$114.94–$123.56
64405 targets the greater occipital nerve; 64400 targets the trigeminal nerve. Choose by the nerve actually injected, not simply by a headache diagnosis.
On this page
CMS RVU26D · Effective 2026-10-01
64405 Occipital nerve block Medicare reimbursement rates in Michigan
Report this injection for a greater occipital nerve block, commonly performed for occipital neuralgia or headache involving the occipital nerve distribution. Compare 64405 office and facility rates across CMS payment localities in Michigan.
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 64405 in Michigan?
Michigan 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
$76.16–$82.20
2 of 2 localities have a supported rate.
Facility setting
$46.27–$50.61
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 injections
About 64405: Greater occipital nerve injection
Report this injection for a greater occipital nerve block, commonly performed for occipital neuralgia or headache involving the occipital nerve distribution.
This service injects anesthetic, steroid, or both around the greater occipital nerve to interrupt pain signals. Pain medicine physicians, anesthesiologists, neurologists, and other qualified clinicians commonly perform the block in an office or outpatient facility for occipital neuralgia or headache symptoms involving the back of the head. Documentation should identify the nerve and side treated, the clinical indication, and the injection performed.
Select this code for the greater occipital nerve rather than another named nerve or an unspecified peripheral nerve branch. CMS 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 treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 64405
- 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 RVU0.92 · 39%
- Practice expense (office) RVU1.23 · 52%
- Malpractice RVU0.21 · 9%
76.8K
Medicare services in 2024 · #644 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.
64405 compared with similar codes
Office rates for Michigan, from the same CMS release.
$76.42–$80.54
Use 64405 when the greater occipital nerve is the target. Code 64450 is for another peripheral nerve or branch when a more specific code does not describe the target.
$85.93–$90.60
64418 targets the suprascapular nerve in the shoulder region. It is not the code for a greater occipital nerve block.
Compare 64405 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
Detroit →
Office / nonfacility
$82.20
Facility
$50.61
Rest Of Michigan →
Office / nonfacility
$76.16
Facility
$46.27
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64405 billing questions
When should this code be chosen instead of 64400?
Use 64405 for the greater occipital nerve. Code 64400 describes an injection targeting the trigeminal nerve, a different nerve and distribution.
How is bilateral treatment reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document treatment of both greater occipital nerves.
Is same-day evaluation and postoperative care separately included?
CMS assigns a 0-day global period, with same-day preoperative and postoperative care included in the procedure.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
What documentation supports reporting this code?
Record the greater occipital nerve treated, laterality, clinical indication, and details of the injection. The documentation should distinguish this nerve from other named nerves treated.
Can an assistant or surgical team be reported for this procedure?
CMS does not pay an assistant at surgery for this code, and 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.
7,09463744,,Revision of spinal shunt,A,,8.72,9.65,NA,9.65,,3.67,22.04,22.04,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09563746,,Removal of spinal shunt,A,,7.15,9.10,NA,9.10,,3.01,19.26,19.26,0,090,0.11,0.76,0.13,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09664400,,Njx aa&/strd trigeminal nrv,A,,0.73,2.71,,0.48,,0.21,3.65,1.42,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09764405,,Njx aa&/strd gr ocpl nrv,A,,0.92,1.23,,0.25,,0.21,2.36,1.38,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09864408,,Njx aa&/strd vagus nrv,A,,0.73,1.55,,0.32,,0.11,2.39,1.16,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09964415,,Njx aa&/strd brch plxs img,A,,1.46,3.06,,0.41,,0.12,4.64,1.99,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10064416,,Njx aa&/strd brch pl nfs img,A,,1.76,0.26,NA,0.26,,0.15,2.17,2.17,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00