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CMS RVU26D · Effective 2026-10-01

64450 in Wyoming**

Office / nonfacility

$80.22

Base rate per service

Facility setting

$37.80

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.

Nerve injection

About 64450: Other peripheral nerve block injection

Report 64450 for an anesthetic and/or steroid injection targeting a peripheral nerve or branch that does not have a more specific CPT code.

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.

CMS billing rules for 64450

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 RVU0.73 · 30%
  • Practice expense (office) RVU1.62 · 67%
  • Malpractice RVU0.07 · 3%

387.6K

Medicare services in 2024 · #264 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.

64450 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

64420

Intercostal block

Single nerve

$105.10

64420 identifies an intercostal nerve block. Use 64450 for another peripheral nerve or branch without a more specific code.

64425

Nerve block

Ilioinguinal and iliohypogastric

$120.13

64425 is specific to the ilioinguinal or iliohypogastric nerves; 64450 is for a different peripheral nerve or branch not specifically named by a code.

64430

Nerve block

Pudendal nerve

$94.91

64430 identifies a pudendal nerve block. Report 64450 only when the target is another peripheral nerve or branch without a more specific code.

64455

Nerve injection

Plantar common digital nerve

$49.49

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.

The same code, a different location

How does Wyoming** compare?

64450 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $80.22

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

    $90.95

    $10.73 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $92.04

    $11.82 higher than Wyoming**

  4. Miami

    $86.62

    $6.40 higher than Wyoming**

  5. Chicago

    $84.30

    $4.08 higher than Wyoming**

  6. Manhattan

    $92.53

    $12.31 higher than Wyoming**

  7. Alaska*

    $95.49

    $15.27 higher than Wyoming**

Other payment areas listed in Wyoming 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, 64450 ranges from $72.07 in Arkansas to $106.34 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

  • Alabama

    Alabama · 64450

    Office

    $73.05

    Facility

    $35.94

    $7.17 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 64450

    Office

    $72.07

    Facility

    $35.63

    $8.15 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 64450

    Office

    $78.82

    Facility

    $37.71

    $1.40 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 64450

    Office

    $85.57

    Facility

    $39.08

    $5.35 higher than Wyoming** for the office setting.

  • Chico

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • El Centro

    California · 64450

    Office

    $85.37

    Facility

    $38.87

    $5.15 higher than Wyoming** for the office setting.

  • Fresno

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Madera

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Merced

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Modesto

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Napa

    California · 64450

    Office

    $98.42

    Facility

    $42.51

    $18.20 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 64450

    Office

    $90.48

    Facility

    $40.34

    $10.26 higher than Wyoming** for the office setting.

  • Redding

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 64450

    Office

    $86.12

    Facility

    $39.63

    $5.90 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 64450

    Office

    $89.44

    Facility

    $40.11

    $9.22 higher than Wyoming** for the office setting.

  • Salinas

    California · 64450

    Office

    $89.10

    Facility

    $39.94

    $8.88 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 64450

    Office

    $91.10

    Facility

    $40.36

    $10.88 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 64450

    Office

    $104.07

    Facility

    $44.26

    $23.85 higher than Wyoming** for the office setting.

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

    California · 64450

    Office

    $103.99

    Facility

    $44.18

    $23.77 higher than Wyoming** for the office setting.

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

    California · 64450

    Office

    $106.34

    Facility

    $45.18

    $26.12 higher than Wyoming** for the office setting.

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

    California · 64450

    Office

    $106.02

    Facility

    $44.85

    $25.80 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 64450

    Office

    $87.68

    Facility

    $39.37

    $7.46 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 64450

    Office

    $91.89

    Facility

    $40.35

    $11.67 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 64450

    Office

    $89.41

    Facility

    $39.95

    $9.19 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 64450

    Office

    $92.81

    Facility

    $40.72

    $12.59 higher than Wyoming** for the office setting.

  • Stockton

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Vallejo

    California · 64450

    Office

    $98.31

    Facility

    $42.40

    $18.09 higher than Wyoming** for the office setting.

  • Visalia

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Yuba City

    California · 64450

    Office

    $85.35

    Facility

    $38.86

    $5.13 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 64450

    Office

    $84.07

    Facility

    $38.94

    $3.85 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 64450

    Office

    $85.98

    Facility

    $40.29

    $5.76 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 64450

    Office

    $80.07

    Facility

    $38.16

    $0.15 lower than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 64450

    Office

    $83.42

    Facility

    $40.45

    $3.20 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 64450

    Office

    $79.63

    Facility

    $39.07

    $0.59 lower than Wyoming** for the office setting.

  • Atlanta

    Georgia · 64450

    Office

    $82.24

    Facility

    $39.14

    $2.02 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 64450

    Office

    $75.44

    Facility

    $37.60

    $4.78 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 64450

    Office

    $87.26

    Facility

    $39.03

    $7.04 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 64450

    Office

    $74.82

    Facility

    $36.01

    $5.40 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 64450

    Office

    $75.27

    Facility

    $36.24

    $4.95 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 64450

    Office

    $78.87

    Facility

    $39.85

    $1.35 lower than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 64450

    Office

    $77.44

    Facility

    $38.71

    $2.78 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 64450

    Office

    $84.27

    Facility

    $40.70

    $4.05 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 64450

    Office

    $75.68

    Facility

    $36.36

    $4.54 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 64450

    Office

    $74.48

    Facility

    $36.13

    $5.74 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 64450

    Office

    $74.63

    Facility

    $36.91

    $5.59 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 64450

    Office

    $77.96

    Facility

    $38.04

    $2.26 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 64450

    Office

    $74.51

    Facility

    $36.97

    $5.71 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 64450

    Office

    $92.07

    Facility

    $41.42

    $11.85 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 64450

    Office

    $83.61

    Facility

    $38.95

    $3.39 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 64450

    Office

    $85.72

    Facility

    $40.21

    $5.50 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 64450

    Office

    $81.53

    Facility

    $38.60

    $1.31 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 64450

    Office

    $75.62

    Facility

    $36.59

    $4.60 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 64450

    Office

    $79.48

    Facility

    $37.44

    $0.74 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 64450

    Office

    $80.54

    Facility

    $39.61

    $0.32 higher than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 64450

    Office

    $76.42

    Facility

    $37.70

    $3.80 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 64450

    Office

    $80.75

    Facility

    $37.10

    $0.53 higher than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 64450

    Office

    $77.48

    Facility

    $37.64

    $2.74 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 64450

    Office

    $78.24

    Facility

    $37.85

    $1.98 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 64450

    Office

    $73.30

    Facility

    $36.74

    $6.92 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 64450

    Office

    $72.70

    Facility

    $36.18

    $7.52 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 64450

    Office

    $80.83

    Facility

    $38.41

    $0.61 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 64450

    Office

    $76.36

    Facility

    $36.78

    $3.86 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 64450

    Office

    $79.44

    Facility

    $37.02

    $0.78 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 64450

    Office

    $75.21

    Facility

    $36.06

    $5.01 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 64450

    Office

    $82.76

    Facility

    $38.60

    $2.54 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 64450

    Office

    $91.18

    Facility

    $41.98

    $10.96 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 64450

    Office

    $87.01

    Facility

    $40.69

    $6.79 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 64450

    Office

    $76.81

    Facility

    $37.91

    $3.41 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 64450

    Office

    $80.49

    Facility

    $38.03

    $0.27 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 64450

    Office

    $94.62

    Facility

    $44.18

    $14.40 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 64450

    Office

    $87.56

    Facility

    $41.11

    $7.34 higher than Wyoming** for the office setting.

  • Queens

    New York · 64450

    Office

    $93.27

    Facility

    $43.13

    $13.05 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 64450

    Office

    $77.43

    Facility

    $37.13

    $2.79 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 64450

    Office

    $76.14

    Facility

    $37.41

    $4.08 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 64450

    Office

    $74.52

    Facility

    $36.64

    $5.70 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 64450

    Office

    $86.63

    Facility

    $39.50

    $6.41 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 64450

    Office

    $79.92

    Facility

    $37.67

    $0.30 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 64450

    Office

    $83.94

    Facility

    $39.78

    $3.72 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 64450

    Office

    $76.26

    Facility

    $37.32

    $3.96 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 64450

    Office

    $81.39

    Facility

    $38.50

    $1.17 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 64450

    Office

    $82.83

    Facility

    $39.01

    $2.61 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 64450

    Office

    $76.37

    Facility

    $37.17

    $3.85 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 64450

    Office

    $79.28

    Facility

    $36.86

    $0.94 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 64450

    Office

    $74.82

    Facility

    $36.26

    $5.40 lower than Wyoming** for the office setting.

  • Austin

    Texas · 64450

    Office

    $83.75

    Facility

    $38.87

    $3.53 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 64450

    Office

    $75.79

    Facility

    $37.19

    $4.43 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 64450

    Office

    $80.02

    Facility

    $37.99

    $0.20 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 64450

    Office

    $80.50

    Facility

    $38.25

    $0.28 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 64450

    Office

    $79.99

    Facility

    $38.17

    $0.23 lower than Wyoming** for the office setting.

  • Galveston

    Texas · 64450

    Office

    $80.24

    Facility

    $38.12

    $0.02 higher than Wyoming** for the office setting.

  • Houston

    Texas · 64450

    Office

    $81.53

    Facility

    $39.40

    $1.31 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 64450

    Office

    $77.84

    Facility

    $37.59

    $2.38 lower than Wyoming** for the office setting.

  • Utah

    Utah · 64450

    Office

    $77.35

    Facility

    $37.47

    $2.87 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 64450

    Office

    $79.22

    Facility

    $37.52

    $1.00 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 64450

    Office

    $81.39

    Facility

    $38.50

    $1.17 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 64450

    Office

    $79.13

    Facility

    $37.14

    $1.09 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 64450

    Office

    $83.46

    Facility

    $38.79

    $3.24 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 64450

    Office

    $93.90

    Facility

    $41.86

    $13.68 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 64450

    Office

    $76.94

    Facility

    $36.30

    $3.28 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 64450

    Office

    $74.75

    Facility

    $37.89

    $5.47 lower than Wyoming** for the office setting.

See how rates vary across the country

64450 · 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.

$72.07

$95.85

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$95.491
AL$73.051
AR$72.071
AZ$78.821
CA$85.35–$106.3429
CO$84.071
CT$85.981
DC$92.041
DE$80.071
FL$79.63–$86.623
GA$75.44–$82.242
GU$87.261
HI$87.261
IA$74.821
ID$75.271
IL$77.44–$84.304
IN$75.681
KS$74.481
KY$74.631
LA$74.51–$77.962
MA$83.61–$92.072
MD$81.53–$92.043
ME$75.62–$79.482
MI$76.42–$80.542
MN$80.751
MO$73.30–$78.243
MS$72.701
MT$80.831
NC$76.361
ND$79.441
NE$75.211
NH$82.761
NJ$87.01–$91.182
NM$76.811
NV$80.491
NY$77.43–$94.625
OH$76.141
OK$74.521
OR$79.92–$86.632
PA$76.26–$83.942
PR$81.391
RI$82.831
SC$76.371
SD$79.281
TN$74.821
TX$75.79–$83.758
UT$77.351
VA$79.22–$92.042
VI$81.391
VT$79.131
WA$83.46–$93.902
WI$76.941
WV$74.751
WY$80.221

Explore 64450 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 Wyoming →

Why are the office and facility amounts different?

For 64450 in Wyoming**, the physician’s office rate is $80.22 and the facility-setting rate is $37.80: a difference of $42.42.

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 64450 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$88.24

$80.22 × 110% = $88.24

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.

Compare your contract offer →

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 64450 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

7,113

Code
64450
Physician work
0.73
Practice expense
1.62
Malpractice
0.07

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 64450 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0000.7300
Practice expense1.62× 1.0001.6200
Malpractice0.07× 0.7400.0518
Total RVUs2.4018
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$80.22

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

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Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.731
Practice expense1.621
Malpractice0.070.74

(0.73 × 1 + 1.62 × 1 + 0.07 × 0.74) × $33.4009 = $80.22

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.731
Practice expense0.351
Malpractice0.070.74

(0.73 × 1 + 0.35 × 1 + 0.07 × 0.74) × $33.4009 = $37.80

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

64450 · Office / nonfacility

$80.22

Effective 2026-10-01

The base rate is $9.00 higher than on 2025-10-01, moving from $71.22 to $80.22 (12.6%).

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

    $71.22changed to$80.22

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.75 changed to 0.73
    • Practice expense RVU 1.40 changed to 1.62
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $71.22

    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$80.22$37.80RVU26D
2026-07-01$80.22$37.80RVU26C
2026-04-01$80.22$37.80RVU26B
2026-01-01$80.22$37.80RVU26A
2025-10-01$71.22$39.52RVU25D
2025-07-01$71.22$39.52RVU25C
2025-04-01$71.22$39.52RVU25B
2025-01-01$71.22$39.52RVU25A

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 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 64450PPRRVU2026_Oct_nonQPP.csv, line 7,113 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet