CPT code 64474: Fascial plane block2026 Medicare rate & RVUs in Washington
Reports a unilateral lower-extremity fascial plane block delivered by continuous infusion, commonly for regional analgesia around hip or thigh surgery.
Medicare pays $276.67–$314.94 for 64474 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 64474 covers
This code describes a lower-extremity fascial plane block on one side that delivers anesthetic through a catheter for continuous infusion. Anesthesiologists and pain specialists may use this approach for regional analgesia around hip or thigh procedures; examples of fascial plane techniques in this area include fascia iliaca and PENG blocks. The record should identify the side and block site, document catheter placement and the continuous infusion approach, and explain the clinical purpose. Document imaging guidance when used.
Choose this code for the continuous-infusion service, rather than the unilateral injection service represented by 64473. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral performance and payment is at 150%. Medicare does not pay an assistant at surgery for this procedure; 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 64474 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $276.67 | $68.11 |
| Seattle (King Cnty) | $314.94 | $71.91 |
How the 64474 rate is calculated
Each of 64474’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 · 64474
RVUs × geographic indexes × conversion factor
Work1.63
1.63 RVUs× 1.000 GPCI
Practice expense6.19
6.19 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
7.9700
Conversion factor
$33.4009
Medicare rate
$266.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64474
The CMS indicators that decide how 64474 is paid alongside other services.
CMS payment indicators · 64474
Fascial plane 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
64474 without 50 · national office
$266.21
Fascial plane block
64474-50 · Bilateral: 150%
$399.32
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).
64474 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64473Fascial plane block
- Use 64473 for a unilateral lower-extremity fascial plane block performed by injection. Use 64474 when the block is delivered by continuous infusion through a catheter.
- 64467Thoracic plane block
- Both describe unilateral continuous-infusion fascial plane blocks, but 64467 is for the thoracic region and 64474 is for the lower extremity.
- 64486TAP block
- 64486 describes a unilateral TAP block by injection for abdominal wall analgesia; 64474 is a lower-extremity fascial plane block by continuous infusion.
64474 billing questions
How does 64474 differ from 64473?
64474 is for a unilateral lower-extremity fascial plane block delivered by continuous infusion through a catheter. 64473 represents the unilateral injection approach.
What documentation supports continuous infusion?
Document the block site and side, catheter placement, the continuous-infusion plan, and the clinical reason for regional analgesia. Record imaging guidance when it is used.
Can modifier 50 be used when both sides are treated?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.
Is same-day postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service, and 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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