$175.03
Choose 27096 when the needle delivers medication into the SI-joint space. Choose 64451 when the target is the nerves supplying the joint.
On this page
CMS RVU26D · Effective 2026-10-01
64451 SI nerve block Medicare reimbursement rates in Nevada
Report this code for an image-guided anesthetic or steroid injection targeting nerves that innervate the sacroiliac joint, such as for suspected SI-joint pain. Compare 64451 office and facility rates across CMS payment localities in Nevada.
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 64451 in Nevada?
Nevada 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
$240.89
1 of 1 localities have a supported rate.
Payment area: Nevada**
One mapped payment locality.
Facility setting
$71.72
1 of 1 localities have a supported rate.
Payment area: Nevada**
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.
Pain management
About 64451: Image-guided sacroiliac nerve block
Report this code for an image-guided anesthetic or steroid injection targeting nerves that innervate the sacroiliac joint, such as for suspected SI-joint pain.
This service is an injection of anesthetic, steroid, or both around nerves that carry sensation from the sacroiliac joint. Clinicians commonly target the L5 dorsal ramus and sacral lateral branches when evaluating or treating suspected SI-joint pain. Pain medicine physicians, anesthesiologists, and physiatrists may perform it in an office or outpatient facility, using fluoroscopy or CT to guide needle placement.
Report the code when the target is the nerves supplying the SI joint, rather than the joint space itself. The record should identify the side and nerve targets, document image guidance, and describe the injectate and clinical indication. Needle placement and imaging guidance are included. The procedure has a 0-day global period, so same-day preoperative and postoperative care are included. For bilateral services, modifier 50 is paid at 150%. In the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 64451
- 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 RVU1.48 · 20%
- Practice expense (office) RVU5.61 · 78%
- Malpractice RVU0.14 · 2%
9.1K
Medicare services in 2024 · #1525 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.
64451 compared with similar codes
Office rates for Nevada, from the same CMS release.
$494.20
64625 is for radiofrequency treatment of SI-joint innervation; 64451 reports an injection of anesthetic, steroid, or both.
$80.49
64450 covers an otherwise unspecified peripheral nerve or branch. Use 64451 when the injection targets nerves innervating the SI joint.
Compare 64451 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
Nevada** →
Office / nonfacility
$240.89
Facility
$71.72
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 64451 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
7,114
- Code
- 64451
- Physician work
- 1.48
- Practice expense
- 5.61
- Malpractice
- 0.14
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.48 | × 1.000 | 1.4800 |
| Practice expense | 5.61 | × 1.001 | 5.6156 |
| Malpractice | 0.14 | × 0.833 | 0.1166 |
| Total RVUs | 7.2122 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nevada**$240.89
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.48 | 1 |
| Practice expense | 5.61 | 1.001 |
| Malpractice | 0.14 | 0.833 |
(1.48 × 1 + 5.61 × 1.001 + 0.14 × 0.833) × $33.4009 = $240.89
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.48 | 1 |
| Practice expense | 0.55 | 1.001 |
| Malpractice | 0.14 | 0.833 |
(1.48 × 1 + 0.55 × 1.001 + 0.14 × 0.833) × $33.4009 = $71.72
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.
64451 billing questions
How is this different from an SI-joint injection?
This code is for injections targeting nerves that innervate the SI joint. Code 27096 is for an injection into the SI-joint space.
Is image guidance separately reported?
No. The service includes fluoroscopic or CT guidance and needle placement.
Can I report this for both sides?
Yes. Report bilateral work with modifier 50; CMS pays the bilateral procedure at 150%.
How does the multiple-procedure reduction affect same-session services?
CMS pays the highest-valued procedure in full and reduces the other procedures to 50% when performed in the same session.
What documentation supports reporting this code?
Document the SI-innervating nerve targets, laterality, image guidance, injectate, and reason for the injection. The record should make clear that the target is neural, not the joint space.
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.
7,11164448,,Njx aa&/strd fem nrv nfs img,A,,1.64,0.25,NA,0.25,,0.14,2.03,2.03,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11264449,,Njx aa&/strd lmbr plex nfs,A,,1.24,0.43,NA,0.43,,0.14,1.81,1.81,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11364450,,Njx aa&/strd other pn/branch,A,,0.73,1.62,,0.35,,0.07,2.42,1.15,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11464451,,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
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097