$77.59
64461 covers one thoracic paravertebral injection site. Use 64462 for each additional site, not as a substitute for the initial-site code.
On this page
CMS RVU26D · Effective 2026-10-01
64461 Paravertebral block Medicare reimbursement rates in Delaware
Reports a single-site thoracic paravertebral nerve block, commonly used to provide regional analgesia for thoracic or breast surgery. Compare 64461 office and facility rates across CMS payment localities in Delaware.
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 64461 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$148.34
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$71.45
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
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.
Anesthesia and pain
About 64461: Thoracic paravertebral single-site block
Reports a single-site thoracic paravertebral nerve block, commonly used to provide regional analgesia for thoracic or breast surgery.
This service is a single-injection thoracic paravertebral nerve block using anesthetic medication, with or without steroid, to reduce pain in the relevant thoracic distribution. Anesthesiologists and acute pain or pain-management clinicians commonly perform it around thoracic procedures, including thoracotomy, or breast surgery. Imaging guidance may be used to place the injection and is included in the service. The block may be performed in an operating room or another procedural setting.
Select this code for one thoracic paravertebral injection site; report 64462 for each additional site when applicable. Document the indication, laterality, site count, medication, and guidance used. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral performance, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 64461
- 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 RVU1.71 · 38%
- Practice expense (office) RVU2.61 · 58%
- Malpractice RVU0.16 · 4%
5.8K
Medicare services in 2024 · #1777 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.
64461 compared with similar codes
Office rates for Delaware, from the same CMS release.
$261.61
64463 is for a thoracic paravertebral block delivered by continuous infusion; 64461 describes a single-injection service.
$140.66
64466 describes a unilateral thoracic fascial plane block. Choose it when the clinician performs that fascial plane technique rather than a paravertebral block.
$162.84
64468 describes a bilateral thoracic fascial plane block, not bilateral thoracic paravertebral injection sites.
Compare 64461 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.
1 of 1 payment localities
Delaware →
Office / nonfacility
$148.34
Facility
$71.45
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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 64461 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
7,117
- Code
- 64461
- Physician work
- 1.71
- Practice expense
- 2.61
- Malpractice
- 0.16
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.71 | × 1.005 | 1.7185 |
| Practice expense | 2.61 | × 0.988 | 2.5787 |
| Malpractice | 0.16 | × 0.899 | 0.1438 |
| Total RVUs | 4.4411 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$148.34
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.71 | 1.005 |
| Practice expense | 2.61 | 0.988 |
| Malpractice | 0.16 | 0.899 |
(1.71 × 1.005 + 2.61 × 0.988 + 0.16 × 0.899) × $33.4009 = $148.34
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.71 | 1.005 |
| Practice expense | 0.28 | 0.988 |
| Malpractice | 0.16 | 0.899 |
(1.71 × 1.005 + 0.28 × 0.988 + 0.16 × 0.899) × $33.4009 = $71.45
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.
64461 billing questions
When should 64462 be used instead?
Use 64461 for one thoracic paravertebral injection site. Code 64462 is the add-on for each additional site.
Can imaging guidance be billed separately?
Imaging guidance, when performed to place this block, is included in 64461 and should not be separately reported as guidance for the same service.
How is a bilateral block reported?
Report bilateral performance with modifier 50. CMS pays the bilateral procedure at 150%.
What should the procedure note support?
Document the thoracic paravertebral target, laterality, number of injection sites, medication, clinical indication, and imaging guidance if used.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for 64461. 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.
7,11464451,,Njx aa&/strd nrv nrvtg si jt,A,,1.48,5.61,,0.55,,0.14,7.23,2.17,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11564454,,Njx aa&/strd gnclr nrv brnch,A,,1.48,5.42,,0.58,,0.13,7.03,2.19,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11664455,,Njx aa&/strd pltr com dg nrv,A,,0.73,0.70,,0.10,,0.07,1.50,0.90,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11764461,,Pvb thoracic single inj site,A,,1.71,2.61,,0.28,,0.16,4.48,2.15,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11864462,,Pvb thoracic 2nd+ inj site,A,,1.07,1.19,,0.18,,0.08,2.34,1.33,0,ZZZ,0.00,0.00,0.00,0,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11964463,,Pvb thoracic cont infusion,A,,1.85,5.90,,0.28,,0.16,7.91,2.29,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,12064466,,Thrc fascial pln blk uni njx,A,,1.46,2.65,,0.24,,0.14,4.25,1.84,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503