Summary & Overview
CPT 64417: Axillary Nerve Injection (Nerve Block)
CPT code 64417 represents an axillary nerve injection in which a provider administers one or more anesthetic agents and/or a steroid to the axillary nerve region. This peripheral nerve block is used for diagnosis or management of shoulder and upper-arm pain and can be performed in ambulatory surgical centers, office procedure rooms, or hospital outpatient departments. Nationally, nerve block procedures like 64417 are significant for pain management, procedural anesthesia, and perioperative analgesia practice patterns.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise summary of what the code covers, common billing considerations, and context for where the service is typically performed. The publication provides benchmarking information, policy and coverage highlights relevant to major commercial payers and Medicare, and clinical context about the procedure’s use in shoulder and axillary-region pain management.
This summary is intended to help coding, billing, and clinical teams quickly understand the clinical intent of the code, typical sites of service, and which major payers are relevant for coverage and claims workflows. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 64417 describes an injection of one or more anesthetic agents and/or a steroid into the region of the axillary nerve, a major nerve arising from the brachial plexus at the armpit. The procedure is reported for one or more injections performed during a single session.
Service type: Nerve block / injectable pain management procedure
Typical site of service: Ambulatory procedure suite, office-based procedure room, or hospital outpatient department (axillary/shoulder region at the armpit)
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient presents to an outpatient orthopedic pain clinic with persistent lateral shoulder pain and weakness three months after a rotator cuff repair. The clinician suspects axillary nerve irritation from surgical scar tissue and persistent deltoid denervation contributing to pain and limited abduction. After clinical evaluation and review of prior imaging, the provider discusses a diagnostic and therapeutic axillary nerve injection to confirm nerve-mediated pain and provide corticosteroid-mediated anti-inflammatory relief.
The typical workflow: the patient checks in to the ambulatory procedure area; informed consent is reviewed and obtained for an injection into the axillary nerve region. Standard monitoring and aseptic technique are used. The provider positions the patient supine or seated with the arm supported. Using surface landmarks and/or ultrasound guidance, the provider localizes the axillary nerve in the axilla or posterior shoulder region and administers one or more injections of local anesthetic with or without steroid. Immediate post-procedure assessment confirms pain reduction and absence of complications. Discharge instructions include activity limitations, signs of infection to watch for, and follow-up for results and potential repeat or alternative interventions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | Use when separate axillary nerve injections are performed on both left and right sides during the same operative session. |