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CMS RVU26D · Effective 2026-10-01

64417 Axillary nerve block Medicare reimbursement rates in Vermont

Reports an anesthetic injection targeting the axillary nerve, commonly for shoulder pain control or perioperative analgesia when that specific nerve is blocked. Compare 64417 office and facility rates across CMS payment localities in Vermont.

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 64417 in Vermont?

Vermont 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

$182.51

1 of 1 localities have a supported rate.

Payment area: Vermont

One mapped payment locality.

Facility setting

$59.17

1 of 1 localities have a supported rate.

Payment area: Vermont

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 64417 in your payment locality →

Pain management

About 64417: Axillary nerve anesthetic block

Reports an anesthetic injection targeting the axillary nerve, commonly for shoulder pain control or perioperative analgesia when that specific nerve is blocked.

This service places anesthetic, sometimes with steroid, around the axillary nerve to interrupt shoulder-region sensation. Pain specialists and anesthesiologists may perform it for diagnostic or therapeutic shoulder pain care, or for analgesia around shoulder surgery. The nerve’s relationship to the humerus and deltoid makes ultrasound or other imaging useful for locating the target; imaging guidance is included in the procedure when performed.

Choose this code when the documented target is the axillary nerve, rather than the brachial plexus or another shoulder nerve. The record should identify the side, clinical indication, nerve target, injectate, and any guidance used. 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%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.

CMS billing rules for 64417

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 RVU1.28 · 23%
  • Practice expense (office) RVU4.16 · 75%
  • Malpractice RVU0.13 · 2%

15.9K

Medicare services in 2024 · #1238 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.

64417 compared with similar codes

Office rates for Vermont, from the same CMS release.

64415

Brachial plexus block

Single injection

$151.98

64415 is for a brachial plexus block. Choose 64417 when the documented injection targets the axillary nerve itself.

64418

Nerve injection

Suprascapular nerve

$87.53

64418 targets the suprascapular nerve, not the axillary nerve. The documented nerve target distinguishes the codes.

64416

Nerve block

Brachial plexus catheter infusion

No office rate

64416 describes continuous infusion through a brachial plexus catheter; 64417 is an injection targeting the axillary nerve.

64450

Nerve block

Other peripheral nerve or branch

$79.13

64450 is a general code for a peripheral nerve or branch when no more specific code applies. Use 64417 for an axillary nerve injection.

Compare 64417 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

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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 64417 in Vermont.

PPRRVU2026_Oct_nonQPP.csv

7,101

Code
64417
Physician work
1.28
Practice expense
4.16
Malpractice
0.13

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office / nonfacility calculation for 64417 in Vermont
ComponentRVULocality factorAdjusted
Physician work1.28× 1.0001.2800
Practice expense4.16× 0.9904.1184
Malpractice0.13× 0.5060.0658
Total RVUs5.4642
Conversion factor× 33.4009

Office / nonfacility rate, Vermont$182.51

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.281
Practice expense4.160.99
Malpractice0.130.506

(1.28 × 1 + 4.16 × 0.99 + 0.13 × 0.506) × $33.4009 = $182.51

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.281
Practice expense0.430.99
Malpractice0.130.506

(1.28 × 1 + 0.43 × 0.99 + 0.13 × 0.506) × $33.4009 = $59.17

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.

64417 billing questions

When should 64417 be selected instead of a brachial plexus block?

Use 64417 when the documented injection specifically targets the axillary nerve. A block directed at the brachial plexus is reported with the code for that broader target.

Is imaging guidance separately reported?

Imaging guidance is included in 64417 when performed. Do not report a separate guidance service for imaging used to place this block.

Can 64417 be reported for both shoulders?

For bilateral treatment, CMS specifies modifier 50 and payment at 150%. The documentation should establish treatment of both sides.

How does the 0-day global period affect same-day care?

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

Can an assistant or co-surgeon be billed for this service?

CMS restricts assistant-at-surgery payment for this code. 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 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 64417PPRRVU2026_Oct_nonQPP.csv, line 7,101 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet