CPT code 64479: Epidural injection, cervical/thoracic, first level2026 Medicare rate & RVUs in North Carolina

Reports an image-guided transforaminal epidural injection at one cervical or thoracic level to deliver anesthetic and/or steroid near a spinal nerve root.

CMS RVU26DEffective Oct 1, 2026One payment locality42.1K Medicare services in 2024

In North Carolina, Medicare pays $269.16 for 64479 in the office and $111.79 when it’s performed in a hospital or facility.

$269.16Office (non-facility)
$111.79Hospital or facility
−5.6%vs the national office rate ($285.24)

Check a contract rate as a % of Medicare · 64479 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 64479 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 64479 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 64479 covers

This service places anesthetic and/or steroid into the epidural space through a transforaminal approach at one cervical or thoracic spinal level. The clinician guides a needle toward the targeted nerve root using fluoroscopy or CT. Pain medicine physicians, anesthesiologists, physiatrists, and other qualified clinicians commonly perform it for cervical or thoracic radicular symptoms, such as pain associated with nerve-root irritation from foraminal narrowing or a disc problem, in an office or facility setting.

Report 64479 for the first treated level in the cervical or thoracic region; documentation should identify the level and side, clinical indication, approach, imaging guidance, and injected agents. Code 64480 is used for each qualifying additional level. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. For a bilateral procedure reported with modifier 50, CMS pays at 150%. An assistant at surgery is not paid; 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 North Carolina compares for 64479

Across 109 of 109 payment localities, the office rate for 64479 runs from $253.23 in Arkansas to $380.54 in San Benito County, CA. North Carolina pays $269.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

64479 in North Carolina vs other payment areas
  1. North Carolina · this page$269.16
  2. Los Angeles, CA · California$323.40+$54.24
  3. Washington, DC area · District of Columbia$326.35+$57.19
  4. Miami, FL · Florida$303.82+$34.66
  5. Chicago, IL · Illinois$295.44+$26.28
  6. Manhattan, NY · New York$326.99+$57.83
  7. Alaska · Alaska$332.75+$63.59

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

64479 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$256.83$109.24
ArkansasArkansas$253.23$108.34
ArizonaArizona$277.96$114.51
Bakersfield, CACalifornia$303.64$118.77
Chico, CACalifornia$303.00$118.13
El Centro, CACalifornia$303.04$118.17
Fresno, CACalifornia$303.00$118.13
Hanford, CACalifornia$303.00$118.13

64479 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.

$253.23

$341.77

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
64479 office rate range by state
State / territoryOffice rate rangeLocalities
AK$332.751
AL$256.831
AR$253.231
AZ$277.961
CA$303.00–$380.5429
CO$297.741
CT$303.851
DC$326.351
DE$282.491
FL$279.62–$303.823
GA$264.49–$290.082
GU$310.391
HI$310.391
IA$263.871
ID$265.401
IL$271.25–$296.434
IN$266.911
KS$262.341
KY$262.021
LA$261.49–$274.112
MA$295.90–$327.152
MD$287.89–$326.353
ME$266.39–$280.942
MI$268.35–$282.682
MN$286.461
MO$256.91–$275.463
MS$255.131
MT$285.231
NC$269.161
ND$281.281
NE$265.371
NH$292.781
NJ$307.65–$323.042
NM$269.651
NV$284.331
NY$273.06–$334.315
OH$267.541
OK$261.921
OR$282.44–$307.382
PA$268.14–$296.242
PR$287.391
RI$292.671
SC$268.731
SD$280.811
TN$263.581
TX$266.40–$296.478
UT$272.321
VA$279.81–$326.352
VI$287.391
VT$279.901
WA$295.43–$334.072
WI$272.051
WV$261.391
WY$283.511

See 64479 in every payment locality

How the 64479 rate is calculated

Each of 64479’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 · 64479

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.23

2.23 RVUs× 1.000 GPCI

Practice expense6.11

6.11 RVUs× 1.000 GPCI

Malpractice0.20

0.20 RVUs× 1.000 GPCI

Adjusted RVUs

8.5400

Conversion factor

$33.4009

Medicare rate

$285.24

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,126

Code
64479
Physician work
2.23
Practice expense
6.11
Malpractice
0.20

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 64479 in North Carolina
ComponentRVULocality factorAdjusted
Physician work2.23× 1.0002.2300
Practice expense6.11× 0.9335.7006
Malpractice0.20× 0.6390.1278
Total RVUs8.0584
Conversion factor× 33.4009

Office rate, North Carolina$269.16

Office: (2.23 × 1 + 6.11 × 0.933 + 0.2 × 0.639) × $33.4009 = $269.16

Facility: (2.23 × 1 + 1.06 × 0.933 + 0.2 × 0.639) × $33.4009 = $111.79

Open 64479 in the RVU calculator

Payment rules and modifiers for 64479

The CMS indicators that decide how 64479 is paid alongside other services.

CMS payment indicators · 64479

Epidural injection, cervical/thoracic, first level

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

64479 without 50 · national office

$285.24

Epidural injection, cervical/thoracic, first level

64479-50 · Bilateral: 150%

$427.86

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

How 64479 has changed in North Carolina

64479 · Office / nonfacility

$269.16

Effective 2026-10-01

The base rate is $28.22 higher than on 2025-10-01, moving from $240.94 to $269.16 (11.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $240.94changed to$269.16

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.29 changed to 2.23
    • Practice expense RVU 5.42 changed to 6.11
    • Malpractice RVU 0.21 changed to 0.20
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $249.79changed to$240.94

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.48 changed to 5.42

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $245.72changed to$249.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $253.39changed to$245.72

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.42 changed to 5.48
    • Malpractice RVU 0.22 changed to 0.21
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $261.79changed to$253.39

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.49 changed to 5.42
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $260.12changed to$261.79

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.38 changed to 5.49
    • Malpractice RVU 0.21 changed to 0.22

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $248.08changed to$260.12

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.75 changed to 5.38
    • Malpractice RVU 0.22 changed to 0.21
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $237.18changed to$248.08

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.46 changed to 4.75
    • Malpractice RVU 0.20 changed to 0.22
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $227.87changed to$237.18

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.19 changed to 4.46

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $226.43changed to$227.87

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.16 changed to 4.19
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $228.34changed to$226.43

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.23 changed to 4.16
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $228.44changed to$228.34

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.20 changed to 4.23
    • Malpractice RVU 0.21 changed to 0.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $227.30changed to$228.44

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $230.95changed to$227.30

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.27 changed to 4.20
    • Malpractice RVU 0.26 changed to 0.21
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $234.74changed to$230.95

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.77 changed to 4.27
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $234.74

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$269.16$111.79RVU26D
2026-07-01$269.16$111.79RVU26C
2026-04-01$269.16$111.79RVU26B
2026-01-01$269.16$111.79RVU26A
2025-10-01$240.94$121.12RVU25D
2025-07-01$240.94$121.12RVU25C
2025-04-01$240.94$121.12RVU25B
2025-01-01$240.94$121.12RVU25A
2024-10-01$249.79$123.72RVU24D
2024-07-01$249.79$123.72RVU24C
2024-04-01$249.79$123.72RVU24B
2024-03-09$249.79$123.72RVU24AR
2024-01-01$245.72$121.70RVU24A
2023-10-01$253.39$125.23RVU23D
2023-07-01$253.39$125.23RVU23C
2023-04-01$253.39$125.23RVU23B
2023-01-01$253.39$125.23RVU23A
2022-10-01$261.79$128.20RVU22D
2022-07-01$261.79$128.20RVU22C
2022-04-01$261.79$128.20RVU22B
2022-01-01$261.79$128.20RVU22A
2021-10-01$260.12$128.65RVU21D
2021-07-01$260.12$128.65RVU21C
2021-04-01$260.12$128.65RVU21B
2021-01-01$260.12$128.65RVU21A
2020-10-01$248.08$130.95RVU20D
2020-07-01$248.08$130.95RVU20C
2020-04-01$248.08$130.95RVU20B
2020-01-01$248.08$130.95RVU20A
2019-10-01$237.18$130.15RVU19D
2019-07-01$237.18$130.15RVU19C
2019-04-01$237.18$130.15RVU19B
2019-01-01$237.18$130.15RVU19A
2018-10-01$227.87$130.68RVU18D
2018-07-01$227.87$130.68RVU18C
2018-04-01$227.87$130.68RVU18B
2018-01-01$227.87$130.68RVU18AR1
2017-10-01$226.43$130.88RVU17D
2017-07-01$226.43$130.88RVU17C
2017-04-01$226.43$130.88RVU17B
2017-01-01$226.43$130.88RVU17A
2016-10-01$228.34$131.44RVU16D
2016-07-01$228.34$131.44RVU16C
2016-04-01$228.34$131.44RVU16B
2016-01-01$228.34$131.44RVU16A
2015-10-01$228.44$132.20RVU15D
2015-07-01$228.44$132.20RVU15C
2015-04-01$227.30$131.54RVU15B
2015-01-01$227.30$131.54RVU15A
2014-10-01$230.95$133.45RVU14D
2014-07-01$230.95$133.45RVU14C
2014-04-01$230.95$133.45RVU14B
2014-01-01$230.95$133.45RVU14A
2013-10-01$234.74$130.34RVU13D
2013-07-01$234.74$130.34RVU13C
2013-04-01$234.74$130.34RVU13B
2013-01-01$234.74$130.34RVU13AR

Price 64479 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

64479 billing questions

When should 64479 be chosen instead of 64483?

Use 64479 for a cervical or thoracic transforaminal epidural injection at the first level. Code 64483 describes the corresponding first-level service in the lumbar or sacral region.

How is an additional cervical or thoracic level reported?

Use add-on code 64480 for each qualifying additional level. It is reported with the primary-level service, not by itself.

Is imaging guidance included?

Yes. The service includes fluoroscopic or CT guidance for needle placement; the documentation should support the approach and targeted level.

What documentation supports this code?

Record the clinical indication, cervical or thoracic level, side, transforaminal approach, imaging guidance, and agents injected. The note should make clear whether an additional level was treated.

How does Medicare treat a bilateral service?

CMS identifies this as a bilateral procedure; when reported with modifier 50, it is paid at 150%.

What same-session payment rules apply?

The service has a 0-day global period, so same-day preoperative and postoperative care is included. Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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
RVUs for 64479PPRRVU2026_Oct_nonQPP.csv, line 7,126 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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