Billing code 64455: Nerve injectionMedicare rate & RVUs in Oregon

Report this injection of anesthetic and/or steroid around a plantar common digital nerve, commonly to diagnose or treat pain from Morton's neuroma.

CMS RVU26DEffective Oct 1, 20262 payment localities58.6K Medicare services in 2024

Medicare pays $49.31–$52.49 for 64455 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.

$49.31–$52.49Office (non-facility)
$29.35–$30.22Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 64455 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Oregon
  2. What 64455 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 64455 covers

A clinician injects anesthetic, steroid, or both around a plantar common digital nerve in the forefoot. The service is commonly performed in an office by a podiatrist, orthopedic clinician, or pain specialist for symptoms such as burning or radiating pain in the ball of the foot associated with suspected Morton's neuroma. The record should identify the treated nerve and side, the clinical indication, and the medication and injection performed.

Report 64455 for the plantar common digital nerve injection, rather than for an injection targeting a different peripheral nerve. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral reporting, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant is paid only when medical necessity is documented; co-surgeons and team surgery 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.

Where 64455 pays more and less in Oregon

64455 office and facility rates by payment locality
Payment localityOfficeFacility
Portland$52.49$30.22
Rest Of Oregon$49.31$29.35

How the 64455 rate is calculated

Each of 64455’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 · 64455

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.73Practice expense 0.70Malpractice 0.07

1.5000 adjusted RVUs×$33.4009 conversion factor=$50.10

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 64455

The CMS indicators that decide how 64455 is paid alongside other services.

CMS payment indicators · 64455

Nerve injection

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

64455 without 50 · national office

$50.10

Nerve injection

64455-50 · Bilateral: 150%

$75.15

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).

When to use modifier 50

64455 compared with similar codes

Compare codes

64455 vs 64450 vs 64632 vs 28080: national Medicare rates

Swap in your local Medicare rate.

  • 64455
    Nerve injection · 0.73 wRVU
    $50.10
  • 64450
    Nerve block · 0.73 wRVU
    $80.83+$30.73
  • 64632
    Nerve destruction · 1.2 wRVU
    $90.18+$40.08
  • 28080
    Neuroma excision · 4.74 wRVU
    $547.44+$497.34

How to choose

64450Nerve block
Choose 64455 for injection of a plantar common digital nerve. 64450 describes injection of another peripheral nerve or branch.
64632Nerve destruction
64455 reports an anesthetic and/or steroid injection. 64632 describes neurolytic destruction of the plantar common digital nerve.
28080Neuroma excision
64455 is an injection treatment for plantar common digital nerve symptoms; 28080 is surgical excision of an interdigital neuroma.

64455 billing questions

When should 64455 be used instead of 64450?

Use 64455 for an injection targeting a plantar common digital nerve, such as for Morton's neuroma. Use 64450 when the injected peripheral nerve or branch is not one of those nerves.

Is this code limited to steroid injections?

No. The service may involve anesthetic, steroid, or both. Document the medication administered and the plantar common digital nerve treated.

How is bilateral treatment reported?

CMS recognizes bilateral reporting with modifier 50 and pays it at 150%. Document the treated nerve and side for each foot.

Does the 0-day global period include same-day care?

Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

Can an assistant or another surgeon be reported?

Assistant-at-surgery payment is allowed only with documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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
RVUs for 64455PPRRVU2026_Oct_nonQPP.csv, line 7,116 (RVU26D)

Open CMS sourceHow we calculate rates

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