Choose 64466 for a unilateral injection; 64467 describes a unilateral block delivered as a continuous infusion through a catheter.
On this page
CMS RVU26D · Effective 2026-10-01
64466 Thoracic block Medicare reimbursement rates in California
Reports a single-injection anesthetic block in a thoracic fascial plane on one side, often for chest-wall pain control around breast or thoracic surgery. Compare 64466 office and facility rates across CMS payment localities in California.
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 64466 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$149.11–$184.27
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $35.16 per service.
Facility setting
$60.89–$68.20
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $7.31 per service.
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 64466 pays more and less in California
29 payment localities
$149.11 to $184.27
Regional anesthesia
About 64466: Unilateral thoracic fascial plane injection
Reports a single-injection anesthetic block in a thoracic fascial plane on one side, often for chest-wall pain control around breast or thoracic surgery.
This code describes an anesthetic injection into a fascial plane in the thoracic region on one side. An anesthesiologist or other qualified clinician may perform the block for chest-wall pain control around breast or thoracic surgery. The operative or anesthesia record should identify the side, target plane, injection technique, and clinical purpose so the service can be distinguished from a thoracic paravertebral block or a catheter infusion.
Report 64466 for the unilateral injection service, not for a continuous infusion through a catheter; the latter has a separate family code. The 0-day global period includes same-day preoperative and postoperative care. 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. CMS identifies bilateral payment at 150% with modifier 50; the family also has a separate bilateral injection code, 64468, so select the descriptor that matches the service. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 64466
- 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 RVU1.46 · 34%
- Practice expense (office) RVU2.65 · 62%
- Malpractice RVU0.14 · 3%
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.
64466 compared with similar codes
Office rates for California, from the same CMS release.
64468 identifies a bilateral thoracic fascial plane injection, while 64466 describes the unilateral service.
64461 is a thoracic paravertebral block, not an injection into a thoracic fascial plane.
Compare 64466 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $149.55 | Facility $61.33 |
| Chico | Office $149.11 | Facility $60.89 |
| El Centro | Office $149.13 | Facility $60.91 |
| Fresno | Office $149.11 | Facility $60.89 |
| Hanford-Corcoran | Office $149.11 | Facility $60.89 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $158.58 | Facility $63.35 |
| Madera | Office $149.11 | Facility $60.89 |
| Merced | Office $149.11 | Facility $60.89 |
| Modesto | Office $149.11 | Facility $60.89 |
| Napa | Office $170.87 | Facility $64.78 |
| Oxnard-Thousand Oaks-Ventura | Office $157.67 | Facility $62.52 |
| Redding | Office $149.11 | Facility $60.89 |
| Rest Of California | Office $149.11 | Facility $60.89 |
| Riverside-San Bernardino-Ontario | Office $150.64 | Facility $62.42 |
| Sacramento-Roseville-Folsom | Office $155.97 | Facility $62.35 |
| Salinas | Office $155.37 | Facility $62.07 |
| San Diego-Chula Vista-Carlsbad | Office $158.62 | Facility $62.35 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $180.35 | Facility $66.85 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $180.19 | Facility $66.69 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $184.27 | Facility $68.20 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $183.62 | Facility $67.55 |
| San Luis Obispo-Paso Robles | Office $152.92 | Facility $61.23 |
| Santa Cruz-Watsonville | Office $159.84 | Facility $62.04 |
| Santa Maria-Santa Barbara | Office $155.84 | Facility $61.98 |
| Santa Rosa-Petaluma | Office $161.43 | Facility $62.58 |
| Stockton | Office $149.11 | Facility $60.89 |
| Vallejo | Office $170.64 | Facility $64.55 |
| Visalia | Office $149.11 | Facility $60.89 |
| Yuba City | Office $149.11 | Facility $60.89 |
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64466 billing questions
How is 64466 different from 64467?
64466 is for a unilateral injection. Use 64467 for a unilateral thoracic fascial plane block performed as a continuous infusion by catheter.
How should a bilateral thoracic injection be reported?
CMS lists bilateral payment at 150% with modifier 50. The code family also has 64468 for a bilateral injection, so choose the code and modifier combination that matches the documented service and applicable CPT instructions.
Is same-day postoperative care separately included?
No. The 0-day global period includes same-day preoperative and postoperative care.
What documentation supports 64466?
Document the thoracic fascial plane targeted, the unilateral site, the injection technique, and the reason for the block. The record should support an injection rather than a catheter-based continuous infusion.
Can an assistant or co-surgeon be reported for this service?
CMS restricts assistant-at-surgery payment for 64466. 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.
