$235.15
Choose 64517 for an injection directed to the hypogastric plexus in pelvic pain management. Choose 64530 when the target is the celiac plexus.
On this page
CMS RVU26D · Effective 2026-10-01
64517 Plexus block Medicare reimbursement rates in Nevada
An anesthetic injection targeting the hypogastric plexus is reported for diagnostic or therapeutic management of visceral pelvic pain. Compare 64517 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 64517 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
$201.75
1 of 1 localities have a supported rate.
Payment area: Nevada**
One mapped payment locality.
Facility setting
$112.82
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 64517: Hypogastric plexus anesthetic injection
An anesthetic injection targeting the hypogastric plexus is reported for diagnostic or therapeutic management of visceral pelvic pain.
This procedure places an anesthetic agent at the hypogastric plexus to interrupt pain signaling from pelvic viscera. Pain medicine physicians, anesthesiologists, and other clinicians who perform image-guided pain procedures commonly use it for persistent pelvic pain, including pain associated with pelvic malignancy. The treatment target is the hypogastric plexus, not the celiac plexus or a lumbar sympathetic chain target.
Report the code when the documented service is an anesthetic injection directed to the hypogastric plexus. The record should identify the pain indication, intended plexus, injection performed, and relevant response or outcome. 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 are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 64517
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU2.15 · 35%
- Practice expense (office) RVU3.72 · 61%
- Malpractice RVU0.20 · 3%
975
Medicare services in 2024 · #2990 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.
64517 compared with similar codes
Office rates for Nevada, from the same CMS release.
$241.68
64520 describes injection at a lumbar or thoracic sympathetic target. It is not the code for an injection directed to the hypogastric plexus.
$153.48
64510 is for injection at the stellate ganglion, a different target from the hypogastric plexus.
Compare 64517 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
$201.75
Facility
$112.82
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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 64517 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
7,142
- Code
- 64517
- Physician work
- 2.15
- Practice expense
- 3.72
- Malpractice
- 0.20
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.15 | × 1.000 | 2.1500 |
| Practice expense | 3.72 | × 1.001 | 3.7237 |
| Malpractice | 0.20 | × 0.833 | 0.1666 |
| Total RVUs | 6.0403 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nevada**$201.75
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.15 | 1 |
| Practice expense | 3.72 | 1.001 |
| Malpractice | 0.2 | 0.833 |
(2.15 × 1 + 3.72 × 1.001 + 0.2 × 0.833) × $33.4009 = $201.75
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.15 | 1 |
| Practice expense | 1.06 | 1.001 |
| Malpractice | 0.2 | 0.833 |
(2.15 × 1 + 1.06 × 1.001 + 0.2 × 0.833) × $33.4009 = $112.82
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.
64517 billing questions
How is this code distinguished from a celiac plexus injection?
Use this code when the injection targets the hypogastric plexus for pelvic visceral pain. A celiac plexus injection targets a different plexus and is reported with 64530.
Should modifier 50 be appended for bilateral treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code, so do not report modifier 50.
Is same-day postoperative care separately included?
No. The 0-day global period includes same-day preoperative and postoperative care.
How does the multiple-procedure reduction affect payment?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50% under the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare 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 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.
7,13964495,,Inj paravert f jnt l/s 3 lev,A,,0.98,1.90,,0.29,,0.08,2.96,1.35,0,ZZZ,0.00,0.00,0.00,0,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14064505,,N block spenopalatine gangl,A,,1.33,2.79,,1.21,,0.38,4.50,2.92,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14164510,,N block stellate ganglion,A,,1.19,3.31,,0.79,,0.11,4.61,2.09,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14264517,,N block inj hypogas plxs,A,,2.15,3.72,,1.06,,0.20,6.07,3.41,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14364520,,N block lumbar/thoracic,A,,1.32,5.81,,0.86,,0.12,7.25,2.30,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14464530,,N block inj celiac pelus,A,,1.54,5.37,,0.87,,0.15,7.06,2.56,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14564553,,Implant neuroelectrodes,A,,5.98,136.45,,5.00,,2.52,144.95,13.50,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,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