A genicular nerve block (CPT 64454) is a minimally invasive procedure for chronic knee pain, particularly from osteoarthritis or after knee replacement surgery. It involves injecting a local anesthetic near the genicular nerves – a network of sensory nerves that transmit pain signals from the knee joint to the brain.
The three primary targets are:
Superior lateral vehicular nerve (SLGN)
Superior medial vehicular nerve (SMGN)
Inferior medial vehicular nerve (IMGN)
A VI block (vastus intermedius) is a specific type of injection that can be included in a more comprehensive genicular nerve block to treat knee pain. A standard genicular nerve block target three main genicular nerves, but advanced versions may include the VI for broader pain coverage.

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