CPT code 64483: Transforaminal epidural injection, lumbar or sacral, first level2026 Medicare rate & RVUs in Metropolitan Boston, MA
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.
In Metropolitan Boston, MA, Medicare pays $305.07 for 64483 in the office and $107.66 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Metropolitan Boston, MA 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. Metropolitan Boston, MA pays $305.07. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Metropolitan Boston, MA · this page$305.07
- Rest of Massachusetts · Massachusetts$275.17−$29.90
- Los Angeles, CA · California$301.62−$3.45
- Washington, DC area · District of Columbia$303.98−$1.09
- Miami, FL · Florida$281.64−$23.43
- Chicago, IL · Illinois$273.64−$31.43
- Manhattan, NY · New York$304.13−$0.94
Other areas in Massachusetts first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $306.05 | $129.97 |
| 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 |
| Madera, CACalifornia | $282.24 | $101.03 |
| Merced, CACalifornia | $282.24 | $101.03 |
| Modesto, CACalifornia | $282.24 | $101.03 |
| Napa, CACalifornia | $328.74 | $110.83 |
| Oxnard, CACalifornia | $300.39 | $104.96 |
| Redding, CACalifornia | $282.24 | $101.03 |
| Rest of CaliforniaCalifornia | $282.24 | $101.03 |
| Riverside, CACalifornia | $284.10 | $102.89 |
| Sacramento, CACalifornia | $296.64 | $104.35 |
| Salinas, CACalifornia | $295.54 | $103.91 |
| San Diego, CACalifornia | $302.81 | $105.07 |
| Marin County, CACalifornia | $348.60 | $115.48 |
| San Francisco, CACalifornia | $348.41 | $115.29 |
| San Benito County, CACalifornia | $356.28 | $117.87 |
| Santa Clara County, CACalifornia | $355.49 | $117.08 |
| San Luis Obispo, CACalifornia | $290.72 | $102.41 |
| Santa Cruz, CACalifornia | $305.97 | $105.09 |
| Santa Maria, CACalifornia | $296.73 | $103.95 |
| Santa Rosa, CACalifornia | $309.10 | $106.06 |
| Stockton, CACalifornia | $282.24 | $101.03 |
| Vallejo, CACalifornia | $328.46 | $110.55 |
| Visalia, CACalifornia | $282.24 | $101.03 |
| Yuba City, CACalifornia | $282.24 | $101.03 |
| ColoradoColorado | $277.00 | $101.08 |
| ConnecticutConnecticut | $282.50 | $104.43 |
| DelawareDelaware | $262.24 | $98.89 |
| Fort Lauderdale, FLFlorida | $272.02 | $104.54 |
| Rest of FloridaFlorida | $259.04 | $100.98 |
| Atlanta, GAGeorgia | $269.35 | $101.37 |
| Rest of GeorgiaGeorgia | $244.64 | $97.16 |
| Hawaii, Guam, HIHawaii | $289.52 | $101.54 |
| IowaIowa | $244.67 | $93.39 |
| IdahoIdaho | $246.08 | $93.98 |
| East St. Louis, ILIllinois | $254.83 | $102.73 |
| Rest of IllinoisIllinois | $250.89 | $99.94 |
| Suburban Chicago, ILIllinois | $275.01 | $105.22 |
| IndianaIndiana | $247.54 | $94.28 |
| KansasKansas | $243.10 | $93.64 |
| KentuckyKentucky | $242.48 | $95.49 |
| New Orleans, LALouisiana | $253.99 | $98.42 |
| Rest of LouisianaLouisiana | $241.93 | $95.61 |
| Baltimore area, MDMaryland | $281.61 | $104.21 |
| Rest of MarylandMaryland | $267.39 | $100.07 |
| Rest of MaineMaine | $246.93 | $94.82 |
| Southern Maine, MEMaine | $261.00 | $97.15 |
| Detroit, MIMichigan | $261.86 | $102.31 |
| Rest of MichiganMichigan | $248.43 | $97.48 |
| MinnesotaMinnesota | $266.60 | $96.47 |
| Metropolitan Kansas City, MOMissouri | $252.70 | $97.45 |
| Metropolitan St. Louis, MOMissouri | $255.41 | $98.01 |
| Rest of MissouriMissouri | $237.48 | $94.96 |
| MississippiMississippi | $235.95 | $93.60 |
| MontanaMontana | $264.86 | $99.52 |
| North CarolinaNorth Carolina | $249.59 | $95.34 |
| North DakotaNorth Dakota | $261.50 | $96.16 |
| NebraskaNebraska | $246.14 | $93.53 |
| New HampshireNew Hampshire | $272.25 | $100.14 |
| Northern New JerseyNew Jersey | $300.73 | $108.94 |
| Rest of New JerseyNew Jersey | $286.05 | $105.51 |
| New MexicoNew Mexico | $249.63 | $98.01 |
| NevadaNevada | $264.12 | $98.62 |
| NYC suburbs and Long Island, NYNew York | $311.00 | $114.42 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $287.60 | $106.55 |
| Queens, NYNew York | $307.26 | $111.83 |
| Rest of New YorkNew York | $253.31 | $96.25 |
| OhioOhio | $247.74 | $96.79 |
| OklahomaOklahoma | $242.48 | $94.84 |
| Portland, OROregon | $286.32 | $102.63 |
| Rest of OregonOregon | $262.39 | $97.72 |
| Metropolitan Philadelphia, PAPennsylvania | $275.17 | $103.06 |
| Rest of PennsylvaniaPennsylvania | $248.37 | $96.59 |
| Puerto RicoPuerto Rico | $266.96 | $99.80 |
| Rhode IslandRhode Island | $271.94 | $101.15 |
| South CarolinaSouth Carolina | $249.02 | $96.25 |
| South DakotaSouth Dakota | $261.10 | $95.76 |
| TennesseeTennessee | $244.28 | $93.99 |
| Austin, TXTexas | $275.79 | $100.87 |
| Beaumont, TXTexas | $246.70 | $96.25 |
| Brazoria, TXTexas | $262.34 | $98.49 |
| Dallas, TXTexas | $263.83 | $99.16 |
| Fort Worth, TXTexas | $261.93 | $98.91 |
| Galveston, TXTexas | $263.01 | $98.83 |
| Houston, TXTexas | $266.12 | $101.94 |
| Rest of TexasTexas | $254.25 | $97.35 |
| UtahUtah | $252.45 | $97.03 |
| VirginiaVirginia | $259.84 | $97.32 |
| Virgin Islands, VIUnited States Virgin Islands | $266.96 | $99.80 |
| VermontVermont | $260.09 | $96.41 |
| Rest of WashingtonWashington | $274.78 | $100.68 |
| King County, WAWashington | $311.73 | $108.86 |
| WisconsinWisconsin | $252.65 | $94.26 |
| West VirginiaWest Virginia | $241.46 | $97.78 |
| WyomingWyoming | $263.39 | $98.06 |
64483 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.
$234.28
$319.26
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 | $306.05 | 1 |
| AL | $237.73 | 1 |
| AR | $234.28 | 1 |
| AZ | $257.93 | 1 |
| CA | $282.24–$356.28 | 29 |
| CO | $277.00 | 1 |
| CT | $282.50 | 1 |
| DC | $303.98 | 1 |
| DE | $262.24 | 1 |
| FL | $259.04–$281.64 | 3 |
| GA | $244.64–$269.35 | 2 |
| GU | $289.52 | 1 |
| HI | $289.52 | 1 |
| IA | $244.67 | 1 |
| ID | $246.08 | 1 |
| IL | $250.89–$275.01 | 4 |
| IN | $247.54 | 1 |
| KS | $243.10 | 1 |
| KY | $242.48 | 1 |
| LA | $241.93–$253.99 | 2 |
| MA | $275.17–$305.07 | 2 |
| MD | $267.39–$303.98 | 3 |
| ME | $246.93–$261.00 | 2 |
| MI | $248.43–$261.86 | 2 |
| MN | $266.60 | 1 |
| MO | $237.48–$255.41 | 3 |
| MS | $235.95 | 1 |
| MT | $264.86 | 1 |
| NC | $249.59 | 1 |
| ND | $261.50 | 1 |
| NE | $246.14 | 1 |
| NH | $272.25 | 1 |
| NJ | $286.05–$300.73 | 2 |
| NM | $249.63 | 1 |
| NV | $264.12 | 1 |
| NY | $253.31–$311.00 | 5 |
| OH | $247.74 | 1 |
| OK | $242.48 | 1 |
| OR | $262.39–$286.32 | 2 |
| PA | $248.37–$275.17 | 2 |
| PR | $266.96 | 1 |
| RI | $271.94 | 1 |
| SC | $249.02 | 1 |
| SD | $261.10 | 1 |
| TN | $244.28 | 1 |
| TX | $246.70–$275.79 | 8 |
| UT | $252.45 | 1 |
| VA | $259.84–$303.98 | 2 |
| VI | $266.96 | 1 |
| VT | $260.09 | 1 |
| WA | $274.78–$311.73 | 2 |
| WI | $252.65 | 1 |
| WV | $241.46 | 1 |
| WY | $263.39 | 1 |
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
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 Metropolitan Boston, MA 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
62
- Locality
- Metropolitan Boston, MA
- Physician work
- 1.041
- Practice expense
- 1.194
- Malpractice
- 0.890
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.85 | × 1.041 | 1.9259 |
| Practice expense | 5.91 | × 1.194 | 7.0565 |
| Malpractice | 0.17 | × 0.890 | 0.1513 |
| Total RVUs | 9.1337 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Metropolitan Boston, MA$305.07
Office: (1.85 × 1.041 + 5.91 × 1.194 + 0.17 × 0.89) × $33.4009 = $305.07
Facility: (1.85 × 1.041 + 0.96 × 1.194 + 0.17 × 0.89) × $33.4009 = $107.66
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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
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).
How 64483 has changed in Metropolitan Boston, MA
64483 · Office / nonfacility
$305.07
Effective 2026-10-01
The base rate is $33.52 higher than on 2025-10-01, moving from $271.55 to $305.07 (12.3%).
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
$271.55changed to$305.07
- 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
- Work GPCI 1.042 changed to 1.041
- Practice expense GPCI 1.197 changed to 1.194
- Malpractice GPCI 0.894 changed to 0.890
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$283.24changed to$271.55
- 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.
March 9, 2024
RVU24AR
$278.61changed to$283.24
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$287.29changed to$278.61
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.28 changed to 5.32
- Work GPCI 1.045 changed to 1.042
- Practice expense GPCI 1.200 changed to 1.197
- Malpractice GPCI 0.868 changed to 0.894
January 1, 2023
RVU23A
$297.24changed to$287.29
- 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 1.049 changed to 1.045
- Practice expense GPCI 1.203 changed to 1.200
- Malpractice GPCI 0.842 changed to 0.868
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$295.34changed to$297.24
- 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.
January 1, 2021
RVU21A
$277.44changed to$295.34
- 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 1.041 changed to 1.049
- Practice expense GPCI 1.191 changed to 1.203
- Malpractice GPCI 0.952 changed to 0.842
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$263.00changed to$277.44
- 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 1.033 changed to 1.041
- Practice expense GPCI 1.179 changed to 1.191
- Malpractice GPCI 1.061 changed to 0.952
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$252.48changed to$263.00
- 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.
January 1, 2018
RVU18AR1
$247.56changed to$252.48
- 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 1.025 changed to 1.033
- Practice expense GPCI 1.171 changed to 1.179
- Malpractice GPCI 0.839 changed to 1.061
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$247.61changed to$247.56
- 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 1.017 changed to 1.025
- Practice expense GPCI 1.163 changed to 1.171
- Malpractice GPCI 0.617 changed to 0.839
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$246.83changed to$247.61
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 4.16 changed to 4.20
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$245.60changed to$246.83
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$248.52changed to$245.60
- 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 1.016 changed to 1.017
- Practice expense GPCI 1.156 changed to 1.163
- Malpractice GPCI 0.704 changed to 0.617
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$248.52
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $305.07 | $107.66 | RVU26D |
| 2026-07-01 | $305.07 | $107.66 | RVU26C |
| 2026-04-01 | $305.07 | $107.66 | RVU26B |
| 2026-01-01 | $305.07 | $107.66 | RVU26A |
| 2025-10-01 | $271.55 | $117.84 | RVU25D |
| 2025-07-01 | $271.55 | $117.84 | RVU25C |
| 2025-04-01 | $271.55 | $117.84 | RVU25B |
| 2025-01-01 | $271.55 | $117.84 | RVU25A |
| 2024-10-01 | $283.24 | $120.67 | RVU24D |
| 2024-07-01 | $283.24 | $120.67 | RVU24C |
| 2024-04-01 | $283.24 | $120.67 | RVU24B |
| 2024-03-09 | $283.24 | $120.67 | RVU24AR |
| 2024-01-01 | $278.61 | $118.70 | RVU24A |
| 2023-10-01 | $287.29 | $120.97 | RVU23D |
| 2023-07-01 | $287.29 | $120.97 | RVU23C |
| 2023-04-01 | $287.29 | $120.97 | RVU23B |
| 2023-01-01 | $287.29 | $120.97 | RVU23A |
| 2022-10-01 | $297.24 | $123.22 | RVU22D |
| 2022-07-01 | $297.24 | $123.22 | RVU22C |
| 2022-04-01 | $297.24 | $123.22 | RVU22B |
| 2022-01-01 | $297.24 | $123.22 | RVU22A |
| 2021-10-01 | $295.34 | $124.07 | RVU21D |
| 2021-07-01 | $295.34 | $124.07 | RVU21C |
| 2021-04-01 | $295.34 | $124.07 | RVU21B |
| 2021-01-01 | $295.34 | $124.07 | RVU21A |
| 2020-10-01 | $277.44 | $126.14 | RVU20D |
| 2020-07-01 | $277.44 | $126.14 | RVU20C |
| 2020-04-01 | $277.44 | $126.14 | RVU20B |
| 2020-01-01 | $277.44 | $126.14 | RVU20A |
| 2019-10-01 | $263.00 | $124.91 | RVU19D |
| 2019-07-01 | $263.00 | $124.91 | RVU19C |
| 2019-04-01 | $263.00 | $124.91 | RVU19B |
| 2019-01-01 | $263.00 | $124.91 | RVU19A |
| 2018-10-01 | $252.48 | $126.00 | RVU18D |
| 2018-07-01 | $252.48 | $126.00 | RVU18C |
| 2018-04-01 | $252.48 | $126.00 | RVU18B |
| 2018-01-01 | $252.48 | $126.00 | RVU18AR1 |
| 2017-10-01 | $247.56 | $123.16 | RVU17D |
| 2017-07-01 | $247.56 | $123.16 | RVU17C |
| 2017-04-01 | $247.56 | $123.16 | RVU17B |
| 2017-01-01 | $247.56 | $123.16 | RVU17A |
| 2016-10-01 | $247.61 | $122.27 | RVU16D |
| 2016-07-01 | $247.61 | $122.27 | RVU16C |
| 2016-04-01 | $247.61 | $122.27 | RVU16B |
| 2016-01-01 | $247.61 | $122.27 | RVU16A |
| 2015-10-01 | $246.83 | $122.71 | RVU15D |
| 2015-07-01 | $246.83 | $122.71 | RVU15C |
| 2015-04-01 | $245.60 | $122.10 | RVU15B |
| 2015-01-01 | $245.60 | $122.10 | RVU15A |
| 2014-10-01 | $248.52 | $122.63 | RVU14D |
| 2014-07-01 | $248.52 | $122.63 | RVU14C |
| 2014-04-01 | $248.52 | $122.63 | RVU14B |
| 2014-01-01 | $248.52 | $122.63 | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Metropolitan Boston, MA rate applies
Metropolitan Boston, MA is a Medicare payment area, not a city. Our Census mapping connects it to 60 cities and communities in Massachusetts. Some span more than one payment area; confirm with the service ZIP.
- Boston
- Arlington
- Ayer
- Bellingham
- Belmont
- Braintree Town
- Brookline
- Burlington
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
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