Billing code 64449: Lumbar plexus blockMedicare rate & RVUs in Georgia
Reports injection of anesthetic and/or steroid at the lumbar plexus for regional anesthesia, perioperative analgesia, or selected pain treatment.
CMS doesn’t publish an office rate for 64449 in Georgia.
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 9 sections
What 64449 covers
This service places anesthetic and/or steroid near the lumbar plexus to interrupt nerve signals from the lower extremity. Anesthesiologists and pain physicians commonly perform it in an operating room, procedure suite, or other setting where regional blocks are provided. A lumbar plexus block may support anesthesia or postoperative pain control for hip or femur procedures, or be used in selected pain-treatment plans.
Report the code when the documented target is the lumbar plexus, rather than an individual femoral or sciatic nerve. The record should identify the indication, laterality, target, and medication injected. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When performed in the same session with other procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. For bilateral service, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; 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 64449 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $61.75 |
| Rest Of Georgia | Unavailable | $59.80 |
How the 64449 rate is calculated
Each of 64449’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 · 64449
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.24Practice expense 0.43Malpractice 0.14
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64449
The CMS indicators that decide how 64449 is paid alongside other services.
CMS payment indicators · 64449
Lumbar plexus 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 50 · payment effect
With and without the modifier
64449 without 50 · national facility
$60.46
Lumbar plexus block
64449-50 · Bilateral: 150%
$90.69
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
64449 compared with similar codes
Compare codes
64449 vs 64447 vs 64448 vs 64445 vs 64446: national Medicare rates
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How to choose
- 64447Femoral nerve block
- Use 64449 for a lumbar plexus target; use 64447 when the injection is directed specifically at the femoral nerve.
- 64448Femoral nerve block
- 64448 describes a femoral nerve block delivered by continuous catheter infusion. It is not the code for a lumbar plexus injection.
- 64445Sciatic nerve block
- 64445 is directed at the sciatic nerve, not the lumbar plexus.
- 64446Sciatic nerve block
- 64446 describes continuous catheter infusion at the sciatic nerve; 64449 identifies the lumbar plexus target.
64449 billing questions
How is this code distinguished from a femoral nerve block?
Use this code when the documented injection targets the lumbar plexus. A block directed at the femoral nerve is reported with the femoral nerve code instead.
Does the code include same-day preoperative and postoperative care?
Yes. It has a 0-day global period, and same-day preoperative and postoperative care is included.
How is bilateral lumbar plexus injection reported?
Report bilateral service with modifier 50. CMS pays the bilateral procedure at 150%.
What happens when this is performed with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported for this procedure?
Assistant-at-surgery services are not paid. 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 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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