$125.34–$138.45
This code targets the ilioinguinal or iliohypogastric nerves. Use 64430 when the injected target is the pudendal nerve.
On this page
CMS RVU26D · Effective 2026-10-01
64430 Nerve block Medicare reimbursement rates in Massachusetts
Reports injection of anesthetic, with or without steroid, around the pudendal nerve for pelvic or perineal pain or procedural anesthesia. Compare 64430 office and facility rates across CMS payment localities in Massachusetts.
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 64430 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$98.79–$108.33
2 of 2 localities have a supported rate.
Facility setting
$49.20–$52.10
2 of 2 localities have a supported rate.
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.
Nerve injection
About 64430: Pudendal nerve injection
Reports injection of anesthetic, with or without steroid, around the pudendal nerve for pelvic or perineal pain or procedural anesthesia.
A clinician places medication near the pudendal nerve to interrupt sensation in the perineum and nearby pelvic structures. Pain medicine physicians and anesthesiologists may use the block to evaluate or treat suspected pudendal neuralgia or other pelvic pain; gynecologists and obstetric clinicians may use it for perineal or procedural anesthesia. The injection may be performed in an office, procedure suite, or hospital, using an approach suited to the patient and clinical target.
Report the code for the pudendal nerve injection whether the goal is diagnostic or therapeutic. The record should identify the indication, nerve targeted, side or sides, approach, and medications injected. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 64430
- 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 RVU0.98 · 34%
- Practice expense (office) RVU1.78 · 62%
- Malpractice RVU0.11 · 4%
3.9K
Medicare services in 2024 · #2006 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.
64430 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$77.12–$84.68
This code targets the paracervical nerve. A block directed to the pudendal nerve is reported with 64430.
$83.61–$92.07
This code is for an unspecified peripheral nerve or branch. 64430 identifies the pudendal nerve as the target.
Compare 64430 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$108.33
Facility
$52.10
Rest Of Massachusetts →
Office / nonfacility
$98.79
Facility
$49.20
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64430 billing questions
When should 64430 be chosen instead of 64450?
Use 64430 when the pudendal nerve is the documented target. Code 64450 is for an otherwise unspecified peripheral nerve or branch, not a substitute for a named pudendal nerve block.
Does the code depend on whether the block is diagnostic or therapeutic?
No. The code describes injection at the pudendal nerve; document whether the purpose is diagnostic, pain relief, or anesthesia.
How is a bilateral pudendal nerve block reported?
CMS identifies this as a bilateral procedure: report modifier 50 for bilateral treatment. Its Medicare payment is 150%.
Can another procedure be reported in the same session?
A distinct procedure may be reported when separately performed and supported by the record. Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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.
7,10364420,,Njx aa&/strd ntrcost nrv 1,A,,1.05,2.03,,0.43,,0.09,3.17,1.57,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10464421,,Njx aa&/strd ntrcost nrv ea,A,,0.49,0.51,,0.11,,0.05,1.05,0.65,0,ZZZ,0.00,0.00,0.00,0,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10564425,,Njx aa&/strd ii ih nerves,A,,0.98,2.55,,0.42,,0.09,3.62,1.49,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10664430,,Njx aa&/strd pudendal nerve,A,,0.98,1.78,,0.37,,0.11,2.87,1.46,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10764435,,Njx aa&/strd paracrv nrv,A,,0.73,1.39,,0.30,,0.13,2.25,1.16,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10864445,,Njx aa&/strd sciatic nrv img,A,,1.36,3.68,,0.47,,0.15,5.19,1.98,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10964446,,Njx aa&/strd sc nrv nfs img,A,,1.71,0.26,NA,0.26,,0.15,2.12,2.12,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00