How much does Medicare pay for CPT 64454?

Medicare allowed an average of $168.67 per service and paid $131.59 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1352.91, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64454?

Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance. It was billed 26,184 times to 21,455 Medicare beneficiaries by 961 providers in 2024.

Does 64454 pay differently in an office than a hospital?

Yes. The allowed amount averaged $224.96 in an office setting and $140.72 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 64454 most?

Anesthesiology, with 10,255 services from 341 clinicians. Next are Ambulatory Surgical Center, Pain Management, Physical Medicine and Rehabilitation.

CPT 64454

Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance

$168.67Medicare-allowed amount per service, averaged across 26,184 services

Providers submitted

$1352.91

Asking price, not received

Medicare allowed

$168.67

The fee schedule figure

Medicare paid

$131.59

Balance is patient coinsurance

Providers submitted an average of $1352.91 for this code and Medicare allowed $168.67 — 8.0× 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 $131.59 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $224.96
Hospital / facility: $140.72

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. 8,687 services were billed in an office setting and 17,497 in a facility.

Services: 26,184
Beneficiaries: 21,455
Providers billing it: 961
Total allowed: $4,416,455

What Medicare pays for CPT 64454

Across 26,184 services billed by 961 providers to 21,455 beneficiaries, Medicare allowed an average of $168.67 per service. That is 1.2 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 64454

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	10,255	9,411	$106.64	341
Ambulatory Surgical Center	4,784	3,313	$294.71	142
Pain Management	3,196	2,519	$182.33	147
Physical Medicine and Rehabilitation	2,643	1,908	$185.20	114
Interventional Pain Management	1,784	1,322	$186.75	74
Certified Registered Nurse Anesthetist (CRNA)	1,496	1,462	$82.76	71
Physician Assistant	480	370	$185.15	12
Sports Medicine	348	295	$158.98	13
Family Practice	341	226	$238.83	11
Nurse Practitioner	279	172	$194.63	9
Orthopedic Surgery	186	143	$164.66	8
Emergency Medicine	96	58	$191.48	3
Diagnostic Radiology	82	70	$205.00	5
Internal Medicine	60	51	$80.15	2
Neurology	58	47	$276.96	3

64454 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
New York	3,690	$138.96	$81.92	111
Florida	2,475	$174.06	$134.22	70
Texas	2,288	$166.22	$130.43	103
California	2,193	$173.14	$113.52	89
Illinois	1,450	$160.17	$113.90	46
Maryland	1,266	$218.71	$163.10	48
Mississippi	1,093	$161.69	$136.81	37
North Carolina	818	$176.48	$136.84	32
New Jersey	734	$206.26	$136.20	31
Arizona	674	$189.96	$139.79	27
Oklahoma	595	$148.60	$113.27	20
Massachusetts	592	$138.23	$89.72	26
Georgia	574	$187.16	$145.73	28
Tennessee	551	$181.32	$149.46	19
Ohio	520	$143.67	$113.00	23
Arkansas	480	$203.85	$177.40	13
Wisconsin	463	$209.06	$168.32	19
Indiana	427	$155.66	$113.64	14
Minnesota	415	$204.46	$155.02	18
Kentucky	401	$168.99	$146.12	16
Pennsylvania	401	$116.55	$73.12	11
Virginia	391	$196.49	$145.02	18
Missouri	369	$124.24	$89.74	14
South Carolina	339	$162.48	$128.62	14
Idaho	281	$83.56	$52.31	7
Nevada	276	$234.95	$175.45	6
Rhode Island	251	$182.73	$141.38	6
Louisiana	218	$194.53	$164.98	8
Oregon	209	$242.95	$182.76	10
Kansas	181	$158.42	$129.13	5
Colorado	177	$223.75	$171.82	7
Utah	147	$177.79	$139.42	8
Iowa	142	$190.12	$158.69	6
New Mexico	134	$152.47	$115.55	4
Alabama	126	$123.36	$109.40	5
Wyoming	114	$176.24	$146.68	3
Michigan	107	$107.86	$62.36	6
Connecticut	91	$158.13	$107.22	4
Washington	90	$188.91	$140.44	6
Maine	76	$88.85	$59.43	4
District of Columbia	69	$98.36	$68.27	4
Delaware	47	$203.98	$166.19	2
New Hampshire	44	$233.93	$183.77	2
Nebraska	43	$194.94	$142.83	3
West Virginia	37	$88.99	$65.09	2
Hawaii	28	$76.31	$32.45	1
AP	23	$84.68	$31.97	1
Montana	20	$221.66	$163.56	1
South Dakota	19	$241.87	$197.19	1
Vermont	18	$82.39	$35.46	1
Alaska	17	$307.11	$199.20	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.