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

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 Houston, TX, Medicare pays $286.92 for 64479 in the office and $119.43 when it’s performed in a hospital or facility.

$286.92Office (non-facility)
$119.43Hospital or facility
+0.6%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $286.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

64479 in Houston, TX vs other payment areas
  1. Houston, TX · this page$286.92
  2. Austin, TX · Texas$296.47+$9.55
  3. Beaumont, TX · Texas$266.40−$20.52
  4. Brazoria, TX · Texas$282.53−$4.39
  5. Dallas, TX · Texas$284.15−$2.77
  6. Fort Worth, TX · Texas$282.20−$4.72
  7. Galveston, TX · Texas$283.26−$3.66

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

Every other payment area

64479 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$274.19$114.12
Los Angeles, CACalifornia$323.40$123.86
Washington, DC areaDistrict of Columbia$326.35$127.65
Miami, FLFlorida$303.82$128.23
Chicago, ILIllinois$295.44$125.92
Manhattan, NYNew York$326.99$130.99
AlaskaAlaska$332.75$153.11
AlabamaAlabama$256.83$109.24

64479 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 64479 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work2.23× 1.0082.2478
Practice expense6.11× 0.9936.0672
Malpractice0.20× 1.3760.2752
Total RVUs8.5903
Conversion factor× 33.4009

Office rate, Houston, TX$286.92

Office: (2.23 × 1.008 + 6.11 × 0.993 + 0.2 × 1.376) × $33.4009 = $286.92

Facility: (2.23 × 1.008 + 1.06 × 0.993 + 0.2 × 1.376) × $33.4009 = $119.43

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

Codes related to 64479

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 64479
CodeHow it relatesOffice range, Houston, TX
Add-on codes
64480Epidural injection, additional cervical/thoracic levelAdd-on for each qualifying additional cervical or thoracic transforaminal level.$143.95
Used instead
64483Transforaminal epidural injection, lumbar or sacral, first levelFirst-level transforaminal epidural injection for the lumbar or sacral region.$266.12
64484Epidural injection, each additional lumbar or sacral levelAdditional-level counterpart for lumbar or sacral transforaminal epidural injections.$118.26
62321Epidural injection, cervical or thoracic, image-guidedCervical or thoracic epidural injection using an interlaminar rather than transforaminal approach.$277.88
64490Facet injection, cervical or thoracic, one levelCervical or thoracic facet-joint injection, targeting a joint rather than a nerve root.$206.71

How 64479 has changed in Houston, TX

64479 · Office / nonfacility

$286.92

Effective 2026-10-01

The base rate is $26.39 higher than on 2025-10-01, moving from $260.53 to $286.92 (10.1%).

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

    $260.53changed to$286.92

    • 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
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $270.11changed to$260.53

    • 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

    $265.70changed to$270.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $274.60changed to$265.70

    • 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
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $284.13changed to$274.60

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.49 changed to 5.42
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $282.23changed to$284.13

    • 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

    $266.94changed to$282.23

    • 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
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $253.59changed to$266.94

    • 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
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $243.48changed to$253.59

    • 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

    $241.26changed to$243.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.16 changed to 4.19
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $242.75changed to$241.26

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.23 changed to 4.16
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $242.88changed to$242.75

    • 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

    $241.68changed to$242.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $245.50changed to$241.68

    • 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
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $249.71changed to$245.50

    • 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
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $249.71

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$286.92$119.43RVU26D
2026-07-01$286.92$119.43RVU26C
2026-04-01$286.92$119.43RVU26B
2026-01-01$286.92$119.43RVU26A
2025-10-01$260.53$130.75RVU25D
2025-07-01$260.53$130.75RVU25C
2025-04-01$260.53$130.75RVU25B
2025-01-01$260.53$130.75RVU25A
2024-10-01$270.11$133.55RVU24D
2024-07-01$270.11$133.55RVU24C
2024-04-01$270.11$133.55RVU24B
2024-03-09$270.11$133.55RVU24AR
2024-01-01$265.70$131.37RVU24A
2023-10-01$274.60$134.13RVU23D
2023-07-01$274.60$134.13RVU23C
2023-04-01$274.60$134.13RVU23B
2023-01-01$274.60$134.13RVU23A
2022-10-01$284.13$136.00RVU22D
2022-07-01$284.13$136.00RVU22C
2022-04-01$284.13$136.00RVU22B
2022-01-01$284.13$136.00RVU22A
2021-10-01$282.23$136.45RVU21D
2021-07-01$282.23$136.45RVU21C
2021-04-01$282.23$136.45RVU21B
2021-01-01$282.23$136.45RVU21A
2020-10-01$266.94$138.46RVU20D
2020-07-01$266.94$138.46RVU20C
2020-04-01$266.94$138.46RVU20B
2020-01-01$266.94$138.46RVU20A
2019-10-01$253.59$137.25RVU19D
2019-07-01$253.59$137.25RVU19C
2019-04-01$253.59$137.25RVU19B
2019-01-01$253.59$137.25RVU19A
2018-10-01$243.48$137.82RVU18D
2018-07-01$243.48$137.82RVU18C
2018-04-01$243.48$137.82RVU18B
2018-01-01$243.48$137.82RVU18AR1
2017-10-01$241.26$137.69RVU17D
2017-07-01$241.26$137.69RVU17C
2017-04-01$241.26$137.69RVU17B
2017-01-01$241.26$137.69RVU17A
2016-10-01$242.75$137.93RVU16D
2016-07-01$242.75$137.93RVU16C
2016-04-01$242.75$137.93RVU16B
2016-01-01$242.75$137.93RVU16A
2015-10-01$242.88$138.77RVU15D
2015-07-01$242.88$138.77RVU15C
2015-04-01$241.68$138.08RVU15B
2015-01-01$241.68$138.08RVU15A
2014-10-01$245.50$140.12RVU14D
2014-07-01$245.50$140.12RVU14C
2014-04-01$245.50$140.12RVU14B
2014-01-01$245.50$140.12RVU14A
2013-10-01$249.71$136.87RVU13D
2013-07-01$249.71$136.87RVU13C
2013-04-01$249.71$136.87RVU13B
2013-01-01$249.71$136.87RVU13AR

Price 64479 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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