Summary & Overview
CPT 64448: Continuous Femoral Nerve Catheter Infusion
CPT code 64448 represents continuous femoral nerve catheter placement with infusion of anesthetic agents and/or a steroid. The code covers placement of a catheter adjacent to the femoral nerve and delivery of continuous medication to manage perioperative or chronic pain in the lower extremity. This procedure matters nationally because continuous peripheral nerve catheters contribute to multimodal pain management strategies, can reduce systemic opioid use, and are commonly used in orthopedic and vascular surgery care pathways.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national overview of clinical context for the procedure, typical sites of service, common billing modifiers used by payers, and what is and is not available in the input data. The publication outlines benchmarks for coding and reimbursement practices where available, highlights policy and coverage considerations for continuous femoral nerve infusions, and summarizes implications for procedural billing workflows. Data not available in the input includes specific payer fee schedules, associated taxonomies, and ICD-10 diagnosis mappings.
Billing Code Overview
CPT code 64448 describes placement of a catheter and administration of one or more anesthetic agents and/or a steroid by continuous infusion into the region of the femoral nerve. This procedure targets the femoral nerve, which provides sensory and motor innervation to portions of the thigh, leg, and foot.
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Service type: Continuous femoral nerve catheter placement with infusion of anesthetic and/or steroid
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Typical site of service: Hospital inpatient or outpatient procedural areas, ambulatory surgery centers, and specialty pain clinics where continuous peripheral nerve catheter infusions are provided
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old male with severe femoral nerve–mediated postoperative pain following total knee arthroplasty. Pain control remains inadequate with systemic opioids and multimodal oral regimens. The anesthesia team places a femoral perineural catheter under ultrasound guidance in the preoperative holding area or procedure suite and initiates a continuous infusion of local anesthetic to provide targeted analgesia to the anterior thigh and knee. The catheter may remain for 48–72 hours with regular nursing assessments of sensory and motor block, catheter site inspection, and infusion pump management. Documentation includes indication, informed consent, laterality (RT or LT modifier), ultrasound or nerve stimulator guidance, catheter insertion technique, medications and concentrations administered, infusion rate and duration, patient response, and removal instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | Use when the femoral catheter is placed on the right side. |
LT |