$161.93–$180.00
Choose 64446 for continuous delivery through a sciatic catheter; 64445 describes a single-injection sciatic block.
On this page
CMS RVU26D · Effective 2026-10-01
64446 Sciatic nerve block Medicare reimbursement rates in Texas
Reports a sciatic nerve block delivered through a catheter for continuous infusion, commonly for ongoing lower-extremity analgesia after surgery. Compare 64446 office and facility rates across CMS payment localities in Texas.
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 64446 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No 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.
Where 64446 pays more and less in Texas
Peripheral nerve block
About 64446: Continuous sciatic nerve catheter block
Reports a sciatic nerve block delivered through a catheter for continuous infusion, commonly for ongoing lower-extremity analgesia after surgery.
This service covers delivery of anesthetic through a catheter placed at the sciatic nerve for continuous regional analgesia. Anesthesiologists and pain physicians commonly provide it around lower-extremity surgery, such as procedures involving the foot, ankle, or lower leg. Imaging guidance, when used, is included in the service. The catheter allows medication delivery to continue beyond a single injection.
Choose this code for a continuous sciatic catheter service rather than a single-injection sciatic block. Documentation should identify the nerve and side, catheter placement, the continuous infusion plan, and any imaging used. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 64446
- 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 RVU1.71 · 81%
- Practice expense (office) RVU0.26 · 12%
- Malpractice RVU0.15 · 7%
3.3K
Medicare services in 2024 · #2104 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.
64446 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
Both describe continuous catheter blocks, but 64448 targets the femoral nerve rather than the sciatic nerve.
No office rate
64449 targets the lumbar plexus for continuous delivery; 64446 is specific to the sciatic nerve.
Compare 64446 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $70.86 |
| Beaumont | Office Unavailable | Facility $69.67 |
| Brazoria | Office Unavailable | Facility $70.09 |
| Dallas | Office Unavailable | Facility $70.58 |
| Fort Worth | Office Unavailable | Facility $70.56 |
| Galveston | Office Unavailable | Facility $70.34 |
| Houston | Office Unavailable | Facility $73.09 |
| Rest Of Texas | Office Unavailable | Facility $69.88 |
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64446 billing questions
How does 64446 differ from 64445?
64446 is for continuous anesthetic delivery through a sciatic nerve catheter. Use 64445 for a single-injection sciatic nerve block.
Can imaging guidance be reported separately?
Imaging guidance, when performed for this block, is included in 64446.
What should the procedure note identify?
Document the sciatic nerve and side, catheter placement, the continuous infusion plan, and imaging used.
How is bilateral reporting handled?
For bilateral performance, CMS specifies modifier 50, with payment at 150%.
How does CMS handle other procedures in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are paid at 50%.
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.
7,10664430,,Njx aa&/strd pudendal nerve,A,,0.98,1.78,,0.37,,0.11,2.87,1.46,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10764435,,Njx aa&/strd paracrv nrv,A,,0.73,1.39,,0.30,,0.13,2.25,1.16,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10864445,,Njx aa&/strd sciatic nrv img,A,,1.36,3.68,,0.47,,0.15,5.19,1.98,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,10964446,,Njx aa&/strd sc nrv nfs img,A,,1.71,0.26,NA,0.26,,0.15,2.12,2.12,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11064447,,Njx aa&/strd femoral nrv img,A,,1.31,2.59,,0.39,,0.12,4.02,1.82,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,11164448,,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