# CPT 64421: Injection Aa&/strd Intercostal Nrv Ea Addl Lvl

Medicare CPT 64421 pays $35.07 in a non-facility setting and $21.71 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $31.86 in Arkansas to $43.61 in Alaska, a 37% spread.

Web page: https://www.med-reveal.com/rates/64421-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Neurology, Pain Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $35.07 |
| National facility | $21.71 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $43.61 | $29.38 |
| District of Columbia | $39.18 | $23.44 |
| New York | $38.42 | $23.51 |
| New Jersey | $38.20 | $23.16 |
| California | $38.02 | $22.21 |
| Washington | $37.62 | $22.39 |
| Massachusetts | $37.38 | $22.37 |
| Connecticut | $37.06 | $22.67 |
| Florida | $36.71 | $23.30 |
| Hawaii | $36.70 | $21.51 |
| Maryland | $36.14 | $22.21 |
| Illinois | $36.07 | $23.17 |
| Colorado | $35.99 | $21.78 |
| Rhode Island | $35.76 | $21.96 |
| Oregon | $35.66 | $21.58 |
| New Hampshire | $35.56 | $21.65 |
| Puerto Rico | $35.23 | $21.73 |
| Virgin Islands | $35.23 | $21.73 |
| Montana | $35.07 | $21.71 |
| Pennsylvania | $34.99 | $21.90 |
| Nevada | $34.81 | $21.44 |
| Delaware | $34.78 | $21.58 |
| Texas | $34.78 | $21.63 |
| Michigan | $34.71 | $22.17 |
| Georgia | $34.64 | $21.89 |
| Wyoming | $34.64 | $21.28 |
| Minnesota | $34.39 | $20.64 |
| Arizona | $34.30 | $21.36 |
| Virginia | $34.29 | $21.16 |
| North Dakota | $34.08 | $20.72 |
| Vermont | $34.08 | $20.85 |
| New Mexico | $33.99 | $21.74 |
| South Dakota | $33.96 | $20.60 |
| Utah | $33.88 | $21.32 |
| Maine | $33.69 | $20.92 |
| Louisiana | $33.67 | $21.47 |
| Missouri | $33.64 | $21.38 |
| Ohio | $33.60 | $21.40 |
| West Virginia | $33.56 | $21.95 |
| South Carolina | $33.53 | $21.18 |
| North Carolina | $33.33 | $20.86 |
| Wisconsin | $33.20 | $20.40 |
| Kentucky | $33.04 | $21.16 |
| Indiana | $32.97 | $20.58 |
| Oklahoma | $32.88 | $20.95 |
| Idaho | $32.83 | $20.54 |
| Tennessee | $32.75 | $20.60 |
| Nebraska | $32.72 | $20.39 |
| Iowa | $32.62 | $20.39 |
| Kansas | $32.61 | $20.53 |
| Mississippi | $32.27 | $20.76 |
| Alabama | $32.22 | $20.53 |
| Arkansas | $31.86 | $20.38 |

## Related codes

- 10140: I&d Hematoma Seroma/fluid Collection — https://www.med-reveal.com/rates/10140-cpt-fee-schedule
- 11055: Paring/cutting Benign Hyperkeratotic Lesion 1 — https://www.med-reveal.com/rates/11055-cpt-fee-schedule
- 11056: Paring/cutting Benign Hyperkeratotic Lesion 2-4 — https://www.med-reveal.com/rates/11056-cpt-fee-schedule
- 11057: Paring/cutting Benign Hyperkeratotic Lesion >4 — https://www.med-reveal.com/rates/11057-cpt-fee-schedule
- 11403: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 2.1-3.0 Cm — https://www.med-reveal.com/rates/11403-cpt-fee-schedule
- 11404: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 3.1-4.0 Cm — https://www.med-reveal.com/rates/11404-cpt-fee-schedule
- 11406: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l >4.0 Cm — https://www.med-reveal.com/rates/11406-cpt-fee-schedule
- 11603: Excision Mal Lesion Trunk/arm/leg 2.1-3.0 Cm — https://www.med-reveal.com/rates/11603-cpt-fee-schedule

Commercial negotiated rates for 64421 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules