CPT code 64479: Epidural injection, cervical/thoracic, first level2026 Medicare rate & RVUs in Virgin Islands, VI
Reports an image-guided transforaminal epidural injection at one cervical or thoracic level to deliver anesthetic and/or steroid near a spinal nerve root.
In Virgin Islands, VI, Medicare pays $287.39 for 64479 in the office and $116.86 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Virgin Islands, VI 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. Virgin Islands, VI pays $287.39. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virgin Islands, VI · this page$287.39
- Los Angeles, CA · California$323.40+$36.01
- Washington, DC area · District of Columbia$326.35+$38.96
- Miami, FL · Florida$303.82+$16.43
- Chicago, IL · Illinois$295.44+$8.05
- Manhattan, NY · New York$326.99+$39.60
- Alaska · Alaska$332.75+$45.36
Other areas in United States Virgin Islands first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $303.00 | $118.13 |
| Merced, CACalifornia | $303.00 | $118.13 |
| Modesto, CACalifornia | $303.00 | $118.13 |
| Napa, CACalifornia | $351.55 | $129.23 |
| Oxnard, CACalifornia | $321.95 | $122.58 |
| Redding, CACalifornia | $303.00 | $118.13 |
| Rest of CaliforniaCalifornia | $303.00 | $118.13 |
| Riverside, CACalifornia | $305.19 | $120.33 |
| Sacramento, CACalifornia | $318.09 | $121.92 |
| Salinas, CACalifornia | $316.90 | $121.41 |
| San Diego, CACalifornia | $324.42 | $122.68 |
| Marin County, CACalifornia | $372.38 | $134.55 |
| San Francisco, CACalifornia | $372.15 | $134.32 |
| San Benito County, CACalifornia | $380.54 | $137.31 |
| Santa Clara County, CACalifornia | $379.61 | $136.38 |
| San Luis Obispo, CACalifornia | $311.78 | $119.66 |
| Santa Cruz, CACalifornia | $327.59 | $122.65 |
| Santa Maria, CACalifornia | $318.11 | $121.43 |
| Santa Rosa, CACalifornia | $330.91 | $123.78 |
| Stockton, CACalifornia | $303.00 | $118.13 |
| Vallejo, CACalifornia | $351.22 | $128.91 |
| Visalia, CACalifornia | $303.00 | $118.13 |
| Yuba City, CACalifornia | $303.00 | $118.13 |
| ColoradoColorado | $297.74 | $118.27 |
| ConnecticutConnecticut | $303.85 | $122.19 |
| DelawareDelaware | $282.49 | $115.84 |
| Fort Lauderdale, FLFlorida | $293.29 | $122.43 |
| Rest of FloridaFlorida | $279.62 | $118.37 |
| Atlanta, GAGeorgia | $290.08 | $118.70 |
| Rest of GeorgiaGeorgia | $264.49 | $114.03 |
| Hawaii, Guam, HIHawaii | $310.39 | $118.61 |
| IowaIowa | $263.87 | $109.53 |
| IdahoIdaho | $265.40 | $110.22 |
| East St. Louis, ILIllinois | $275.69 | $120.51 |
| Rest of IllinoisIllinois | $271.25 | $117.25 |
| Suburban Chicago, ILIllinois | $296.43 | $123.20 |
| IndianaIndiana | $266.91 | $110.55 |
| KansasKansas | $262.34 | $109.86 |
| KentuckyKentucky | $262.02 | $112.07 |
| New Orleans, LALouisiana | $274.11 | $115.39 |
| Rest of LouisianaLouisiana | $261.49 | $112.22 |
| Metropolitan Boston, MAMassachusetts | $327.15 | $125.76 |
| Rest of MassachusettsMassachusetts | $295.90 | $118.28 |
| Baltimore area, MDMaryland | $302.92 | $121.93 |
| Rest of MarylandMaryland | $287.89 | $117.19 |
| Rest of MaineMaine | $266.39 | $111.21 |
| Southern Maine, MEMaine | $280.94 | $113.79 |
| Detroit, MIMichigan | $282.68 | $119.91 |
| Rest of MichiganMichigan | $268.35 | $114.35 |
| MinnesotaMinnesota | $286.46 | $112.89 |
| Metropolitan Kansas City, MOMissouri | $272.64 | $114.26 |
| Metropolitan St. Louis, MOMissouri | $275.46 | $114.88 |
| Rest of MissouriMissouri | $256.91 | $111.51 |
| MississippiMississippi | $255.13 | $109.90 |
| MontanaMontana | $285.23 | $116.56 |
| North CarolinaNorth Carolina | $269.16 | $111.79 |
| North DakotaNorth Dakota | $281.28 | $112.60 |
| NebraskaNebraska | $265.37 | $109.69 |
| New HampshireNew Hampshire | $292.78 | $117.19 |
| Northern New JerseyNew Jersey | $323.04 | $127.38 |
| Rest of New JerseyNew Jersey | $307.65 | $123.45 |
| New MexicoNew Mexico | $269.65 | $114.97 |
| NevadaNevada | $284.33 | $115.49 |
| NYC suburbs and Long Island, NYNew York | $334.31 | $133.75 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $309.39 | $124.69 |
| Queens, NYNew York | $330.11 | $130.73 |
| Rest of New YorkNew York | $273.06 | $112.81 |
| OhioOhio | $267.54 | $113.54 |
| OklahomaOklahoma | $261.92 | $111.29 |
| Portland, OROregon | $307.38 | $119.98 |
| Rest of OregonOregon | $282.44 | $114.44 |
| Metropolitan Philadelphia, PAPennsylvania | $296.24 | $120.65 |
| Rest of PennsylvaniaPennsylvania | $268.14 | $113.30 |
| Puerto RicoPuerto Rico | $287.39 | $116.86 |
| Rhode IslandRhode Island | $292.67 | $118.43 |
| South CarolinaSouth Carolina | $268.73 | $112.88 |
| South DakotaSouth Dakota | $280.81 | $112.13 |
| TennesseeTennessee | $263.58 | $110.25 |
| Austin, TXTexas | $296.47 | $118.01 |
| Beaumont, TXTexas | $266.40 | $112.91 |
| Brazoria, TXTexas | $282.53 | $115.38 |
| Dallas, TXTexas | $284.15 | $116.15 |
| Fort Worth, TXTexas | $282.20 | $115.88 |
| Galveston, TXTexas | $283.26 | $115.77 |
| Houston, TXTexas | $286.92 | $119.43 |
| Rest of TexasTexas | $274.19 | $114.12 |
| UtahUtah | $272.32 | $113.76 |
| VirginiaVirginia | $279.81 | $114.00 |
| VermontVermont | $279.90 | $112.92 |
| Rest of WashingtonWashington | $295.43 | $117.82 |
| King County, WAWashington | $334.07 | $127.11 |
| WisconsinWisconsin | $272.05 | $110.46 |
| West VirginiaWest Virginia | $261.39 | $114.81 |
| WyomingWyoming | $283.51 | $114.83 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $332.75 | 1 |
| AL | $256.83 | 1 |
| AR | $253.23 | 1 |
| AZ | $277.96 | 1 |
| CA | $303.00–$380.54 | 29 |
| CO | $297.74 | 1 |
| CT | $303.85 | 1 |
| DC | $326.35 | 1 |
| DE | $282.49 | 1 |
| FL | $279.62–$303.82 | 3 |
| GA | $264.49–$290.08 | 2 |
| GU | $310.39 | 1 |
| HI | $310.39 | 1 |
| IA | $263.87 | 1 |
| ID | $265.40 | 1 |
| IL | $271.25–$296.43 | 4 |
| IN | $266.91 | 1 |
| KS | $262.34 | 1 |
| KY | $262.02 | 1 |
| LA | $261.49–$274.11 | 2 |
| MA | $295.90–$327.15 | 2 |
| MD | $287.89–$326.35 | 3 |
| ME | $266.39–$280.94 | 2 |
| MI | $268.35–$282.68 | 2 |
| MN | $286.46 | 1 |
| MO | $256.91–$275.46 | 3 |
| MS | $255.13 | 1 |
| MT | $285.23 | 1 |
| NC | $269.16 | 1 |
| ND | $281.28 | 1 |
| NE | $265.37 | 1 |
| NH | $292.78 | 1 |
| NJ | $307.65–$323.04 | 2 |
| NM | $269.65 | 1 |
| NV | $284.33 | 1 |
| NY | $273.06–$334.31 | 5 |
| OH | $267.54 | 1 |
| OK | $261.92 | 1 |
| OR | $282.44–$307.38 | 2 |
| PA | $268.14–$296.24 | 2 |
| PR | $287.39 | 1 |
| RI | $292.67 | 1 |
| SC | $268.73 | 1 |
| SD | $280.81 | 1 |
| TN | $263.58 | 1 |
| TX | $266.40–$296.47 | 8 |
| UT | $272.32 | 1 |
| VA | $279.81–$326.35 | 2 |
| VI | $287.39 | 1 |
| VT | $279.90 | 1 |
| WA | $295.43–$334.07 | 2 |
| WI | $272.05 | 1 |
| WV | $261.39 | 1 |
| WY | $283.51 | 1 |
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
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 Virgin Islands, VI 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
107
- Locality
- Virgin Islands, VI
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.23 | × 1.000 | 2.2300 |
| Practice expense | 6.11 | × 1.011 | 6.1772 |
| Malpractice | 0.20 | × 0.985 | 0.1970 |
| Total RVUs | 8.6042 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virgin Islands, VI$287.39
Office: (2.23 × 1 + 6.11 × 1.011 + 0.2 × 0.985) × $33.4009 = $287.39
Facility: (2.23 × 1 + 1.06 × 1.011 + 0.2 × 0.985) × $33.4009 = $116.86
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
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 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).
How 64479 has changed in Virgin Islands, VI
64479 · Office / nonfacility
$287.39
Effective 2026-10-01
The base rate is $30.10 higher than on 2025-10-01, moving from $257.29 to $287.39 (11.7%).
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
$257.29changed to$287.39
- 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 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$266.79changed to$257.29
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 5.48 changed to 5.42
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$262.43changed to$266.79
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$270.08changed to$262.43
- 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 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$268.73changed to$270.08
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$278.26changed to$268.73
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 5.49 changed to 5.42
- 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
$276.36changed to$278.26
- 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.
January 1, 2021
RVU21A
$263.29changed to$276.36
- 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
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$251.52changed to$263.29
- 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 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$241.46changed to$251.52
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.19 changed to 4.46
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$239.51changed to$241.46
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.16 changed to 4.19
- Practice expense GPCI 1.006 changed to 1.007
- Malpractice GPCI 0.993 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$234.52changed to$239.51
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 4.23 changed to 4.16
- Practice expense GPCI 0.960 changed to 1.006
- Malpractice GPCI 0.996 changed to 0.993
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$234.69changed to$234.52
- 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.
July 1, 2015
RVU15C
$233.52changed to$234.69
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$244.95changed to$233.52
- 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 1.004 changed to 0.960
- Malpractice GPCI 1.003 changed to 0.996
Held through RVU15B.
January 1, 2014
RVU14A
$249.81changed to$244.95
- 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 1.002 changed to 1.004
- Malpractice GPCI 1.010 changed to 1.003
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $249.81
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $287.39 | $116.86 | RVU26D |
| 2026-07-01 | $287.39 | $116.86 | RVU26C |
| 2026-04-01 | $287.39 | $116.86 | RVU26B |
| 2026-01-01 | $287.39 | $116.86 | RVU26A |
| 2025-10-01 | $257.29 | $127.00 | RVU25D |
| 2025-07-01 | $257.29 | $127.00 | RVU25C |
| 2025-04-01 | $257.29 | $127.00 | RVU25B |
| 2025-01-01 | $257.29 | $127.00 | RVU25A |
| 2024-10-01 | $266.79 | $129.69 | RVU24D |
| 2024-07-01 | $266.79 | $129.69 | RVU24C |
| 2024-04-01 | $266.79 | $129.69 | RVU24B |
| 2024-03-09 | $266.79 | $129.69 | RVU24AR |
| 2024-01-01 | $262.43 | $127.57 | RVU24A |
| 2023-10-01 | $270.08 | $130.71 | RVU23D |
| 2023-07-01 | $268.73 | $130.47 | RVU23C |
| 2023-04-01 | $268.73 | $130.47 | RVU23B |
| 2023-01-01 | $268.73 | $130.47 | RVU23A |
| 2022-10-01 | $278.26 | $133.15 | RVU22D |
| 2022-07-01 | $278.26 | $133.15 | RVU22C |
| 2022-04-01 | $278.26 | $133.15 | RVU22B |
| 2022-01-01 | $278.26 | $133.15 | RVU22A |
| 2021-10-01 | $276.36 | $133.56 | RVU21D |
| 2021-07-01 | $276.36 | $133.56 | RVU21C |
| 2021-04-01 | $276.36 | $133.56 | RVU21B |
| 2021-01-01 | $276.36 | $133.56 | RVU21A |
| 2020-10-01 | $263.29 | $136.33 | RVU20D |
| 2020-07-01 | $263.29 | $136.33 | RVU20C |
| 2020-04-01 | $263.29 | $136.33 | RVU20B |
| 2020-01-01 | $263.29 | $136.33 | RVU20A |
| 2019-10-01 | $251.52 | $135.76 | RVU19D |
| 2019-07-01 | $251.52 | $135.76 | RVU19C |
| 2019-04-01 | $251.52 | $135.76 | RVU19B |
| 2019-01-01 | $251.52 | $135.76 | RVU19A |
| 2018-10-01 | $241.46 | $136.33 | RVU18D |
| 2018-07-01 | $241.46 | $136.33 | RVU18C |
| 2018-04-01 | $241.46 | $136.33 | RVU18B |
| 2018-01-01 | $241.46 | $136.33 | RVU18AR1 |
| 2017-10-01 | $239.51 | $136.25 | RVU17D |
| 2017-07-01 | $239.51 | $136.25 | RVU17C |
| 2017-04-01 | $239.51 | $136.25 | RVU17B |
| 2017-01-01 | $239.51 | $136.25 | RVU17A |
| 2016-10-01 | $234.52 | $134.50 | RVU16D |
| 2016-07-01 | $234.52 | $134.50 | RVU16C |
| 2016-04-01 | $234.52 | $134.50 | RVU16B |
| 2016-01-01 | $234.52 | $134.50 | RVU16A |
| 2015-10-01 | $234.69 | $135.34 | RVU15D |
| 2015-07-01 | $234.69 | $135.34 | RVU15C |
| 2015-04-01 | $233.52 | $134.67 | RVU15B |
| 2015-01-01 | $233.52 | $134.67 | RVU15A |
| 2014-10-01 | $244.95 | $139.57 | RVU14D |
| 2014-07-01 | $244.95 | $139.57 | RVU14C |
| 2014-04-01 | $244.95 | $139.57 | RVU14B |
| 2014-01-01 | $244.95 | $139.57 | RVU14A |
| 2013-10-01 | $249.81 | $136.96 | RVU13D |
| 2013-07-01 | $249.81 | $136.96 | RVU13C |
| 2013-04-01 | $249.81 | $136.96 | RVU13B |
| 2013-01-01 | $249.81 | $136.96 | RVU13AR |
Where the Virgin Islands, VI rate applies
Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.
- Charlotte Amalie
- Charlotte Amalie East
- Charlotte Amalie West
- Christiansted
- Coral Bay
- Cruz Bay
- Frederiksted
- Frederiksted Southeast
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
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