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See a sample rate comparisonCPT 64461 Fee Schedule
Medicare rates as of October 2026
CPT 64461 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
Pvb Thoracic Single Inj Site, Paravertebral Block Pvb Paraspinous Block Thoracic Single Injection Site Includes Imaging Guidance When Performed
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | 59Distinct Procedural Service 50Bilateral Procedure |
| Hospital Outpatient Group (APC) | APC 5442 - Level 2 Nerve Injections |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Add-on Codes | 64462 |
| Common Revenue Codes | 03600361Sign up to view all 6 |
| Medicare Fee Schedule | $149.64 national non-facility rate (2026)View Medicare rates for 64461 |
| Medicaid Fee Schedule | $117.395 median of the 8 states in the free previewView Medicaid rates for 64461 |
National average reimbursement for CPT 64461 by major payers:
$181.87
BCBS / Anthem
$192.92
UnitedHealthcare
$202.03
Aetna
$152.77
Cigna
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CPT 64461
5 of 25 sample ratesHigher to lower in this preview
South Campus Surgery Center
$3,254.00Published rateJacksonville Endoscopy Centers LLC, Jacksonville Center For Endoscopy
$967.00Published rateThe Eastside Endoscopy Center LLC
$587.00Published rateNspc Surgery Center Of Maryland LLC
$374.00Published ratePoole Endoscopy Center, LLC
$207.00Published rate
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See a sample payer proposalCPT 64461 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 64461. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 64461-CPT | Pvb Thoracic Single Inj Site, Paravertebral Block Pvb Paraspinous Block Thoracic Single Injection Site Includes Imaging Guidance When Performed |
| 64462-CPT | Pvb Thoracic 2nd Inj Site, Paravertebral Block Pvb Paraspinous Block Thoracic Second And Any Additional Injection Site S Includes Imaging Guidance When Performed List Separately In Addition To Code For Primary Procedure |
| 64463-CPT | Anesthesia Injection In Back, Injection Of Anesthesia In Center Of Back Given By Thin Tube (Catheter) Generally During Breast Surgery Or Treatment Of Fractured Ribs. |
| 64483-CPT | Njx Aa Strd Tfrm Epi L S 1, Injection S Anesthetic Agent S And Or Steroid Transforaminal Epidural With Imaging Guidance Fluoroscopy Or Ct Lumbar Or Sacral Single Level |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64461. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64461 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
What APC is CPT 64461 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 64461 to APC 5442 (Level 2 Nerve Injections). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 64461 in an ambulatory surgery center?
CMS lists CPT 64461 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 64461?
CMS add-on code edits list CPT 64461 as a primary code for these add-on codes: 64462.
Which revenue codes are billed with CPT 64461?
Hospital price transparency files list CPT 64461 under these revenue codes: including 0360, 0361, 0761, 0964 and 0510. A revenue code names the hospital department or charge category for the line; it does not change what the service is.