Billing code 64415: Brachial plexus blockMedicare rate & RVUs in Illinois
Reports a single injection to block the brachial plexus, commonly for anesthesia or pain control during shoulder and upper-arm procedures.
Medicare pays $148.34–$161.18 for 64415 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. Which amount applies depends on the service address.
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 64415 covers
This service is a single injection of anesthetic, steroid, or both to block the brachial plexus. Anesthesiologists, pain physicians, and other clinicians performing regional anesthesia commonly use it for perioperative anesthesia or analgesia for shoulder and upper-arm procedures. The approach may be interscalene, supraclavicular, or infraclavicular, depending on the intended block. Imaging guidance, when performed, is included in the service.
Report this code for a single-injection brachial plexus block; use the continuous-infusion catheter code when the clinician places a catheter for ongoing infusion instead. Document the indication, side, injection approach, medication, and technique, including imaging guidance when used. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 identifies a bilateral service, 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 64415 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$148.34 to $161.18
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $161.02 | $72.07 |
| East St. Louis | $150.87 | $69.44 |
| Rest Of Illinois | $148.34 | $67.53 |
| Suburban Chicago | $161.18 | $70.27 |
How the 64415 rate is calculated
Each of 64415’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 · 64415
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.46Practice expense 3.06Malpractice 0.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64415
The CMS indicators that decide how 64415 is paid alongside other services.
CMS payment indicators · 64415
Brachial 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
64415 without 50 · national office
$154.98
Brachial plexus block
64415-50 · Bilateral: 150%
$232.47
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).
64415 compared with similar codes
Compare codes
64415 vs 64416 vs 64417 vs 64418: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64416Nerve block
- 64415 is for a single brachial plexus injection. Choose 64416 when a catheter is used for continuous infusion.
- 64417Axillary nerve block
- 64417 blocks the axillary nerve specifically; 64415 targets the brachial plexus.
- 64418Nerve injection
- 64418 targets the suprascapular nerve. Use 64415 when the service is a brachial plexus block.
64415 billing questions
When should 64415 be reported instead of 64416?
Use 64415 for a single-injection brachial plexus block. Use 64416 when a catheter is placed for continuous infusion.
Is imaging guidance separately reported with this block?
Imaging guidance, when performed, is included in 64415. Document the guidance and block approach in the procedure record.
What documentation supports 64415?
Record the clinical indication, laterality, brachial plexus approach, medication injected, and whether imaging guidance was used.
How is a bilateral block reported?
Report modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.
How does the multiple-procedure reduction affect 64415?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported for this procedure?
CMS does not pay an assistant at surgery for this service. 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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