CPT code 64483: Transforaminal epidural injection, lumbar or sacral, first level2026 Medicare rate & RVUs in Pennsylvania
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.
Medicare pays $248.37–$275.17 for 64483 in the office in Pennsylvania, from Rest of Pennsylvania to Metropolitan Philadelphia, PA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia, PA | $275.17 | $103.06 |
| Rest of Pennsylvania | $248.37 | $96.59 |
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.
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).
64483 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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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