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

Image-guided injection of anesthetic and/or steroid through a lumbar or sacral neural foramen into the epidural space, reported for the first level treated.

CMS RVU26DEffective Oct 1, 2026One payment locality898K Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $289.52 for 64483 in the office and $101.54 when it’s performed in a hospital or facility.

$289.52Office (non-facility)
$101.54Hospital or facility
+9.3%vs the national office rate ($264.87)

Check a contract rate as a % of Medicare · 64483 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 64483 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 64483 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 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.

How Hawaii, Guam, HI compares for 64483

Across 109 of 109 payment localities, the office rate for 64483 runs from $234.28 in Arkansas to $356.28 in San Benito County, CA. Hawaii, Guam, HI pays $289.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

64483 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$289.52
  2. Los Angeles, CA · California$301.62+$12.10
  3. Washington, DC area · District of Columbia$303.98+$14.46
  4. Miami, FL · Florida$281.64−$7.88
  5. Chicago, IL · Illinois$273.64−$15.88
  6. Manhattan, NY · New York$304.13+$14.61
  7. Alaska · Alaska$306.05+$16.53

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

Every other payment area

64483 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$237.73$93.06
ArkansasArkansas$234.28$92.26
ArizonaArizona$257.93$97.72
Bakersfield, CACalifornia$282.77$101.57
Chico, CACalifornia$282.24$101.03
El Centro, CACalifornia$282.26$101.06
Fresno, CACalifornia$282.24$101.03
Hanford, CACalifornia$282.24$101.03

64483 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.

$234.28

$319.26

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

View every state and territory as a table
64483 office rate range by state
State / territoryOffice rate rangeLocalities
AK$306.051
AL$237.731
AR$234.281
AZ$257.931
CA$282.24–$356.2829
CO$277.001
CT$282.501
DC$303.981
DE$262.241
FL$259.04–$281.643
GA$244.64–$269.352
GU$289.521
HI$289.521
IA$244.671
ID$246.081
IL$250.89–$275.014
IN$247.541
KS$243.101
KY$242.481
LA$241.93–$253.992
MA$275.17–$305.072
MD$267.39–$303.983
ME$246.93–$261.002
MI$248.43–$261.862
MN$266.601
MO$237.48–$255.413
MS$235.951
MT$264.861
NC$249.591
ND$261.501
NE$246.141
NH$272.251
NJ$286.05–$300.732
NM$249.631
NV$264.121
NY$253.31–$311.005
OH$247.741
OK$242.481
OR$262.39–$286.322
PA$248.37–$275.172
PR$266.961
RI$271.941
SC$249.021
SD$261.101
TN$244.281
TX$246.70–$275.798
UT$252.451
VA$259.84–$303.982
VI$266.961
VT$260.091
WA$274.78–$311.732
WI$252.651
WV$241.461
WY$263.391

See 64483 in every payment locality

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.

How the rate is built · 64483

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.85

1.85 RVUs× 1.000 GPCI

Practice expense5.91

5.91 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

7.9300

Conversion factor

$33.4009

Medicare rate

$264.87

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,128

Code
64483
Physician work
1.85
Practice expense
5.91
Malpractice
0.17

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 64483 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work1.85× 1.0001.8500
Practice expense5.91× 1.1376.7197
Malpractice0.17× 0.5790.0984
Total RVUs8.6681
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$289.52

Office: (1.85 × 1 + 5.91 × 1.137 + 0.17 × 0.579) × $33.4009 = $289.52

Facility: (1.85 × 1 + 0.96 × 1.137 + 0.17 × 0.579) × $33.4009 = $101.54

Open 64483 in the RVU calculator

Payment rules and modifiers for 64483

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

CMS payment indicators · 64483

Transforaminal epidural injection, lumbar or sacral, first level

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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

64483 without 50 · national office

$264.87

Transforaminal epidural injection, lumbar or sacral, first level

64483-50 · Bilateral: 150%

$397.31

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 64483

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

Codes related to 64483
CodeHow it relatesOffice range, Hawaii, Guam, HI
Add-on codes
64484Epidural injection, each additional lumbar or sacral levelAdd-on reported for each additional lumbar or sacral transforaminal level.$127.70
Same family
64479Epidural injection, cervical/thoracic, first levelCervical or thoracic transforaminal epidural injection, first level.$310.39
64480Epidural injection, additional cervical/thoracic levelAdd-on for each additional cervical or thoracic transforaminal level.$155.14
Used instead
62323Lumbar epidural injection, interlaminar or caudal, with imaging guidanceInterlaminar or caudal lumbar or sacral epidural injection with imaging guidance.$299.43

How 64483 has changed in Hawaii, Guam, HI

64483 · Office / nonfacility

$289.52

Effective 2026-10-01

The base rate is $30.41 higher than on 2025-10-01, moving from $259.11 to $289.52 (11.7%).

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

    $259.11changed to$289.52

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.90 changed to 1.85
    • Practice expense RVU 5.24 changed to 5.91
    • Malpractice RVU 0.16 changed to 0.17
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $270.08changed to$259.11

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.32 changed to 5.24
    • Malpractice RVU 0.18 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $265.68changed to$270.08

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $273.40changed to$265.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.28 changed to 5.32
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $282.47changed to$273.40

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.35 changed to 5.28
    • Malpractice RVU 0.19 changed to 0.18
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $280.75changed to$282.47

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.26 changed to 5.35
    • Malpractice RVU 0.17 changed to 0.19

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $265.15changed to$280.75

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.65 changed to 5.26
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $253.17changed to$265.15

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.39 changed to 4.65
    • Malpractice RVU 0.15 changed to 0.18
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $242.80changed to$253.17

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.14 changed to 4.39
    • Malpractice RVU 0.16 changed to 0.15

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $242.27changed to$242.80

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.12 changed to 4.14
    • Malpractice RVU 0.15 changed to 0.16
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $246.51changed to$242.27

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.20 changed to 4.12
    • Malpractice RVU 0.16 changed to 0.15
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $245.73changed to$246.51

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.16 changed to 4.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $244.51changed to$245.73

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $247.63changed to$244.51

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.24 changed to 4.16
    • Malpractice RVU 0.15 changed to 0.16
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $256.91changed to$247.63

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.80 changed to 4.24
    • Malpractice RVU 0.16 changed to 0.15
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$256.91

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$289.52$101.54RVU26D
2026-07-01$289.52$101.54RVU26C
2026-04-01$289.52$101.54RVU26B
2026-01-01$289.52$101.54RVU26A
2025-10-01$259.11$111.56RVU25D
2025-07-01$259.11$111.56RVU25C
2025-04-01$259.11$111.56RVU25B
2025-01-01$259.11$111.56RVU25A
2024-10-01$270.08$114.03RVU24D
2024-07-01$270.08$114.03RVU24C
2024-04-01$270.08$114.03RVU24B
2024-03-09$270.08$114.03RVU24AR
2024-01-01$265.68$112.17RVU24A
2023-10-01$273.40$114.56RVU23D
2023-07-01$273.40$114.56RVU23C
2023-04-01$273.40$114.56RVU23B
2023-01-01$273.40$114.56RVU23A
2022-10-01$282.47$117.13RVU22D
2022-07-01$282.47$117.13RVU22C
2022-04-01$282.47$117.13RVU22B
2022-01-01$282.47$117.13RVU22A
2021-10-01$280.75$118.03RVU21D
2021-07-01$280.75$118.03RVU21C
2021-04-01$280.75$118.03RVU21B
2021-01-01$280.75$118.03RVU21A
2020-10-01$265.15$119.82RVU20D
2020-07-01$265.15$119.82RVU20C
2020-04-01$265.15$119.82RVU20B
2020-01-01$265.15$119.82RVU20A
2019-10-01$253.17$118.94RVU19D
2019-07-01$253.17$118.94RVU19C
2019-04-01$253.17$118.94RVU19B
2019-01-01$253.17$118.94RVU19A
2018-10-01$242.80$119.86RVU18D
2018-07-01$242.80$119.86RVU18C
2018-04-01$242.80$119.86RVU18B
2018-01-01$242.80$119.86RVU18AR1
2017-10-01$242.27$119.68RVU17D
2017-07-01$242.27$119.68RVU17C
2017-04-01$242.27$119.68RVU17B
2017-01-01$242.27$119.68RVU17A
2016-10-01$246.51$121.28RVU16D
2016-07-01$246.51$121.28RVU16C
2016-04-01$246.51$121.28RVU16B
2016-01-01$246.51$121.28RVU16A
2015-10-01$245.73$121.72RVU15D
2015-07-01$245.73$121.72RVU15C
2015-04-01$244.51$121.11RVU15B
2015-01-01$244.51$121.11RVU15A
2014-10-01$247.63$121.52RVU14D
2014-07-01$247.63$121.52RVU14C
2014-04-01$247.63$121.52RVU14B
2014-01-01$247.63$121.52RVU14A
2013-10-01$256.91$120.67RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 64483 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

64483 billing questions

How are two lumbar levels reported?

Report one unit of 64483 for the first level and one unit of 64484 for the additional level. Document the side treated at each level.

How is a bilateral injection at one level billed?

Report 64483 with modifier 50 when the same level is injected on both the left and right. CMS pays the bilateral procedure at 150% of the unilateral amount.

Can fluoroscopy or CT guidance be billed separately?

No. Fluoroscopic or CT guidance is included in 64483, so codes such as 77003 or 77012 are not reported separately for the same injection.

What if the injection is done under ultrasound guidance only?

64483 describes an injection performed with fluoroscopic or CT guidance. For ultrasound-guided lumbar or sacral transforaminal injections, 0230T describes the first level and 0231T describes each additional level.

Is an S1 transforaminal injection reported with this code?

Yes. An injection through the S1 foramen is sacral and falls under 64483 rather than the cervical or thoracic first-level code 64479.

Is a same-day E/M visit separately reportable?

Routine same-day preoperative and postoperative care is included in the 0-day global. A significant, separately identifiable E/M service beyond that care may be reported with modifier 25.

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 64483PPRRVU2026_Oct_nonQPP.csv, line 7,128 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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