Summary & Overview
CPT 64447: Femoral Nerve Injection (Anesthetic and/or Steroid)
CPT code 64447 represents a femoral nerve injection—administration of one or more anesthetic agents and/or a steroid into the femoral nerve region during a single procedure. This peripheral nerve block code is commonly used for analgesia and diagnostic or therapeutic management of lower-extremity pain. Nationally, use of regional nerve injections affects pain management pathways, procedural volumes in ambulatory settings, and payer coverage policies for interventional pain treatments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for femoral nerve injections, common service sites, and the procedural nature of the code. The publication summarizes typical billing considerations, common modifiers encountered in claims, and how payers approach coverage and reimbursement for peripheral nerve injection procedures.
The report provides benchmarks and policy context relevant to providers, billing staff, and payers: utilization patterns for regional nerve injections, typical sites of service where 64447 is reported, and how this code fits within interventional pain management workflows. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 64447 describes an injection of one or more anesthetic agents and/or a steroid into the region of the femoral nerve, which provides sensory and motor innervation to the leg and foot. The code is reported for one or more injections performed during a single procedure.
Service Type: Peripheral nerve block / nerve injection
Typical Site of Service: Ambulatory surgical center, hospital outpatient department, or office-based procedure suite
Clinical & Coding Specifications
Clinical Context
A 56-year-old patient presents to an ambulatory surgical center with chronic anterior thigh and knee pain radiating from the inguinal region after a femoral shaft fracture and subsequent hardware placement. Conservative management including physical therapy, oral analgesics, and activity modification provided inadequate relief. The pain localizes to the femoral nerve distribution with reproducible symptoms on physical exam and partial response to prior diagnostic local anesthetic. The interventional pain physician performs a femoral nerve block/injection to deliver a local anesthetic with a steroid to reduce inflammation and provide prolonged analgesia.
The procedure is performed in a monitored setting (office-based procedure room, ambulatory surgery center, or hospital outpatient department) with standard sterile technique and ultrasound guidance. Pre-procedure assessment documents indication, informed consent, allergies, anticoagulation status, and baseline neurologic exam. The provider administers a single or multiple injections to the femoral nerve region, observes the patient for immediate complications, provides post-procedure discharge instructions, and documents the outcome and planned follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service on the same day | Use when a distinct E/M visit is performed and documented on the same day as the injection |