Billing code 64450: Nerve blockMedicare rate & RVUs in Oklahoma
Report 64450 for an anesthetic and/or steroid injection targeting a peripheral nerve or branch that does not have a more specific code.
Medicare pays $74.52 for 64450 in the office in Oklahoma (Oklahoma). 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 64450 covers
A clinician injects anesthetic, steroid, or both around a peripheral nerve or branch not identified by a more specific nerve-block code. The block may be used to reduce pain or help evaluate whether a particular nerve is contributing to symptoms. Pain physicians, anesthesiologists, surgeons, and other clinicians may perform it in an office, outpatient procedure area, or hospital. The documented target must be the nerve or branch actually treated; this code is not a substitute for a code that names the nerve or anatomic target.
Report the service based on the documented nerve, indication, laterality, and injectate. The record should identify the target and support the clinical purpose of the block; for a diagnostic block, document the patient’s response when assessed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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.
64450 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $74.52 | $36.64 |
How the 64450 rate is calculated
Each of 64450’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 · 64450
RVUs × geographic indexes × conversion factor
Work0.73
0.73 RVUs× 1.000 GPCI
Practice expense1.62
1.62 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
2.4200
Conversion factor
$33.4009
Medicare rate
$80.83
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64450
The CMS indicators that decide how 64450 is paid alongside other services.
CMS payment indicators · 64450
Nerve 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
64450 without 50 · national office
$80.83
Nerve block
64450-50 · Bilateral: 150%
$121.25
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).
64450 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 64420Intercostal block
- 64420 identifies an intercostal nerve block. Use 64450 for another peripheral nerve or branch without a more specific code.
- 64425Nerve block
- 64425 is specific to the ilioinguinal or iliohypogastric nerves; 64450 is for a different peripheral nerve or branch not specifically named by a code.
- 64430Nerve block
- 64430 identifies a pudendal nerve block. Report 64450 only when the target is another peripheral nerve or branch without a more specific code.
- 64455Nerve injection
- 64455 is specific to a plantar common digital nerve injection. Use 64450 for a different peripheral nerve or branch not covered by a more specific code.
64450 billing questions
When should 64450 be chosen instead of a code for a named nerve?
Use 64450 when the treated peripheral nerve or branch does not have a more specific code. For a nerve with its own code, report that code rather than using 64450 as a general substitute.
What should the procedure note identify?
Document the nerve or branch treated, the clinical indication, laterality, and the anesthetic and/or steroid injected. For a diagnostic block, record the response when it is assessed.
How is a bilateral service reported?
Use modifier 50 for a bilateral procedure; CMS pays it at 150%.
How does the multiple-procedure reduction affect 64450?
When it is performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.
Can an assistant, co-surgeon, or surgical team be billed for this procedure?
Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted for this code.
Are same-day preoperative and postoperative services included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
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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