CPT code 62321: Epidural injection, cervical or thoracic, image-guided2026 Medicare rate & RVUs in Guam
Reports an image-guided interlaminar cervical or thoracic epidural injection for diagnostic or therapeutic medication delivery without an indwelling infusion catheter.
Medicare pays $302.40 for 62321 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 62321 covers
Anesthesiologists, interventional pain physicians, and other qualified clinicians use this service to deliver medication through an interlaminar approach in the cervical or thoracic spine. A common clinical situation is treatment of cervical radicular pain with an epidural steroid injection. Fluoroscopy or CT guides needle placement. The service covers an injection, rather than placement of an indwelling catheter for ongoing infusion.
Select the code based on the spinal region, interlaminar approach, use of imaging, and whether medication is delivered through a catheter. Documentation should identify the treated level, approach, imaging guidance, indication, and injected substance. Imaging guidance is included in this code. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
62321 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $302.40 | $96.56 |
How the 62321 rate is calculated
Each of 62321’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 62321
RVUs × geographic indexes × conversion factor
Work1.90
1.90 RVUs× 1.000 GPCI
Practice expense6.20
6.20 RVUs× 1.000 GPCI
Malpractice0.18
0.18 RVUs× 1.000 GPCI
Adjusted RVUs
8.2800
Conversion factor
$33.4009
Medicare rate
$276.56
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 62321
The CMS indicators that decide how 62321 is paid alongside other services.
CMS payment indicators · 62321
Epidural injection, cervical or thoracic, image-guided
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 9 | The concept doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
62321 without 51 · national office
$276.56
Epidural injection, cervical or thoracic, image-guided
62321-51 · Second procedure: 50%
$138.28
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
62321 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 62320Epidural injectionCervical or thoracic, no imaging
- Both describe cervical or thoracic interlaminar injections; 62321 includes imaging guidance, while 62320 is for a service performed without imaging guidance.
- 62323Lumbar epidural injectionInterlaminar or caudal, with imaging guidance
- Both describe image-guided interlaminar injections, but 62323 is for the lumbar or sacral region rather than the cervical or thoracic region.
- 62325Epidural injectionCervical or thoracic, catheter
- Both involve image guidance in the cervical or thoracic region. Choose 62325 for indwelling catheter delivery by continuous infusion or intermittent bolus rather than an injection without ongoing catheter delivery.
62321 billing questions
When should 62321 be chosen over 62320?
Use 62321 for an interlaminar cervical or thoracic injection performed with imaging guidance. Code 62320 describes the corresponding service without imaging guidance.
How does 62321 differ from 62325?
62321 is for an injection without an indwelling catheter for ongoing infusion. 62325 is the image-guided cervical or thoracic catheter service for continuous infusion or intermittent bolus delivery.
Can imaging guidance be billed separately?
Imaging guidance is included in 62321. Do not separately report the guidance for this injection.
What documentation supports 62321?
Document the cervical or thoracic level, interlaminar approach, imaging guidance, clinical indication, and substance injected. The record should support that the service was an injection rather than indwelling catheter delivery.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in 62321's 0-day global period.
Can an assistant or co-surgeon be billed for 62321?
Assistant-at-surgery payment is statutorily restricted for this code. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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