CPT code 64493: Facet joint injection, lumbar or sacral, one level2026 Medicare rate & RVUs in Riverside, CA
Reports an image-guided injection into a lumbar or sacral facet joint, or its innervating nerves, at one spinal level for diagnostic or therapeutic care.
In Riverside, CA, Medicare pays $203.67 for 64493 in the office and $84.33 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 64493 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 64493 covers
A physician, commonly a pain specialist, anesthesiologist, or radiologist, uses fluoroscopy or CT to guide an injection to a lumbar or sacral paravertebral facet joint or the nerves supplying it. The injection may be diagnostic, such as evaluating suspected facet-mediated back pain, or therapeutic. The code represents one spinal level, not one needle or one side; the documented target must be in the lumbar or sacral region.
Report 64493 for the first treated level. Document the spinal level, side, target, clinical reason, and image guidance. The imaging guidance is part of the service. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 Riverside, CA compares for 64493
Across 109 of 109 payment localities, the office rate for 64493 runs from $168.90 in Arkansas to $253.89 in San Benito County, CA. Riverside, CA pays $203.67. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Riverside, CA · this page$203.67
- Bakersfield, CA · California$202.58−$1.09
- Chico, CA · California$202.14−$1.53
- El Centro, CA · California$202.16−$1.51
- Fresno, CA · California$202.14−$1.53
- Hanford, CA · California$202.14−$1.53
- Los Angeles, CA · California$215.78+$12.11
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Madera, CACalifornia | $202.14 | $82.80 |
| Merced, CACalifornia | $202.14 | $82.80 |
| Modesto, CACalifornia | $202.14 | $82.80 |
| Napa, CACalifornia | $234.53 | $91.02 |
| Oxnard, CACalifornia | $214.81 | $86.10 |
| Redding, CACalifornia | $202.14 | $82.80 |
| Rest of CaliforniaCalifornia | $202.14 | $82.80 |
| Sacramento, CACalifornia | $212.21 | $85.57 |
| Salinas, CACalifornia | $211.42 | $85.22 |
| San Diego, CACalifornia | $216.44 | $86.21 |
| Marin County, CACalifornia | $248.42 | $94.89 |
| San Francisco, CACalifornia | $248.27 | $94.73 |
| San Benito County, CACalifornia | $253.89 | $96.87 |
| Santa Clara County, CACalifornia | $253.24 | $96.22 |
| San Luis Obispo, CACalifornia | $208.00 | $83.98 |
| Santa Cruz, CACalifornia | $218.55 | $86.26 |
| Santa Maria, CACalifornia | $212.22 | $85.26 |
| Santa Rosa, CACalifornia | $220.77 | $87.06 |
| Stockton, CACalifornia | $202.14 | $82.80 |
| Vallejo, CACalifornia | $234.31 | $90.79 |
| Visalia, CACalifornia | $202.14 | $82.80 |
| Yuba City, CACalifornia | $202.14 | $82.80 |
| Washington, DC areaDistrict of Columbia | $217.84 | $89.57 |
| Miami, FLFlorida | $203.12 | $89.77 |
| Chicago, ILIllinois | $197.47 | $88.04 |
| Manhattan, NYNew York | $218.37 | $91.84 |
| AlaskaAlaska | $221.86 | $105.90 |
| AlabamaAlabama | $171.32 | $76.05 |
| ArkansasArkansas | $168.90 | $75.37 |
| ArizonaArizona | $185.49 | $79.98 |
| ColoradoColorado | $198.68 | $82.82 |
| ConnecticutConnecticut | $202.85 | $85.58 |
| DelawareDelaware | $188.52 | $80.94 |
| Fort Lauderdale, FLFlorida | $195.94 | $85.63 |
| Rest of FloridaFlorida | $186.74 | $82.65 |
| Atlanta, GAGeorgia | $193.65 | $83.02 |
| Rest of GeorgiaGeorgia | $176.57 | $79.44 |
| Hawaii, Guam, HIHawaii | $207.09 | $83.28 |
| IowaIowa | $175.98 | $76.35 |
| IdahoIdaho | $177.02 | $76.84 |
| East St. Louis, ILIllinois | $184.22 | $84.05 |
| Rest of IllinoisIllinois | $181.16 | $81.75 |
| Suburban Chicago, ILIllinois | $198.02 | $86.19 |
| IndianaIndiana | $178.03 | $77.10 |
| KansasKansas | $174.98 | $76.55 |
| KentuckyKentucky | $174.86 | $78.06 |
| New Orleans, LALouisiana | $182.98 | $80.52 |
| Rest of LouisianaLouisiana | $174.52 | $78.15 |
| Metropolitan Boston, MAMassachusetts | $218.34 | $88.32 |
| Rest of MassachusettsMassachusetts | $197.45 | $82.79 |
| Baltimore area, MDMaryland | $202.23 | $85.40 |
| Rest of MarylandMaryland | $192.13 | $81.94 |
| Rest of MaineMaine | $177.72 | $77.54 |
| Southern Maine, MEMaine | $187.43 | $79.53 |
| Detroit, MIMichigan | $188.82 | $83.75 |
| Rest of MichiganMichigan | $179.13 | $79.72 |
| MinnesotaMinnesota | $191.05 | $79.00 |
| Metropolitan Kansas City, MOMissouri | $181.96 | $79.72 |
| Metropolitan St. Louis, MOMissouri | $183.85 | $80.19 |
| Rest of MissouriMissouri | $171.46 | $77.60 |
| MississippiMississippi | $170.22 | $76.47 |
| MontanaMontana | $190.38 | $81.49 |
| North CarolinaNorth Carolina | $179.57 | $77.98 |
| North DakotaNorth Dakota | $187.61 | $78.72 |
| NebraskaNebraska | $176.98 | $76.48 |
| New HampshireNew Hampshire | $195.39 | $82.04 |
| Northern New JerseyNew Jersey | $215.62 | $89.31 |
| Rest of New JerseyNew Jersey | $205.35 | $86.45 |
| New MexicoNew Mexico | $180.01 | $80.16 |
| NevadaNevada | $189.74 | $80.74 |
| NYC suburbs and Long Island, NYNew York | $223.31 | $93.85 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $206.54 | $87.31 |
| Queens, NYNew York | $220.42 | $91.71 |
| Rest of New YorkNew York | $182.18 | $78.74 |
| OhioOhio | $178.57 | $79.15 |
| OklahomaOklahoma | $174.76 | $77.52 |
| Portland, OROregon | $205.11 | $84.13 |
| Rest of OregonOregon | $188.45 | $80.00 |
| Metropolitan Philadelphia, PAPennsylvania | $197.76 | $84.41 |
| Rest of PennsylvaniaPennsylvania | $178.95 | $79.00 |
| Puerto RicoPuerto Rico | $191.81 | $81.73 |
| Rhode IslandRhode Island | $195.32 | $82.84 |
| South CarolinaSouth Carolina | $179.33 | $78.72 |
| South DakotaSouth Dakota | $187.28 | $78.39 |
| TennesseeTennessee | $175.82 | $76.84 |
| Austin, TXTexas | $197.85 | $82.65 |
| Beaumont, TXTexas | $177.79 | $78.70 |
| Brazoria, TXTexas | $188.53 | $80.62 |
| Dallas, TXTexas | $189.62 | $81.17 |
| Fort Worth, TXTexas | $188.32 | $80.96 |
| Galveston, TXTexas | $189.02 | $80.90 |
| Houston, TXTexas | $191.58 | $83.46 |
| Rest of TexasTexas | $182.98 | $79.65 |
| UtahUtah | $181.73 | $79.38 |
| VirginiaVirginia | $186.69 | $79.66 |
| Virgin Islands, VIUnited States Virgin Islands | $191.81 | $81.73 |
| VermontVermont | $186.71 | $78.91 |
| Rest of WashingtonWashington | $197.13 | $82.47 |
| King County, WAWashington | $222.94 | $89.33 |
| WisconsinWisconsin | $181.43 | $77.11 |
| West VirginiaWest Virginia | $174.55 | $79.93 |
| WyomingWyoming | $189.17 | $80.28 |
64493 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.
$168.90
$228.02
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 | $221.86 | 1 |
| AL | $171.32 | 1 |
| AR | $168.90 | 1 |
| AZ | $185.49 | 1 |
| CA | $202.14–$253.89 | 29 |
| CO | $198.68 | 1 |
| CT | $202.85 | 1 |
| DC | $217.84 | 1 |
| DE | $188.52 | 1 |
| FL | $186.74–$203.12 | 3 |
| GA | $176.57–$193.65 | 2 |
| GU | $207.09 | 1 |
| HI | $207.09 | 1 |
| IA | $175.98 | 1 |
| ID | $177.02 | 1 |
| IL | $181.16–$198.02 | 4 |
| IN | $178.03 | 1 |
| KS | $174.98 | 1 |
| KY | $174.86 | 1 |
| LA | $174.52–$182.98 | 2 |
| MA | $197.45–$218.34 | 2 |
| MD | $192.13–$217.84 | 3 |
| ME | $177.72–$187.43 | 2 |
| MI | $179.13–$188.82 | 2 |
| MN | $191.05 | 1 |
| MO | $171.46–$183.85 | 3 |
| MS | $170.22 | 1 |
| MT | $190.38 | 1 |
| NC | $179.57 | 1 |
| ND | $187.61 | 1 |
| NE | $176.98 | 1 |
| NH | $195.39 | 1 |
| NJ | $205.35–$215.62 | 2 |
| NM | $180.01 | 1 |
| NV | $189.74 | 1 |
| NY | $182.18–$223.31 | 5 |
| OH | $178.57 | 1 |
| OK | $174.76 | 1 |
| OR | $188.45–$205.11 | 2 |
| PA | $178.95–$197.76 | 2 |
| PR | $191.81 | 1 |
| RI | $195.32 | 1 |
| SC | $179.33 | 1 |
| SD | $187.28 | 1 |
| TN | $175.82 | 1 |
| TX | $177.79–$197.85 | 8 |
| UT | $181.73 | 1 |
| VA | $186.69–$217.84 | 2 |
| VI | $191.81 | 1 |
| VT | $186.71 | 1 |
| WA | $197.13–$222.94 | 2 |
| WI | $181.43 | 1 |
| WV | $174.55 | 1 |
| WY | $189.17 | 1 |
How the 64493 rate is calculated
Each of 64493’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 · 64493
RVUs × geographic indexes × conversion factor
Work1.48
1.48 RVUs× 1.000 GPCI
Practice expense4.08
4.08 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
5.7000
Conversion factor
$33.4009
Medicare rate
$190.39
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Riverside, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,137
- Code
- 64493
- Physician work
- 1.48
- Practice expense
- 4.08
- Malpractice
- 0.14
GPCI2026.csv
20
- Locality
- Riverside, CA
- Physician work
- 1.018
- Practice expense
- 1.096
- Malpractice
- 0.853
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.48 | × 1.018 | 1.5066 |
| Practice expense | 4.08 | × 1.096 | 4.4717 |
| Malpractice | 0.14 | × 0.853 | 0.1194 |
| Total RVUs | 6.0977 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Riverside, CA$203.67
Office: (1.48 × 1.018 + 4.08 × 1.096 + 0.14 × 0.853) × $33.4009 = $203.67
Facility: (1.48 × 1.018 + 0.82 × 1.096 + 0.14 × 0.853) × $33.4009 = $84.33
Payment rules and modifiers for 64493
The CMS indicators that decide how 64493 is paid alongside other services.
CMS payment indicators · 64493
Facet joint injection, lumbar or sacral, one 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) | 2 | Paid. |
| 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
64493 without 50 · national office
$190.39
Facet joint injection, lumbar or sacral, one level
64493-50 · Bilateral: 150%
$285.59
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 64493 has changed in Riverside, CA
64493 · Office / nonfacility
$203.67
Effective 2026-10-01
The base rate is $20.51 higher than on 2025-10-01, moving from $183.16 to $203.67 (11.2%).
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
$183.16changed to$203.67
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.52 changed to 1.48
- Practice expense RVU 3.64 changed to 4.08
- Malpractice RVU 0.16 changed to 0.14
- Work GPCI 1.014 changed to 1.018
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.892 changed to 0.853
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$188.92changed to$183.16
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.66 changed to 3.64
- Malpractice RVU 0.15 changed to 0.16
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$185.84changed to$188.92
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$188.81changed to$185.84
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.58 changed to 3.66
- Malpractice RVU 0.17 changed to 0.15
- Work GPCI 1.021 changed to 1.014
- Practice expense GPCI 1.079 changed to 1.093
- Malpractice GPCI 0.924 changed to 0.892
January 1, 2023
RVU23A
$189.85changed to$188.81
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.56 changed to 3.58
- Malpractice RVU 0.14 changed to 0.17
- Work GPCI 1.027 changed to 1.021
- Practice expense GPCI 1.065 changed to 1.079
- Malpractice GPCI 0.955 changed to 0.924
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$192.20changed to$189.85
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.58 changed to 3.56
- Malpractice RVU 0.15 changed to 0.14
- Malpractice GPCI 0.896 changed to 0.955
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$186.73changed to$192.20
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.28 changed to 3.58
- Malpractice RVU 0.13 changed to 0.15
- Work GPCI 1.024 changed to 1.027
- Practice expense GPCI 1.070 changed to 1.065
- Malpractice GPCI 0.830 changed to 0.896
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$185.64changed to$186.73
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.26 changed to 3.28
- Work GPCI 1.021 changed to 1.024
- Practice expense GPCI 1.074 changed to 1.070
- Malpractice GPCI 0.753 changed to 0.830
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$183.92changed to$185.64
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.23 changed to 3.26
- Work GPCI 1.020 changed to 1.021
- Malpractice GPCI 0.689 changed to 0.753
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$182.70changed to$183.92
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.20 changed to 3.23
- Work GPCI 1.024 changed to 1.020
- Practice expense GPCI 1.079 changed to 1.074
- Malpractice GPCI 0.626 changed to 0.689
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$182.70
Held through RVU17B, RVU17C, RVU17D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $203.67 | $84.33 | RVU26D |
| 2026-07-01 | $203.67 | $84.33 | RVU26C |
| 2026-04-01 | $203.67 | $84.33 | RVU26B |
| 2026-01-01 | $203.67 | $84.33 | RVU26A |
| 2025-10-01 | $183.16 | $91.59 | RVU25D |
| 2025-07-01 | $183.16 | $91.59 | RVU25C |
| 2025-04-01 | $183.16 | $91.59 | RVU25B |
| 2025-01-01 | $183.16 | $91.59 | RVU25A |
| 2024-10-01 | $188.92 | $93.23 | RVU24D |
| 2024-07-01 | $188.92 | $93.23 | RVU24C |
| 2024-04-01 | $188.92 | $93.23 | RVU24B |
| 2024-03-09 | $188.92 | $93.23 | RVU24AR |
| 2024-01-01 | $185.84 | $91.71 | RVU24A |
| 2023-10-01 | $188.81 | $93.75 | RVU23D |
| 2023-07-01 | $188.81 | $93.75 | RVU23C |
| 2023-04-01 | $188.81 | $93.75 | RVU23B |
| 2023-01-01 | $188.81 | $93.75 | RVU23A |
| 2022-10-01 | $189.85 | $94.40 | RVU22D |
| 2022-07-01 | $189.85 | $94.40 | RVU22C |
| 2022-04-01 | $189.85 | $94.40 | RVU22B |
| 2022-01-01 | $189.85 | $94.40 | RVU22A |
| 2021-10-01 | $192.20 | $95.21 | RVU21D |
| 2021-07-01 | $192.20 | $95.21 | RVU21C |
| 2021-04-01 | $192.20 | $95.21 | RVU21B |
| 2021-01-01 | $192.20 | $95.21 | RVU21A |
| 2020-10-01 | $186.73 | $95.98 | RVU20D |
| 2020-07-01 | $186.73 | $95.98 | RVU20C |
| 2020-04-01 | $186.73 | $95.98 | RVU20B |
| 2020-01-01 | $186.73 | $95.98 | RVU20A |
| 2019-10-01 | $185.64 | $95.45 | RVU19D |
| 2019-07-01 | $185.64 | $95.45 | RVU19C |
| 2019-04-01 | $185.64 | $95.45 | RVU19B |
| 2019-01-01 | $185.64 | $95.45 | RVU19A |
| 2018-10-01 | $183.92 | $95.77 | RVU18D |
| 2018-07-01 | $183.92 | $95.77 | RVU18C |
| 2018-04-01 | $183.92 | $95.77 | RVU18B |
| 2018-01-01 | $183.92 | $95.77 | RVU18AR1 |
| 2017-10-01 | $182.70 | $95.57 | RVU17D |
| 2017-07-01 | $182.70 | $95.57 | RVU17C |
| 2017-04-01 | $182.70 | $95.57 | RVU17B |
| 2017-01-01 | $182.70 | $95.57 | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | 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 Riverside, CA rate applies
Riverside, CA is a Medicare payment area, not a city. Our Census mapping connects it to 127 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Ontario
- Riverside
- San Bernardino
- Adelanto
- Aguanga
- Anza
- Apple Valley
- Baker
64493 billing questions
When should 64493 be used instead of 64494?
Use 64493 for the first lumbar or sacral spinal level treated. Report 64494 as the add-on for the second level.
Can 64493 be reported bilaterally?
Yes. For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Is fluoroscopy or CT billed separately?
No. Image guidance by fluoroscopy or CT is included in the facet-joint injection service.
What documentation supports 64493?
Document the lumbar or sacral level, the side and injection target, the clinical indication, and use of fluoroscopy or CT guidance.
How does CMS handle other procedures in the same session?
The highest-valued procedure is paid in full, while other procedures are subject to the standard multiple-procedure reduction. Same-day preoperative and postoperative care is included in the 0-day global period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. CMS does not permit co-surgeons or team surgery for this code.
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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