How much does Medicare pay for CPT 64418?

Medicare allowed an average of $78.98 per service and paid $60.72 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $627.88, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64418?

Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve. It was billed 12,251 times to 6,850 Medicare beneficiaries by 288 providers in 2024.

Does 64418 pay differently in an office than a hospital?

Yes. The allowed amount averaged $83.89 in an office setting and $42.50 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 64418 most?

Anesthesiology, with 2,227 services from 53 clinicians. Next are Physical Medicine and Rehabilitation, Pain Management, Interventional Pain Management.

CPT 64418

Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve

$78.98Medicare-allowed amount per service, averaged across 12,251 services

Providers submitted

$627.88

Asking price, not received

Medicare allowed

$78.98

The fee schedule figure

Medicare paid

$60.72

Balance is patient coinsurance

Providers submitted an average of $627.88 for this code and Medicare allowed $78.98 — 7.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $60.72 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $83.89
Hospital / facility: $42.50

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 10,797 services were billed in an office setting and 1,454 in a facility.

Services: 12,251
Beneficiaries: 6,850
Providers billing it: 288
Total allowed: $967,584

What Medicare pays for CPT 64418

Across 12,251 services billed by 288 providers to 6,850 beneficiaries, Medicare allowed an average of $78.98 per service. That is 1.8 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 64418

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	2,227	1,080	$89.10	53
Physical Medicine and Rehabilitation	1,943	995	$82.40	40
Pain Management	1,930	1,319	$86.19	55
Interventional Pain Management	1,401	919	$88.24	44
Rheumatology	1,089	658	$78.94	14
Neurology	883	265	$70.28	10
Physician Assistant	812	350	$70.50	11
Ambulatory Surgical Center	619	392	$34.84	21
Family Practice	475	266	$69.74	14
Nurse Practitioner	414	247	$58.57	9
Orthopedic Surgery	222	173	$87.54	7
Internal Medicine	119	98	$79.33	4
Sports Medicine	64	55	$56.84	4
Certified Registered Nurse Anesthetist (CRNA)	32	15	$43.10	1
General Practice	21	18	$45.39	1

64418 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	3,056	$84.28	$63.08	56
California	1,480	$91.10	$62.08	39
New York	991	$104.53	$69.87	19
Pennsylvania	931	$63.83	$46.39	12
Maryland	680	$57.08	$40.81	7
Ohio	565	$68.99	$54.18	15
New Jersey	556	$110.63	$79.45	16
Texas	455	$66.82	$53.05	18
Louisiana	353	$66.69	$52.73	2
North Carolina	322	$67.36	$55.18	4
Mississippi	245	$69.92	$60.86	8
South Carolina	236	$104.29	$82.51	4
Indiana	229	$63.35	$56.02	5
Colorado	228	$88.81	$68.82	4
Minnesota	228	$50.10	$40.03	9
Tennessee	199	$56.33	$49.64	6
Arizona	194	$68.32	$53.86	10
Wisconsin	145	$68.26	$52.38	5
Virginia	143	$96.84	$72.04	7
Arkansas	142	$38.05	$33.99	5
Kentucky	110	$69.39	$56.37	4
Illinois	103	$68.16	$49.58	6
New Hampshire	79	$60.78	$48.88	1
Rhode Island	65	$68.69	$56.01	1
Alabama	62	$73.49	$64.50	2
Nevada	58	$48.14	$37.27	2
Georgia	53	$74.67	$61.02	4
Oregon	49	$58.07	$44.60	3
Massachusetts	45	$90.62	$63.85	2
Hawaii	44	$26.50	$21.52	1
Kansas	39	$88.54	$64.63	1
Nebraska	32	$43.10	$37.15	1
Missouri	29	$47.48	$36.98	2
Connecticut	18	$43.89	$33.80	1
District of Columbia	17	$84.01	$60.37	1
Oklahoma	16	$57.92	$43.09	1
Washington	15	$79.93	$60.83	1
Maine	13	$27.53	$22.39	1
South Dakota	13	$85.35	$66.02	1
Utah	13	$28.09	$20.11	1

Related codes

64483Injection of anesthetic and/or steroid drug into sacral spine nerve ro$263.09
64493Injection of lower or sacral spine facet joint$243.14
64494Injection of lower or sacral spine facet joint$96.60
64450Injection of anesthetic agent and/or steroid into other nerve or branc$44.99
64447Injection of anesthetic agent and/or steroid into thigh nerve (femoral$58.78
64484Injection of anesthetic and/or steroid drug into sacral spine nerve ro$84.15
64490Injection of upper or middle spine facet joint$259.70
64415Injection of anesthetic agent and/or steroid into arm nerve bundle (br$67.89
64491Injection of upper or middle spine facet joint$100.48
64445Injection of anesthetic agent and/or steroid into lower back and leg n$173.06
64405Injection of anesthetic agent and/or steroid into upper neck and back$71.75
64479Injection of anesthetic and/or steroid drug into upper or middle spine$275.58

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.