CPT code 64480: Epidural injection, additional cervical/thoracic level2026 Medicare rate & RVUs in South Dakota
Reports an additional cervical or thoracic transforaminal epidural level beyond the first when treating a targeted spinal nerve root.
In South Dakota, Medicare pays $140.52 for 64480 in the office and $50.67 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 64480 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 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.
How South Dakota compares for 64480
Across 109 of 109 payment localities, the office rate for 64480 runs from $127.05 in Arkansas to $189.84 in San Benito County, CA. South Dakota pays $140.52. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$140.52
- Los Angeles, CA · California$161.66+$21.14
- Washington, DC area · District of Columbia$163.32+$22.80
- Miami, FL · Florida$152.68+$12.16
- Chicago, IL · Illinois$148.49+$7.97
- Manhattan, NY · New York$163.84+$23.32
- Alaska · Alaska$167.36+$26.84
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $128.84 | $50.22 |
| ArkansasArkansas | $127.05 | $49.87 |
| ArizonaArizona | $139.32 | $52.26 |
| Bakersfield, CACalifornia | $151.88 | $53.41 |
| Chico, CACalifornia | $151.53 | $53.06 |
| El Centro, CACalifornia | $151.55 | $53.08 |
| Fresno, CACalifornia | $151.53 | $53.06 |
| Hanford, CACalifornia | $151.53 | $53.06 |
| Madera, CACalifornia | $151.53 | $53.06 |
| Merced, CACalifornia | $151.53 | $53.06 |
| Modesto, CACalifornia | $151.53 | $53.06 |
| Napa, CACalifornia | $175.47 | $57.05 |
| Oxnard, CACalifornia | $160.90 | $54.70 |
| Redding, CACalifornia | $151.53 | $53.06 |
| Rest of CaliforniaCalifornia | $151.53 | $53.06 |
| Riverside, CACalifornia | $152.74 | $54.26 |
| Sacramento, CACalifornia | $158.99 | $54.50 |
| Salinas, CACalifornia | $158.39 | $54.26 |
| San Diego, CACalifornia | $162.09 | $54.63 |
| Marin County, CACalifornia | $185.76 | $59.08 |
| San Francisco, CACalifornia | $185.64 | $58.95 |
| San Benito County, CACalifornia | $189.84 | $60.28 |
| Santa Clara County, CACalifornia | $189.33 | $59.77 |
| San Luis Obispo, CACalifornia | $155.84 | $53.51 |
| Santa Cruz, CACalifornia | $163.62 | $54.45 |
| Santa Maria, CACalifornia | $158.98 | $54.22 |
| Santa Rosa, CACalifornia | $165.27 | $54.94 |
| Stockton, CACalifornia | $151.53 | $53.06 |
| Vallejo, CACalifornia | $175.29 | $56.87 |
| Visalia, CACalifornia | $151.53 | $53.06 |
| Yuba City, CACalifornia | $151.53 | $53.06 |
| ColoradoColorado | $149.03 | $53.43 |
| ConnecticutConnecticut | $152.22 | $55.46 |
| DelawareDelaware | $141.58 | $52.81 |
| Fort Lauderdale, FLFlorida | $147.23 | $56.21 |
| Rest of FloridaFlorida | $140.40 | $54.50 |
| Atlanta, GAGeorgia | $145.41 | $54.13 |
| Rest of GeorgiaGeorgia | $132.84 | $52.69 |
| Hawaii, Guam, HIHawaii | $155.14 | $52.98 |
| IowaIowa | $132.22 | $50.01 |
| IdahoIdaho | $133.00 | $50.34 |
| East St. Louis, ILIllinois | $138.67 | $56.00 |
| Rest of IllinoisIllinois | $136.31 | $54.28 |
| Suburban Chicago, ILIllinois | $148.77 | $56.50 |
| IndianaIndiana | $133.75 | $50.46 |
| KansasKansas | $131.51 | $50.29 |
| KentuckyKentucky | $131.52 | $51.65 |
| New Orleans, LALouisiana | $137.54 | $53.00 |
| Rest of LouisianaLouisiana | $131.28 | $51.76 |
| Metropolitan Boston, MAMassachusetts | $163.59 | $56.31 |
| Rest of MassachusettsMassachusetts | $148.15 | $53.54 |
| Baltimore area, MDMaryland | $151.77 | $55.36 |
| Rest of MarylandMaryland | $144.25 | $53.32 |
| Rest of MaineMaine | $133.55 | $50.89 |
| Southern Maine, MEMaine | $140.70 | $51.66 |
| Detroit, MIMichigan | $141.97 | $55.27 |
| Rest of MichiganMichigan | $134.71 | $52.68 |
| MinnesotaMinnesota | $143.28 | $50.82 |
| Metropolitan Kansas City, MOMissouri | $136.76 | $52.39 |
| Metropolitan St. Louis, MOMissouri | $138.15 | $52.62 |
| Rest of MissouriMissouri | $129.03 | $51.58 |
| MississippiMississippi | $128.07 | $50.71 |
| MontanaMontana | $142.95 | $53.10 |
| North CarolinaNorth Carolina | $134.92 | $51.09 |
| North DakotaNorth Dakota | $140.77 | $50.93 |
| NebraskaNebraska | $132.95 | $50.02 |
| New HampshireNew Hampshire | $146.60 | $53.07 |
| Northern New JerseyNew Jersey | $161.70 | $57.48 |
| Rest of New JerseyNew Jersey | $154.09 | $55.98 |
| New MexicoNew Mexico | $135.38 | $52.99 |
| NevadaNevada | $142.44 | $52.50 |
| NYC suburbs and Long Island, NYNew York | $167.54 | $60.71 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $155.01 | $56.62 |
| Queens, NYNew York | $165.32 | $59.12 |
| Rest of New YorkNew York | $136.85 | $51.50 |
| OhioOhio | $134.27 | $52.24 |
| OklahomaOklahoma | $131.41 | $51.18 |
| Portland, OROregon | $153.76 | $53.94 |
| Rest of OregonOregon | $141.46 | $51.97 |
| Metropolitan Philadelphia, PAPennsylvania | $148.48 | $54.94 |
| Rest of PennsylvaniaPennsylvania | $134.54 | $52.06 |
| Puerto RicoPuerto Rico | $144.00 | $53.17 |
| Rhode IslandRhode Island | $146.61 | $53.79 |
| South CarolinaSouth Carolina | $134.79 | $51.77 |
| TennesseeTennessee | $132.14 | $50.46 |
| Austin, TXTexas | $148.43 | $53.37 |
| Beaumont, TXTexas | $133.68 | $51.91 |
| Brazoria, TXTexas | $141.56 | $52.52 |
| Dallas, TXTexas | $142.39 | $52.90 |
| Fort Worth, TXTexas | $141.43 | $52.84 |
| Galveston, TXTexas | $141.94 | $52.72 |
| Houston, TXTexas | $143.95 | $54.73 |
| Rest of TexasTexas | $137.49 | $52.22 |
| UtahUtah | $136.57 | $52.11 |
| VirginiaVirginia | $140.17 | $51.85 |
| Virgin Islands, VIUnited States Virgin Islands | $144.00 | $53.17 |
| VermontVermont | $140.14 | $51.19 |
| Rest of WashingtonWashington | $147.90 | $53.29 |
| King County, WAWashington | $166.98 | $56.74 |
| WisconsinWisconsin | $136.20 | $50.13 |
| West VirginiaWest Virginia | $131.41 | $53.33 |
| WyomingWyoming | $142.00 | $52.15 |
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.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,127
- Code
- 64480
- Physician work
- 1.17
- Practice expense
- 3.00
- Malpractice
- 0.11
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.17 | × 1.000 | 1.1700 |
| Practice expense | 3.00 | × 1.000 | 3.0000 |
| Malpractice | 0.11 | × 0.336 | 0.0370 |
| Total RVUs | 4.2070 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$140.52
Office: (1.17 × 1 + 3 × 1 + 0.11 × 0.336) × $33.4009 = $140.52
Facility: (1.17 × 1 + 0.31 × 1 + 0.11 × 0.336) × $33.4009 = $50.67
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).
How 64480 has changed in South Dakota
64480 · Office / nonfacility
$140.52
Effective 2026-10-01
The base rate is $13.21 higher than on 2025-10-01, moving from $127.31 to $140.52 (10.4%).
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
$127.31changed to$140.52
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.20 changed to 1.17
- Practice expense RVU 2.69 changed to 3.00
- Malpractice RVU 0.12 changed to 0.11
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$132.22changed to$127.31
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.73 changed to 2.69
- Malpractice RVU 0.11 changed to 0.12
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$130.06changed to$132.22
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$133.64changed to$130.06
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.70 changed to 2.73
- Malpractice RVU 0.12 changed to 0.11
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$138.02changed to$133.64
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.75 changed to 2.70
- Malpractice RVU 0.11 changed to 0.12
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$136.26changed to$138.02
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.66 changed to 2.75
- Malpractice RVU 0.13 changed to 0.11
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$127.55changed to$136.26
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.29 changed to 2.66
- Malpractice RVU 0.12 changed to 0.13
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$120.61changed to$127.55
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.10 changed to 2.29
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$113.28changed to$120.61
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.90 changed to 2.10
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$111.88changed to$113.28
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.87 changed to 1.90
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$112.93changed to$111.88
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.91 changed to 1.87
- Malpractice RVU 0.11 changed to 0.12
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$112.97changed to$112.93
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.90 changed to 1.91
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$112.41changed to$112.97
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$113.58changed to$112.41
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.17 changed to 0.11
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$114.58changed to$113.58
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.09 changed to 1.90
- Malpractice RVU 0.18 changed to 0.17
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $114.58
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $140.52 | $50.67 | RVU26D |
| 2026-07-01 | $140.52 | $50.67 | RVU26C |
| 2026-04-01 | $140.52 | $50.67 | RVU26B |
| 2026-01-01 | $140.52 | $50.67 | RVU26A |
| 2025-10-01 | $127.31 | $57.12 | RVU25D |
| 2025-07-01 | $127.31 | $57.12 | RVU25C |
| 2025-04-01 | $127.31 | $57.12 | RVU25B |
| 2025-01-01 | $127.31 | $57.12 | RVU25A |
| 2024-10-01 | $132.22 | $57.99 | RVU24D |
| 2024-07-01 | $132.22 | $57.99 | RVU24C |
| 2024-04-01 | $132.22 | $57.99 | RVU24B |
| 2024-03-09 | $132.22 | $57.99 | RVU24AR |
| 2024-01-01 | $130.06 | $57.04 | RVU24A |
| 2023-10-01 | $133.64 | $58.75 | RVU23D |
| 2023-07-01 | $133.64 | $58.75 | RVU23C |
| 2023-04-01 | $133.64 | $58.75 | RVU23B |
| 2023-01-01 | $133.64 | $58.75 | RVU23A |
| 2022-10-01 | $138.02 | $59.46 | RVU22D |
| 2022-07-01 | $138.02 | $59.46 | RVU22C |
| 2022-04-01 | $138.02 | $59.46 | RVU22B |
| 2022-01-01 | $138.02 | $59.46 | RVU22A |
| 2021-10-01 | $136.26 | $60.54 | RVU21D |
| 2021-07-01 | $136.26 | $60.54 | RVU21C |
| 2021-04-01 | $136.26 | $60.54 | RVU21B |
| 2021-01-01 | $136.26 | $60.54 | RVU21A |
| 2020-10-01 | $127.55 | $62.22 | RVU20D |
| 2020-07-01 | $127.55 | $62.22 | RVU20C |
| 2020-04-01 | $127.55 | $62.22 | RVU20B |
| 2020-01-01 | $127.55 | $62.22 | RVU20A |
| 2019-10-01 | $120.61 | $62.23 | RVU19D |
| 2019-07-01 | $120.61 | $62.23 | RVU19C |
| 2019-04-01 | $120.61 | $62.23 | RVU19B |
| 2019-01-01 | $120.61 | $62.23 | RVU19A |
| 2018-10-01 | $113.28 | $62.52 | RVU18D |
| 2018-07-01 | $113.28 | $62.52 | RVU18C |
| 2018-04-01 | $113.28 | $62.52 | RVU18B |
| 2018-01-01 | $113.28 | $62.52 | RVU18AR1 |
| 2017-10-01 | $111.88 | $62.71 | RVU17D |
| 2017-07-01 | $111.88 | $62.71 | RVU17C |
| 2017-04-01 | $111.88 | $62.71 | RVU17B |
| 2017-01-01 | $111.88 | $62.71 | RVU17A |
| 2016-10-01 | $112.93 | $62.80 | RVU16D |
| 2016-07-01 | $112.93 | $62.80 | RVU16C |
| 2016-04-01 | $112.93 | $62.80 | RVU16B |
| 2016-01-01 | $112.93 | $62.80 | RVU16A |
| 2015-10-01 | $112.97 | $63.03 | RVU15D |
| 2015-07-01 | $112.97 | $63.03 | RVU15C |
| 2015-04-01 | $112.41 | $62.71 | RVU15B |
| 2015-01-01 | $112.41 | $62.71 | RVU15A |
| 2014-10-01 | $113.58 | $64.15 | RVU14D |
| 2014-07-01 | $113.58 | $64.15 | RVU14C |
| 2014-04-01 | $113.58 | $64.15 | RVU14B |
| 2014-01-01 | $113.58 | $64.15 | RVU14A |
| 2013-10-01 | $114.58 | $62.53 | RVU13D |
| 2013-07-01 | $114.58 | $62.53 | RVU13C |
| 2013-04-01 | $114.58 | $62.53 | RVU13B |
| 2013-01-01 | $114.58 | $62.53 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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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