Billing code 64463: Paravertebral blockMedicare rate & RVUs in Texas
Reports a thoracic paravertebral block using a catheter for continuous anesthetic infusion, commonly to provide perioperative pain control after chest or breast surgery.
Medicare pays $246.09–$275.15 for 64463 in the office in Texas, from Beaumont to Austin. 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 64463 covers
Code 64463 reports a thoracic paravertebral block performed with a catheter for continuous anesthetic infusion. The catheter delivers medication near the thoracic spinal nerves beside the vertebral column. Anesthesiologists and pain medicine physicians commonly perform the block for perioperative analgesia, including after thoracotomy or breast surgery, in an operating room or other procedural setting. Imaging guidance, when used for the block, is included.
Select this code for the continuous catheter technique rather than a single-injection thoracic block. Document the thoracic site, laterality, catheter technique, and plan for continuous infusion. The service 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 at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 64463 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$246.09 to $275.15
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $275.15 | $76.54 |
| Beaumont | $246.09 | $75.27 |
| Brazoria | $261.75 | $75.72 |
| Dallas | $263.21 | $76.25 |
| Fort Worth | $261.31 | $76.22 |
| Galveston | $262.40 | $76.00 |
| Houston | $265.33 | $78.93 |
| Rest Of Texas | $253.63 | $75.49 |
How the 64463 rate is calculated
Each of 64463’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 · 64463
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.85Practice expense 5.90Malpractice 0.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64463
The CMS indicators that decide how 64463 is paid alongside other services.
CMS payment indicators · 64463
Paravertebral 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
64463 without 50 · national office
$264.20
Paravertebral block
64463-50 · Bilateral: 150%
$396.30
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).
64463 compared with similar codes
Compare codes
64463 vs 64461 vs 64462 vs 64467: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64461Paravertebral block
- Use 64461 for a single-injection thoracic paravertebral block. Use 64463 when a catheter is used for continuous infusion.
- 64462Paravertebral block
- 64462 represents an additional thoracic paravertebral injection site in the single-injection code family; it does not describe continuous catheter infusion.
- 64467Thoracic plane block
- Both describe continuous catheter infusion, but 64467 is a thoracic fascial plane block, not a paravertebral block.
64463 billing questions
How does 64463 differ from 64461?
64463 is for a thoracic paravertebral block using a catheter for continuous infusion. 64461 describes a single-injection thoracic paravertebral block.
Can imaging guidance be billed separately?
Imaging guidance, when used for the block, is included in 64463.
How is a bilateral block reported?
CMS identifies 64463 as a bilateral procedure; modifier 50 is paid at 150%. Document the treated sides.
What documentation supports choosing 64463?
Document the thoracic paravertebral location, laterality, catheter technique, and that the catheter is intended for continuous infusion. A single-injection technique points to a different code.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 64463. 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 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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