CPT code 64483: Transforaminal epidural injection, lumbar or sacral, first level2026 Medicare rate & RVUs

Medicare pays $264.87 for 64483 nationally in the office and $99.53 in a hospital or facility. Local office rates run $234.28–$356.28.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 64483 covers

At a lumbar or sacral neural foramen, the clinician advances a needle under fluoroscopy or CT to deliver local anesthetic, corticosteroid, or both near the affected nerve root and epidural space. Typical indications include radicular leg pain associated with a herniated lumbar disc or foraminal stenosis; an S1 foraminal injection is a sacral example. Interventional pain physicians, anesthesiologists, and physiatrists perform these injections in offices, ambulatory surgery centers, and hospital outpatient departments. Contrast may be used to confirm needle position and epidural spread.

Report one unit of 64483 for the first lumbar or sacral level, whether unilateral or bilateral; report 64484 for each additional level. Fluoroscopic or CT guidance is included. Document the treated level, side, guidance method, contrast findings when contrast is used, and injectate. For both sides at the same level, report 64483 with modifier 50; CMS pays bilateral procedures at 150% of the unilateral amount. The 0-day global includes routine same-day preoperative and postoperative care. When multiple procedures are performed in one session, CMS pays the highest-valued procedure in full and other eligible procedures at 50%. CMS does not pay an assistant at surgery; 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.

Where 64483 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

64483 rates by state

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

How the 64483 rate is calculated

Each of 64483’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.

Payment rules and modifiers for 64483

The CMS indicators that decide how 64483 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

64483 compared with similar codes

How to choose

62323Lumbar epidural injectionInterlaminar or caudal, with imaging guidance

62323 covers an interlaminar or caudal approach into the lumbar or sacral epidural space. Report 64483 when the needle enters through a neural foramen.

64479Epidural injectionCervical/thoracic, first level

64479 is the first-level transforaminal code for the cervical or thoracic spine. Use 64483 for lumbar levels and sacral foramina.

64484Epidural injectionEach additional lumbar or sacral level

64484 is an add-on for each additional lumbar or sacral transforaminal level and cannot be reported alone. Report 64483 for the first level.

64493Facet joint injectionLumbar or sacral, one level

64493 targets a lumbar facet joint or its medial branch nerves. 64483 delivers medication into the epidural space through a neural foramen.

Codes related to 64483

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

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

Open CMS sourceHow we calculate rates