CPT code 62321: Epidural injection, cervical or thoracic, image-guided2026 Medicare rate & RVUs in Puerto Rico
Reports an image-guided interlaminar cervical or thoracic epidural injection for diagnostic or therapeutic medication delivery without an indwelling infusion catheter.
In Puerto Rico, Medicare pays $278.75 for 62321 in the office and $95.72 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 62321 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Puerto Rico compares for 62321
Across 109 of 109 payment localities, the office rate for 62321 runs from $244.44 in Arkansas to $372.28 in San Benito County, CA. Puerto Rico pays $278.75. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$278.75
- Los Angeles, CA · California$315.04+$36.29
- Washington, DC area · District of Columbia$317.53+$38.78
- Miami, FL · Florida$294.24+$15.49
- Chicago, IL · Illinois$285.82+$7.07
- Manhattan, NY · New York$317.69+$38.94
- Alaska · Alaska$319.05+$40.30
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $248.06 | $89.66 |
| ArkansasArkansas | $244.44 | $88.94 |
| ArizonaArizona | $269.27 | $93.85 |
| Bakersfield, CACalifornia | $295.29 | $96.88 |
| Chico, CACalifornia | $294.73 | $96.32 |
| El Centro, CACalifornia | $294.76 | $96.35 |
| Fresno, CACalifornia | $294.73 | $96.32 |
| Hanford, CACalifornia | $294.73 | $96.32 |
| Madera, CACalifornia | $294.73 | $96.32 |
| Merced, CACalifornia | $294.73 | $96.32 |
| Modesto, CACalifornia | $294.73 | $96.32 |
| Napa, CACalifornia | $343.45 | $104.85 |
| Oxnard, CACalifornia | $313.76 | $99.78 |
| Redding, CACalifornia | $294.73 | $96.32 |
| Rest of CaliforniaCalifornia | $294.73 | $96.32 |
| Riverside, CACalifornia | $296.70 | $98.29 |
| Sacramento, CACalifornia | $309.81 | $99.27 |
| Salinas, CACalifornia | $308.66 | $98.85 |
| San Diego, CACalifornia | $316.30 | $99.78 |
| Marin County, CACalifornia | $364.24 | $108.98 |
| San Francisco, CACalifornia | $364.04 | $108.78 |
| San Benito County, CACalifornia | $372.28 | $111.23 |
| Santa Clara County, CACalifornia | $371.45 | $110.40 |
| San Luis Obispo, CACalifornia | $303.63 | $97.44 |
| Santa Cruz, CACalifornia | $319.63 | $99.67 |
| Santa Maria, CACalifornia | $309.92 | $98.84 |
| Santa Rosa, CACalifornia | $322.89 | $100.58 |
| Stockton, CACalifornia | $294.73 | $96.32 |
| Vallejo, CACalifornia | $343.16 | $104.56 |
| Visalia, CACalifornia | $294.73 | $96.32 |
| Yuba City, CACalifornia | $294.73 | $96.32 |
| ColoradoColorado | $289.26 | $96.64 |
| ConnecticutConnecticut | $295.04 | $100.06 |
| DelawareDelaware | $273.78 | $94.92 |
| Fort Lauderdale, FLFlorida | $284.11 | $100.72 |
| Rest of FloridaFlorida | $270.47 | $97.40 |
| Atlanta, GAGeorgia | $281.27 | $97.34 |
| Rest of GeorgiaGeorgia | $255.35 | $93.87 |
| Hawaii, Guam, HIHawaii | $302.40 | $96.56 |
| IowaIowa | $255.33 | $89.69 |
| IdahoIdaho | $256.82 | $90.27 |
| East St. Louis, ILIllinois | $266.09 | $99.54 |
| Rest of IllinoisIllinois | $261.93 | $96.64 |
| Suburban Chicago, ILIllinois | $287.24 | $101.32 |
| IndianaIndiana | $258.35 | $90.53 |
| KansasKansas | $253.70 | $90.04 |
| KentuckyKentucky | $253.06 | $92.12 |
| New Orleans, LALouisiana | $265.16 | $94.81 |
| Rest of LouisianaLouisiana | $252.49 | $92.28 |
| Metropolitan Boston, MAMassachusetts | $318.67 | $102.52 |
| Rest of MassachusettsMassachusetts | $287.33 | $96.70 |
| Baltimore area, MDMaryland | $294.12 | $99.87 |
| Rest of MarylandMaryland | $279.19 | $95.98 |
| Rest of MaineMaine | $257.72 | $91.17 |
| Southern Maine, MEMaine | $272.48 | $93.07 |
| Detroit, MIMichigan | $273.44 | $98.74 |
| Rest of MichiganMichigan | $259.32 | $94.04 |
| MinnesotaMinnesota | $278.33 | $92.05 |
| Metropolitan Kansas City, MOMissouri | $263.79 | $93.80 |
| Metropolitan St. Louis, MOMissouri | $266.63 | $94.29 |
| Rest of MissouriMissouri | $247.83 | $91.77 |
| MississippiMississippi | $246.21 | $90.34 |
| MontanaMontana | $276.55 | $95.51 |
| North CarolinaNorth Carolina | $260.51 | $91.61 |
| North DakotaNorth Dakota | $272.99 | $91.96 |
| NebraskaNebraska | $256.87 | $89.78 |
| New HampshireNew Hampshire | $284.30 | $95.84 |
| Northern New JerseyNew Jersey | $314.10 | $104.10 |
| Rest of New JerseyNew Jersey | $298.73 | $101.05 |
| New MexicoNew Mexico | $260.58 | $94.57 |
| NevadaNevada | $275.76 | $94.55 |
| NYC suburbs and Long Island, NYNew York | $324.91 | $109.66 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $300.35 | $102.12 |
| Queens, NYNew York | $320.97 | $106.99 |
| Rest of New YorkNew York | $264.42 | $92.44 |
| OhioOhio | $258.59 | $93.31 |
| OklahomaOklahoma | $253.06 | $91.40 |
| Portland, OROregon | $299.02 | $97.89 |
| Rest of OregonOregon | $273.95 | $93.64 |
| Metropolitan Philadelphia, PAPennsylvania | $287.35 | $98.90 |
| Rest of PennsylvaniaPennsylvania | $259.25 | $93.06 |
| Rhode IslandRhode Island | $283.95 | $96.94 |
| South CarolinaSouth Carolina | $259.92 | $92.64 |
| South DakotaSouth Dakota | $272.57 | $91.53 |
| TennesseeTennessee | $254.93 | $90.37 |
| Austin, TXTexas | $288.01 | $96.48 |
| Beaumont, TXTexas | $257.49 | $92.75 |
| Brazoria, TXTexas | $273.88 | $94.48 |
| Dallas, TXTexas | $275.45 | $95.14 |
| Fort Worth, TXTexas | $273.46 | $94.96 |
| Galveston, TXTexas | $274.58 | $94.82 |
| Houston, TXTexas | $277.88 | $98.11 |
| Rest of TexasTexas | $265.41 | $93.61 |
| UtahUtah | $263.52 | $93.35 |
| VirginiaVirginia | $271.27 | $93.32 |
| Virgin Islands, VIUnited States Virgin Islands | $278.75 | $95.72 |
| VermontVermont | $271.52 | $92.30 |
| Rest of WashingtonWashington | $286.92 | $96.30 |
| King County, WAWashington | $325.64 | $103.51 |
| WisconsinWisconsin | $263.70 | $90.27 |
| West VirginiaWest Virginia | $252.02 | $94.70 |
| WyomingWyoming | $275.00 | $93.96 |
62321 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$244.44
$333.51
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $319.05 | 1 |
| AL | $248.06 | 1 |
| AR | $244.44 | 1 |
| AZ | $269.27 | 1 |
| CA | $294.73–$372.28 | 29 |
| CO | $289.26 | 1 |
| CT | $295.04 | 1 |
| DC | $317.53 | 1 |
| DE | $273.78 | 1 |
| FL | $270.47–$294.24 | 3 |
| GA | $255.35–$281.27 | 2 |
| GU | $302.40 | 1 |
| HI | $302.40 | 1 |
| IA | $255.33 | 1 |
| ID | $256.82 | 1 |
| IL | $261.93–$287.24 | 4 |
| IN | $258.35 | 1 |
| KS | $253.70 | 1 |
| KY | $253.06 | 1 |
| LA | $252.49–$265.16 | 2 |
| MA | $287.33–$318.67 | 2 |
| MD | $279.19–$317.53 | 3 |
| ME | $257.72–$272.48 | 2 |
| MI | $259.32–$273.44 | 2 |
| MN | $278.33 | 1 |
| MO | $247.83–$266.63 | 3 |
| MS | $246.21 | 1 |
| MT | $276.55 | 1 |
| NC | $260.51 | 1 |
| ND | $272.99 | 1 |
| NE | $256.87 | 1 |
| NH | $284.30 | 1 |
| NJ | $298.73–$314.10 | 2 |
| NM | $260.58 | 1 |
| NV | $275.76 | 1 |
| NY | $264.42–$324.91 | 5 |
| OH | $258.59 | 1 |
| OK | $253.06 | 1 |
| OR | $273.95–$299.02 | 2 |
| PA | $259.25–$287.35 | 2 |
| PR | $278.75 | 1 |
| RI | $283.95 | 1 |
| SC | $259.92 | 1 |
| SD | $272.57 | 1 |
| TN | $254.93 | 1 |
| TX | $257.49–$288.01 | 8 |
| UT | $263.52 | 1 |
| VA | $271.27–$317.53 | 2 |
| VI | $278.75 | 1 |
| VT | $271.52 | 1 |
| WA | $286.92–$325.64 | 2 |
| WI | $263.70 | 1 |
| WV | $252.02 | 1 |
| WY | $275.00 | 1 |
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.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,965
- Code
- 62321
- Physician work
- 1.90
- Practice expense
- 6.20
- Malpractice
- 0.18
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.90 | × 1.000 | 1.9000 |
| Practice expense | 6.20 | × 1.011 | 6.2682 |
| Malpractice | 0.18 | × 0.985 | 0.1773 |
| Total RVUs | 8.3455 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$278.75
Office: (1.9 × 1 + 6.2 × 1.011 + 0.18 × 0.985) × $33.4009 = $278.75
Facility: (1.9 × 1 + 0.78 × 1.011 + 0.18 × 0.985) × $33.4009 = $95.72
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%).
How 62321 has changed in Puerto Rico
62321 · Office / nonfacility
$278.75
Effective 2026-10-01
The base rate is $26.57 higher than on 2025-10-01, moving from $252.18 to $278.75 (10.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$252.18changed to$278.75
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.95 changed to 1.90
- Practice expense RVU 5.63 changed to 6.20
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$263.86changed to$252.18
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 5.75 changed to 5.63
- Malpractice RVU 0.19 changed to 0.18
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$259.56changed to$263.86
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$267.46changed to$259.56
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.71 changed to 5.75
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$266.01changed to$267.46
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$275.58changed to$266.01
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 5.77 changed to 5.71
- Malpractice RVU 0.20 changed to 0.19
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$279.28changed to$275.58
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 5.82 changed to 5.77
- Malpractice RVU 0.19 changed to 0.20
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$267.42changed to$279.28
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 5.24 changed to 5.82
- Malpractice RVU 0.18 changed to 0.19
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$260.35changed to$267.42
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 5.08 changed to 5.24
- Malpractice RVU 0.16 changed to 0.18
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$254.98changed to$260.35
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.94 changed to 5.08
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$225.12changed to$254.98
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.87 changed to 4.94
- Malpractice RVU 0.24 changed to 0.16
- Practice expense GPCI 0.856 changed to 1.007
- Malpractice GPCI 0.642 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$225.12
Held through RVU17B, RVU17C, RVU17D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $278.75 | $95.72 | RVU26D |
| 2026-07-01 | $278.75 | $95.72 | RVU26C |
| 2026-04-01 | $278.75 | $95.72 | RVU26B |
| 2026-01-01 | $278.75 | $95.72 | RVU26A |
| 2025-10-01 | $252.18 | $103.97 | RVU25D |
| 2025-07-01 | $252.18 | $103.97 | RVU25C |
| 2025-04-01 | $252.18 | $103.97 | RVU25B |
| 2025-01-01 | $252.18 | $103.97 | RVU25A |
| 2024-10-01 | $263.86 | $106.65 | RVU24D |
| 2024-07-01 | $263.86 | $106.65 | RVU24C |
| 2024-04-01 | $263.86 | $106.65 | RVU24B |
| 2024-03-09 | $263.86 | $106.65 | RVU24AR |
| 2024-01-01 | $259.56 | $104.91 | RVU24A |
| 2023-10-01 | $267.46 | $106.92 | RVU23D |
| 2023-07-01 | $266.01 | $106.74 | RVU23C |
| 2023-04-01 | $266.01 | $106.74 | RVU23B |
| 2023-01-01 | $266.01 | $106.74 | RVU23A |
| 2022-10-01 | $275.58 | $108.84 | RVU22D |
| 2022-07-01 | $275.58 | $108.84 | RVU22C |
| 2022-04-01 | $275.58 | $108.84 | RVU22B |
| 2022-01-01 | $275.58 | $108.84 | RVU22A |
| 2021-10-01 | $279.28 | $109.75 | RVU21D |
| 2021-07-01 | $279.28 | $109.75 | RVU21C |
| 2021-04-01 | $279.28 | $109.75 | RVU21B |
| 2021-01-01 | $279.28 | $109.75 | RVU21A |
| 2020-10-01 | $267.42 | $111.72 | RVU20D |
| 2020-07-01 | $267.42 | $111.72 | RVU20C |
| 2020-04-01 | $267.42 | $111.72 | RVU20B |
| 2020-01-01 | $267.42 | $111.72 | RVU20A |
| 2019-10-01 | $260.35 | $110.82 | RVU19D |
| 2019-07-01 | $260.35 | $110.82 | RVU19C |
| 2019-04-01 | $260.35 | $110.82 | RVU19B |
| 2019-01-01 | $260.35 | $110.82 | RVU19A |
| 2018-10-01 | $254.98 | $111.07 | RVU18D |
| 2018-07-01 | $254.98 | $111.07 | RVU18C |
| 2018-04-01 | $254.98 | $111.07 | RVU18B |
| 2018-01-01 | $254.98 | $111.07 | RVU18AR1 |
| 2017-10-01 | $225.12 | $105.62 | RVU17D |
| 2017-07-01 | $225.12 | $105.62 | RVU17C |
| 2017-04-01 | $225.12 | $105.62 | RVU17B |
| 2017-01-01 | $225.12 | $105.62 | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
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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