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CMS RVU26D · Effective 2026-10-01

64430 Nerve block Medicare reimbursement rates in Utah

Reports injection of anesthetic, with or without steroid, around the pudendal nerve for pelvic or perineal pain or procedural anesthesia. Compare 64430 office and facility rates across CMS payment localities in Utah.

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 64430 in Utah?

Utah 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

$91.92

1 of 1 localities have a supported rate.

Payment area: Utah

One mapped payment locality.

Facility setting

$47.65

1 of 1 localities have a supported rate.

Payment area: Utah

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.

Find 64430 in your payment locality →

Nerve injection

About 64430: Pudendal nerve injection

Reports injection of anesthetic, with or without steroid, around the pudendal nerve for pelvic or perineal pain or procedural anesthesia.

A clinician places medication near the pudendal nerve to interrupt sensation in the perineum and nearby pelvic structures. Pain medicine physicians and anesthesiologists may use the block to evaluate or treat suspected pudendal neuralgia or other pelvic pain; gynecologists and obstetric clinicians may use it for perineal or procedural anesthesia. The injection may be performed in an office, procedure suite, or hospital, using an approach suited to the patient and clinical target.

Report the code for the pudendal nerve injection whether the goal is diagnostic or therapeutic. The record should identify the indication, nerve targeted, side or sides, approach, and medications injected. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

CMS billing rules for 64430

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 RVU0.98 · 34%
  • Practice expense (office) RVU1.78 · 62%
  • Malpractice RVU0.11 · 4%

3.9K

Medicare services in 2024 · #2006 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.

64430 compared with similar codes

Office rates for Utah, from the same CMS release.

64425

Nerve block

Ilioinguinal and iliohypogastric

$115.49

This code targets the ilioinguinal or iliohypogastric nerves. Use 64430 when the injected target is the pudendal nerve.

64435

Nerve block

Paracervical (uterine)

$71.92

This code targets the paracervical nerve. A block directed to the pudendal nerve is reported with 64430.

64450

Nerve block

Other peripheral nerve or branch

$77.35

This code is for an unspecified peripheral nerve or branch. 64430 identifies the pudendal nerve as the target.

Compare 64430 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

Office and facility base rates · shared scale starting at $0
  • Utah →

    Office / nonfacility

    $91.92

    Facility

    $47.65

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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 64430 in Utah.

PPRRVU2026_Oct_nonQPP.csv

7,106

Code
64430
Physician work
0.98
Practice expense
1.78
Malpractice
0.11

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office / nonfacility calculation for 64430 in Utah
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense1.78× 0.9401.6732
Malpractice0.11× 0.8980.0988
Total RVUs2.7520
Conversion factor× 33.4009

Office / nonfacility rate, Utah$91.92

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.981
Practice expense1.780.94
Malpractice0.110.898

(0.98 × 1 + 1.78 × 0.94 + 0.11 × 0.898) × $33.4009 = $91.92

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.981
Practice expense0.370.94
Malpractice0.110.898

(0.98 × 1 + 0.37 × 0.94 + 0.11 × 0.898) × $33.4009 = $47.65

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.

64430 billing questions

When should 64430 be chosen instead of 64450?

Use 64430 when the pudendal nerve is the documented target. Code 64450 is for an otherwise unspecified peripheral nerve or branch, not a substitute for a named pudendal nerve block.

Does the code depend on whether the block is diagnostic or therapeutic?

No. The code describes injection at the pudendal nerve; document whether the purpose is diagnostic, pain relief, or anesthesia.

How is a bilateral pudendal nerve block reported?

CMS identifies this as a bilateral procedure: report modifier 50 for bilateral treatment. Its Medicare payment is 150%.

Can another procedure be reported in the same session?

A distinct procedure may be reported when separately performed and supported by the record. Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%.

What same-day care is included?

The 0-day global period includes same-day preoperative and postoperative care. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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.

RVUs for 64430PPRRVU2026_Oct_nonQPP.csv, line 7,106 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)