2025 CPT code 64448

Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance when performed.

Refer to the most recent CPT coding guidelines for nerve blocks and continuous infusions.Imaging guidance is now an inclusive component of this code.Bilateral procedures require modifier 50.

Modifiers 50 (bilateral procedure) may be applicable.Consult the most current CPT and payer-specific guidelines regarding modifier usage.

Medical necessity for a continuous femoral nerve block is established when other less invasive pain management options have been deemed insufficient to manage moderate to severe acute or chronic pain.The justification should support the need for continuous infusion and should detail the specific pain characteristics warranting this level of intervention.

The physician or qualified healthcare professional is responsible for patient preparation, anesthesia administration (if necessary), catheter placement using appropriate techniques (possibly including imaging guidance), securing the catheter, initiating continuous infusion of the anesthetic and/or steroid, monitoring the patient’s response, and managing any complications.

IMPORTANT For femoral nerve anesthetic and/or steroid injection not by continuous infusion, see 64447.Do not report 64448 in conjunction with 01996, 76942, 77002, 77003.

In simple words: This code describes a procedure where a thin tube (catheter) is placed near the femoral nerve in the leg to deliver pain-relieving medication (anesthetic and/or steroid) continuously.Imaging is used to guide the placement of the catheter.

This CPT code encompasses the injection of one or more anesthetic agents and/or steroids via continuous infusion into the femoral nerve area.The procedure includes catheter placement and, as of January 1, 2023, incorporates imaging guidance.The femoral nerve is a major peripheral nerve that supplies the anterior thigh, medial leg, and foot.Steroids are anti-inflammatory agents that may be used in conjunction with anesthetics to manage pain.

Example 1: Postoperative pain management following total knee arthroplasty: A continuous femoral nerve block is placed to manage severe postoperative pain, utilizing ultrasound guidance for catheter placement.The patient receives continuous infusion of anesthetic and steroid for 72 hours., Trauma patient with severe leg pain:A patient sustains a severe leg fracture. A continuous femoral nerve block is performed to manage pain during the initial trauma management, and the catheter is used for postoperative pain control., Preoperative pain management for complex limb surgery: A continuous femoral nerve block is utilized to manage severe preoperative pain in a patient who is scheduled for a major limb reconstructive surgery. This reduces the amount of general anesthetic required and minimizes postoperative pain.

* Preoperative diagnosis and justification for the block.* Documentation of patient preparation and anesthesia (if used).* Detailed description of the procedure including the approach, catheter placement technique (including location and depth), imaging guidance used, type and amount of anesthetic(s) and steroid(s) infused.* Post-procedure assessment of the patient's response and management of any complications.* Documentation of infusion rate and duration.* Any associated medication reconciliation documentation.

** This code is used for continuous infusion; for single injection use code 64447.Always refer to the most up-to-date CPT guidelines and payer-specific policies for accurate coding and reimbursement.

  • Revenue Code: P6C (MINOR PROCEDURES - OTHER)
  • RVU: Data not provided.Consult current Medicare Physician Fee Schedule (MPFS) for RVU values.
  • Global Days : Information not provided. The global period will vary depending on payer and other factors.
  • Payment Status: Active
  • Modifier TC rule: Modifier TC (Technical Component) is not applicable to this code, as the code describes the entire procedure, including catheter placement and continuous infusion.
  • Fee Schedule : Data not provided.Consult historical Medicare Physician Fee Schedule (MPFS) data for prior years’ reimbursement rates.
  • Specialties:Anesthesiology, Pain Medicine, Neurosurgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Office
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