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CPT code 64480: Epidural injection, additional cervical/thoracic level2026 Medicare rate & RVUs in Houston, TX

Reports an additional cervical or thoracic transforaminal epidural level beyond the first when treating a targeted spinal nerve root.

CMS RVU26DEffective Oct 1, 2026One payment locality11K Medicare services in 2024

In Houston, TX, Medicare pays $143.95 for 64480 in the office and $54.73 when it’s performed in a hospital or facility.

$143.95Office (non-facility)
$54.73Hospital or facility
+0.7%vs the national office rate ($142.96)

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.

We’ll open 64480 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 64480 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 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 Houston, TX 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. Houston, TX pays $143.95. The RVUs are the same everywhere; the geographic indexes change the dollars.

64480 in Houston, TX vs other payment areas
  1. Houston, TX · this page$143.95
  2. Austin, TX · Texas$148.43+$4.48
  3. Beaumont, TX · Texas$133.68−$10.27
  4. Brazoria, TX · Texas$141.56−$2.39
  5. Dallas, TX · Texas$142.39−$1.56
  6. Fort Worth, TX · Texas$141.43−$2.52
  7. Galveston, TX · Texas$141.94−$2.01

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

Every other payment area

64480 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$137.49$52.22
Los Angeles, CACalifornia$161.66$55.37
Washington, DC areaDistrict of Columbia$163.32$57.48
Miami, FLFlorida$152.68$59.15
Chicago, ILIllinois$148.49$58.19
Manhattan, NYNew York$163.84$59.44
AlaskaAlaska$167.36$71.67
AlabamaAlabama$128.84$50.22

64480 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.

$127.05

$170.69

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

View every state and territory as a table
64480 office rate range by state
State / territoryOffice rate rangeLocalities
AK$167.361
AL$128.841
AR$127.051
AZ$139.321
CA$151.53–$189.8429
CO$149.031
CT$152.221
DC$163.321
DE$141.581
FL$140.40–$152.683
GA$132.84–$145.412
GU$155.141
HI$155.141
IA$132.221
ID$133.001
IL$136.31–$148.774
IN$133.751
KS$131.511
KY$131.521
LA$131.28–$137.542
MA$148.15–$163.592
MD$144.25–$163.323
ME$133.55–$140.702
MI$134.71–$141.972
MN$143.281
MO$129.03–$138.153
MS$128.071
MT$142.951
NC$134.921
ND$140.771
NE$132.951
NH$146.601
NJ$154.09–$161.702
NM$135.381
NV$142.441
NY$136.85–$167.545
OH$134.271
OK$131.411
OR$141.46–$153.762
PA$134.54–$148.482
PR$144.001
RI$146.611
SC$134.791
SD$140.521
TN$132.141
TX$133.68–$148.438
UT$136.571
VA$140.17–$163.322
VI$144.001
VT$140.141
WA$147.90–$166.982
WI$136.201
WV$131.411
WY$142.001

See 64480 in every payment locality

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

Office or facility?

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 64480 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.17× 1.0081.1794
Practice expense3.00× 0.9932.9790
Malpractice0.11× 1.3760.1514
Total RVUs4.3097
Conversion factor× 33.4009

Office rate, Houston, TX$143.95

Office: (1.17 × 1.008 + 3 × 0.993 + 0.11 × 1.376) × $33.4009 = $143.95

Facility: (1.17 × 1.008 + 0.31 × 0.993 + 0.11 × 1.376) × $33.4009 = $54.73

Open 64480 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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

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).

When to use modifier 50

Codes related to 64480

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

Codes related to 64480
CodeHow it relatesOffice range, Houston, TX
Primary code
64479Epidural injection, cervical/thoracic, first levelPrimary code for the initial cervical or thoracic transforaminal level.$286.92
Used instead
64483Transforaminal epidural injection, lumbar or sacral, first levelPrimary transforaminal injection code when the treated level is lumbar or sacral.$266.12
64484Epidural injection, each additional lumbar or sacral levelAdd-on for additional lumbar or sacral transforaminal levels.$118.26
64490Facet injection, cervical or thoracic, one levelCervical or thoracic facet-joint injection, targeting a joint rather than a nerve root.$206.71

How 64480 has changed in Houston, TX

64480 · Office / nonfacility

$143.95

Effective 2026-10-01

The base rate is $11.85 higher than on 2025-10-01, moving from $132.10 to $143.95 (9.0%).

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

    $132.10changed to$143.95

    • 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
    • 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

    $136.81changed to$132.10

    • 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.

  3. March 9, 2024

    RVU24AR

    $134.58changed to$136.81

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $139.25changed to$134.58

    • 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
    • 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

    $144.21changed to$139.25

    • 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
    • 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

    $142.80changed to$144.21

    • 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.

  7. January 1, 2021

    RVU21A

    $132.71changed to$142.80

    • 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
    • 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

    $124.75changed to$132.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.10 changed to 2.29
    • 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

    $117.33changed to$124.75

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.90 changed to 2.10

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $115.72changed to$117.33

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.87 changed to 1.90
    • 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

    $116.34changed to$115.72

    • 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
    • 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

    $116.40changed to$116.34

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.90 changed to 1.91

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $115.82changed to$116.40

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $117.64changed to$115.82

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.17 changed to 0.11
    • 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

    $118.10changed to$117.64

    • 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
    • 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: $118.10

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$143.95$54.73RVU26D
2026-07-01$143.95$54.73RVU26C
2026-04-01$143.95$54.73RVU26B
2026-01-01$143.95$54.73RVU26A
2025-10-01$132.10$61.70RVU25D
2025-07-01$132.10$61.70RVU25C
2025-04-01$132.10$61.70RVU25B
2025-01-01$132.10$61.70RVU25A
2024-10-01$136.81$62.36RVU24D
2024-07-01$136.81$62.36RVU24C
2024-04-01$136.81$62.36RVU24B
2024-03-09$136.81$62.36RVU24AR
2024-01-01$134.58$61.34RVU24A
2023-10-01$139.25$63.16RVU23D
2023-07-01$139.25$63.16RVU23C
2023-04-01$139.25$63.16RVU23B
2023-01-01$139.25$63.16RVU23A
2022-10-01$144.21$63.38RVU22D
2022-07-01$144.21$63.38RVU22C
2022-04-01$144.21$63.38RVU22B
2022-01-01$144.21$63.38RVU22A
2021-10-01$142.80$64.89RVU21D
2021-07-01$142.80$64.89RVU21C
2021-04-01$142.80$64.89RVU21B
2021-01-01$142.80$64.89RVU21A
2020-10-01$132.71$66.08RVU20D
2020-07-01$132.71$66.08RVU20C
2020-04-01$132.71$66.08RVU20B
2020-01-01$132.71$66.08RVU20A
2019-10-01$124.75$65.67RVU19D
2019-07-01$124.75$65.67RVU19C
2019-04-01$124.75$65.67RVU19B
2019-01-01$124.75$65.67RVU19A
2018-10-01$117.33$65.96RVU18D
2018-07-01$117.33$65.96RVU18C
2018-04-01$117.33$65.96RVU18B
2018-01-01$117.33$65.96RVU18AR1
2017-10-01$115.72$66.11RVU17D
2017-07-01$115.72$66.11RVU17C
2017-04-01$115.72$66.11RVU17B
2017-01-01$115.72$66.11RVU17A
2016-10-01$116.34$65.91RVU16D
2016-07-01$116.34$65.91RVU16C
2016-04-01$116.34$65.91RVU16B
2016-01-01$116.34$65.91RVU16A
2015-10-01$116.40$66.15RVU15D
2015-07-01$116.40$66.15RVU15C
2015-04-01$115.82$65.82RVU15B
2015-01-01$115.82$65.82RVU15A
2014-10-01$117.64$68.01RVU14D
2014-07-01$117.64$68.01RVU14C
2014-04-01$117.64$68.01RVU14B
2014-01-01$117.64$68.01RVU14A
2013-10-01$118.10$65.94RVU13D
2013-07-01$118.10$65.94RVU13C
2013-04-01$118.10$65.94RVU13B
2013-01-01$118.10$65.94RVU13AR

Price 64480 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

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
RVUs for 64480PPRRVU2026_Oct_nonQPP.csv, line 7,127 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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