and medication administered.

Can ultrasound guidance be reported separately?

When ultrasound needle guidance is performed and documented, 76942 may be separately reportable. The record should support the guidance service as well as the nerve injection.

How does Medicare pay when both sides are treated?

For bilateral treatment, Medicare pays 150% when the service is reported with modifier 50.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures in that session are subject to 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 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.

RVUs for 64418PPRRVU2026_Oct_nonQPP.csv, line 7,102 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet