CPT code 64480: Epidural injection, additional cervical/thoracic level2026 Medicare rate & RVUs
Reports an additional cervical or thoracic transforaminal epidural level beyond the first when treating a targeted spinal nerve root.
Medicare pays $142.96 for 64480 nationally in the office and $53.11 in a hospital or facility. Local office rates run $127.05–$189.84.
Medicare rate · 64480
Epidural injection, additional cervical/thoracic level
- Work RVUs
- 1.17
- Total RVUs
- 4.28
- Global days
- ZZZ
National rate · 2026
$142.96
Office setting, before claim adjustments.
See every locality for 64480 →Billed by an NP, PA or therapist? →
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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On this page 10 sections
What 64480 covers
This add-on represents an injection at another cervical or thoracic spinal level, using a transforaminal approach to deliver anesthetic and/or steroid near a targeted nerve root. Interventional pain physicians, anesthesiologists, physiatrists, and radiologists may perform it for conditions such as cervical or thoracic radicular pain. Imaging guidance, such as fluoroscopy or CT, is part of the service; the code does not represent a separate imaging service.
Report 64480 for each additional level treated after the first, with 64479 for the initial cervical or thoracic level. The record should identify the treated spinal levels, approach, injectate, and guidance used; another injection or needle pass at the same level is not another level. CMS classifies 64480 as an add-on code, so it must be billed with its primary procedure and is paid within that procedure’s global period. For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.
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.
Where 64480 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$127.05 to $189.84
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $128.84 | $50.22 |
| Alaska | $167.36 | $71.67 |
| Arizona | $139.32 | $52.26 |
| Arkansas | $127.05 | $49.87 |
| Atlanta, GA | $145.41 | $54.13 |
| Austin, TX | $148.43 | $53.37 |
| Bakersfield, CA | $151.88 | $53.41 |
| Baltimore area, MD | $151.77 | $55.36 |
| Beaumont, TX | $133.68 | $51.91 |
| Brazoria, TX | $141.56 | $52.52 |
| Chicago, IL | $148.49 | $58.19 |
| Chico, CA | $151.53 | $53.06 |
| Colorado | $149.03 | $53.43 |
| Connecticut | $152.22 | $55.46 |
| Dallas, TX | $142.39 | $52.90 |
| Delaware | $141.58 | $52.81 |
| Detroit, MI | $141.97 | $55.27 |
| East St. Louis, IL | $138.67 | $56.00 |
| El Centro, CA | $151.55 | $53.08 |
| Fort Lauderdale, FL | $147.23 | $56.21 |
| Fort Worth, TX | $141.43 | $52.84 |
| Fresno, CA | $151.53 | $53.06 |
| Galveston, TX | $141.94 | $52.72 |
| Hanford, CA | $151.53 | $53.06 |
| Hawaii, Guam, HI | $155.14 | $52.98 |
| Houston, TX | $143.95 | $54.73 |
| Idaho | $133.00 | $50.34 |
| Indiana | $133.75 | $50.46 |
| Iowa | $132.22 | $50.01 |
| Kansas | $131.51 | $50.29 |
| Kentucky | $131.52 | $51.65 |
| King County, WA | $166.98 | $56.74 |
| Los Angeles, CA | $161.66 | $55.37 |
| Madera, CA | $151.53 | $53.06 |
| Manhattan, NY | $163.84 | $59.44 |
| Marin County, CA | $185.76 | $59.08 |
| Merced, CA | $151.53 | $53.06 |
| Metropolitan Boston, MA | $163.59 | $56.31 |
| Metropolitan Kansas City, MO | $136.76 | $52.39 |
| Metropolitan Philadelphia, PA | $148.48 | $54.94 |
| Metropolitan St. Louis, MO | $138.15 | $52.62 |
| Miami, FL | $152.68 | $59.15 |
| Minnesota | $143.28 | $50.82 |
| Mississippi | $128.07 | $50.71 |
| Modesto, CA | $151.53 | $53.06 |
| Montana | $142.95 | $53.10 |
| Napa, CA | $175.47 | $57.05 |
| Nebraska | $132.95 | $50.02 |
| Nevada | $142.44 | $52.50 |
| New Hampshire | $146.60 | $53.07 |
| New Mexico | $135.38 | $52.99 |
| New Orleans, LA | $137.54 | $53.00 |
| North Carolina | $134.92 | $51.09 |
| North Dakota | $140.77 | $50.93 |
| Northern New Jersey | $161.70 | $57.48 |
| NYC suburbs and Long Island, NY | $167.54 | $60.71 |
| Ohio | $134.27 | $52.24 |
| Oklahoma | $131.41 | $51.18 |
| Oxnard, CA | $160.90 | $54.70 |
| Portland, OR | $153.76 | $53.94 |
| Poughkeepsie and northern NYC suburbs, NY | $155.01 | $56.62 |
| Puerto Rico | $144.00 | $53.17 |
| Queens, NY | $165.32 | $59.12 |
| Redding, CA | $151.53 | $53.06 |
| Rest of California | $151.53 | $53.06 |
| Rest of Florida | $140.40 | $54.50 |
| Rest of Georgia | $132.84 | $52.69 |
| Rest of Illinois | $136.31 | $54.28 |
| Rest of Louisiana | $131.28 | $51.76 |
| Rest of Maine | $133.55 | $50.89 |
| Rest of Maryland | $144.25 | $53.32 |
| Rest of Massachusetts | $148.15 | $53.54 |
| Rest of Michigan | $134.71 | $52.68 |
| Rest of Missouri | $129.03 | $51.58 |
| Rest of New Jersey | $154.09 | $55.98 |
| Rest of New York | $136.85 | $51.50 |
| Rest of Oregon | $141.46 | $51.97 |
| Rest of Pennsylvania | $134.54 | $52.06 |
| Rest of Texas | $137.49 | $52.22 |
| Rest of Washington | $147.90 | $53.29 |
| Rhode Island | $146.61 | $53.79 |
| Riverside, CA | $152.74 | $54.26 |
| Sacramento, CA | $158.99 | $54.50 |
| Salinas, CA | $158.39 | $54.26 |
| San Benito County, CA | $189.84 | $60.28 |
| San Diego, CA | $162.09 | $54.63 |
| San Francisco, CA | $185.64 | $58.95 |
| San Luis Obispo, CA | $155.84 | $53.51 |
| Santa Clara County, CA | $189.33 | $59.77 |
| Santa Cruz, CA | $163.62 | $54.45 |
| Santa Maria, CA | $158.98 | $54.22 |
| Santa Rosa, CA | $165.27 | $54.94 |
| South Carolina | $134.79 | $51.77 |
| South Dakota | $140.52 | $50.67 |
| Southern Maine, ME | $140.70 | $51.66 |
| Stockton, CA | $151.53 | $53.06 |
| Suburban Chicago, IL | $148.77 | $56.50 |
| Tennessee | $132.14 | $50.46 |
| Utah | $136.57 | $52.11 |
| Vallejo, CA | $175.29 | $56.87 |
| Vermont | $140.14 | $51.19 |
| Virgin Islands, VI | $144.00 | $53.17 |
| Virginia | $140.17 | $51.85 |
| Visalia, CA | $151.53 | $53.06 |
| Washington, DC area | $163.32 | $57.48 |
| West Virginia | $131.41 | $53.33 |
| Wisconsin | $136.20 | $50.13 |
| Wyoming | $142.00 | $52.15 |
| Yuba City, CA | $151.53 | $53.06 |
64480 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.
$127.05
$170.69
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 | $167.36 | 1 |
| AL | $128.84 | 1 |
| AR | $127.05 | 1 |
| AZ | $139.32 | 1 |
| CA | $151.53–$189.84 | 29 |
| CO | $149.03 | 1 |
| CT | $152.22 | 1 |
| DC | $163.32 | 1 |
| DE | $141.58 | 1 |
| FL | $140.40–$152.68 | 3 |
| GA | $132.84–$145.41 | 2 |
| GU | $155.14 | 1 |
| HI | $155.14 | 1 |
| IA | $132.22 | 1 |
| ID | $133.00 | 1 |
| IL | $136.31–$148.77 | 4 |
| IN | $133.75 | 1 |
| KS | $131.51 | 1 |
| KY | $131.52 | 1 |
| LA | $131.28–$137.54 | 2 |
| MA | $148.15–$163.59 | 2 |
| MD | $144.25–$163.32 | 3 |
| ME | $133.55–$140.70 | 2 |
| MI | $134.71–$141.97 | 2 |
| MN | $143.28 | 1 |
| MO | $129.03–$138.15 | 3 |
| MS | $128.07 | 1 |
| MT | $142.95 | 1 |
| NC | $134.92 | 1 |
| ND | $140.77 | 1 |
| NE | $132.95 | 1 |
| NH | $146.60 | 1 |
| NJ | $154.09–$161.70 | 2 |
| NM | $135.38 | 1 |
| NV | $142.44 | 1 |
| NY | $136.85–$167.54 | 5 |
| OH | $134.27 | 1 |
| OK | $131.41 | 1 |
| OR | $141.46–$153.76 | 2 |
| PA | $134.54–$148.48 | 2 |
| PR | $144.00 | 1 |
| RI | $146.61 | 1 |
| SC | $134.79 | 1 |
| SD | $140.52 | 1 |
| TN | $132.14 | 1 |
| TX | $133.68–$148.43 | 8 |
| UT | $136.57 | 1 |
| VA | $140.17–$163.32 | 2 |
| VI | $144.00 | 1 |
| VT | $140.14 | 1 |
| WA | $147.90–$166.98 | 2 |
| WI | $136.20 | 1 |
| WV | $131.41 | 1 |
| WY | $142.00 | 1 |
How the 64480 rate is calculated
Each of 64480’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 · 64480
RVUs × geographic indexes × conversion factor
Work1.17
1.17 RVUs× 1.000 GPCI
Practice expense3.00
3.00 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
4.2800
Conversion factor
$33.4009
Medicare rate
$142.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64480
The CMS indicators that decide how 64480 is paid alongside other services.
CMS payment indicators · 64480
Epidural injection, additional cervical/thoracic level
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
64480 without 50 · national office
$142.96
Epidural injection, additional cervical/thoracic level
64480-50 · Bilateral: 150%
$214.44
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).
64480 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64479Epidural injectionCervical/thoracic, first level
- 64479 covers the initial cervical or thoracic transforaminal level; 64480 covers each additional level and is reported with 64479.
- 64484Epidural injectionEach additional lumbar or sacral level
- 64484 covers additional lumbar or sacral transforaminal levels. Choose the add-on code according to the spinal region treated.
- 64490Facet injectionCervical or thoracic, one level
- 64490 targets a cervical or thoracic facet joint. 64480 targets an additional nerve-root level through a transforaminal approach.
64480 billing questions
When is 64480 reported instead of 64479?
Use 64479 for the initial cervical or thoracic transforaminal level. Report 64480 for each additional level treated in the same procedure.
Can 64480 be billed by itself?
No. It is an add-on code and must be reported with the primary procedure, 64479.
Does another injection at the same level support another unit?
No. The add-on is based on an additional spinal level, not additional needle passes or injections at the same level.
How is bilateral treatment reported under the CMS rule?
For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.
What distinguishes 64480 from 64484?
64480 is for each additional cervical or thoracic transforaminal level. 64484 is for each additional lumbar or sacral level.
What documentation supports the additional-level code?
Document the cervical or thoracic levels treated, the transforaminal approach, the injectate, and the imaging guidance used.
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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