$241.03–$369.32
62323 covers an interlaminar or caudal approach into the lumbar or sacral epidural space. Report 64483 when the needle enters through a neural foramen.
On this page
CMS RVU26D · Effective 2026-10-01
64483 Transforaminal epidural injection Medicare reimbursement rates
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. Compare 64483 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 64483?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$234.28–$356.28
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $122.00 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 64483 pays more and less
109 payment localities
$234.28 to $356.28
Spine pain management
About 64483: Lumbar or sacral transforaminal epidural injection, single level
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.
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.
CMS billing rules for 64483
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.85 · 23%
- Practice expense (office) RVU5.91 · 75%
- Malpractice RVU0.17 · 2%
898K
Medicare services in 2024 · #155 by national volume
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.
64483 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$253.23–$380.54
64479 is the first-level transforaminal code for the cervical or thoracic spine. Use 64483 for lumbar levels and sacral foramina.
$104.69–$156.25
64484 is an add-on for each additional lumbar or sacral transforaminal level and cannot be reported alone. Report 64483 for the first level.
$168.90–$253.89
64493 targets a lumbar facet joint or its medial branch nerves. 64483 delivers medication into the epidural space through a neural foramen.
See how rates vary across the country
64483 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Compare 64483 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $237.73 | Facility $93.06 |
| Alaska* | Office $306.05 | Facility $129.97 |
| Arizona | Office $257.93 | Facility $97.72 |
| Arkansas | Office $234.28 | Facility $92.26 |
| Atlanta | Office $269.35 | Facility $101.37 |
| Austin | Office $275.79 | Facility $100.87 |
| Bakersfield | Office $282.77 | Facility $101.57 |
| Baltimore/Surr. Cntys | Office $281.61 | Facility $104.21 |
| Beaumont | Office $246.70 | Facility $96.25 |
| Brazoria | Office $262.34 | Facility $98.49 |
| Chicago | Office $273.64 | Facility $107.48 |
| Chico | Office $282.24 | Facility $101.03 |
| Colorado | Office $277.00 | Facility $101.08 |
| Connecticut | Office $282.50 | Facility $104.43 |
| Dallas | Office $263.83 | Facility $99.16 |
| Dc + Md/Va Suburbs | Office $303.98 | Facility $109.22 |
| Delaware | Office $262.24 | Facility $98.89 |
| Detroit | Office $261.86 | Facility $102.31 |
| East St. Louis | Office $254.83 | Facility $102.73 |
| El Centro | Office $282.26 | Facility $101.06 |
| Fort Lauderdale | Office $272.02 | Facility $104.54 |
| Fort Worth | Office $261.93 | Facility $98.91 |
| Fresno | Office $282.24 | Facility $101.03 |
| Galveston | Office $263.01 | Facility $98.83 |
| Hanford-Corcoran | Office $282.24 | Facility $101.03 |
| Hawaii, Guam | Office $289.52 | Facility $101.54 |
| Houston | Office $266.12 | Facility $101.94 |
| Idaho | Office $246.08 | Facility $93.98 |
| Indiana | Office $247.54 | Facility $94.28 |
| Iowa | Office $244.67 | Facility $93.39 |
| Kansas | Office $243.10 | Facility $93.64 |
| Kentucky | Office $242.48 | Facility $95.49 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $301.62 | Facility $106.03 |
| Madera | Office $282.24 | Facility $101.03 |
| Manhattan | Office $304.13 | Facility $112.01 |
| Merced | Office $282.24 | Facility $101.03 |
| Metropolitan Boston | Office $305.07 | Facility $107.66 |
| Metropolitan Kansas City | Office $252.70 | Facility $97.45 |
| Metropolitan Philadelphia | Office $275.17 | Facility $103.06 |
| Metropolitan St. Louis | Office $255.41 | Facility $98.01 |
| Miami | Office $281.64 | Facility $109.53 |
| Minnesota | Office $266.60 | Facility $96.47 |
| Mississippi | Office $235.95 | Facility $93.60 |
| Modesto | Office $282.24 | Facility $101.03 |
| Montana** | Office $264.86 | Facility $99.52 |
| Napa | Office $328.74 | Facility $110.83 |
| Nebraska | Office $246.14 | Facility $93.53 |
| Nevada** | Office $264.12 | Facility $98.62 |
| New Hampshire | Office $272.25 | Facility $100.14 |
| New Mexico | Office $249.63 | Facility $98.01 |
| New Orleans | Office $253.99 | Facility $98.42 |
| North Carolina | Office $249.59 | Facility $95.34 |
| North Dakota** | Office $261.50 | Facility $96.16 |
| Northern Nj | Office $300.73 | Facility $108.94 |
| Nyc Suburbs/Long Island | Office $311.00 | Facility $114.42 |
| Ohio | Office $247.74 | Facility $96.79 |
| Oklahoma | Office $242.48 | Facility $94.84 |
| Oxnard-Thousand Oaks-Ventura | Office $300.39 | Facility $104.96 |
| Portland | Office $286.32 | Facility $102.63 |
| Poughkpsie/N Nyc Suburbs | Office $287.60 | Facility $106.55 |
| Puerto Rico | Office $266.96 | Facility $99.80 |
| Queens | Office $307.26 | Facility $111.83 |
| Redding | Office $282.24 | Facility $101.03 |
| Rest Of California | Office $282.24 | Facility $101.03 |
| Rest Of Florida | Office $259.04 | Facility $100.98 |
| Rest Of Georgia | Office $244.64 | Facility $97.16 |
| Rest Of Illinois | Office $250.89 | Facility $99.94 |
| Rest Of Louisiana | Office $241.93 | Facility $95.61 |
| Rest Of Maine | Office $246.93 | Facility $94.82 |
| Rest Of Maryland | Office $267.39 | Facility $100.07 |
| Rest Of Massachusetts | Office $275.17 | Facility $101.07 |
| Rest Of Michigan | Office $248.43 | Facility $97.48 |
| Rest Of Missouri | Office $237.48 | Facility $94.96 |
| Rest Of New Jersey | Office $286.05 | Facility $105.51 |
| Rest Of New York | Office $253.31 | Facility $96.25 |
| Rest Of Oregon | Office $262.39 | Facility $97.72 |
| Rest Of Pennsylvania | Office $248.37 | Facility $96.59 |
| Rest Of Texas | Office $254.25 | Facility $97.35 |
| Rest Of Washington | Office $274.78 | Facility $100.68 |
| Rhode Island | Office $271.94 | Facility $101.15 |
| Riverside-San Bernardino-Ontario | Office $284.10 | Facility $102.89 |
| Sacramento-Roseville-Folsom | Office $296.64 | Facility $104.35 |
| Salinas | Office $295.54 | Facility $103.91 |
| San Diego-Chula Vista-Carlsbad | Office $302.81 | Facility $105.07 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $348.60 | Facility $115.48 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $348.41 | Facility $115.29 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $356.28 | Facility $117.87 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $355.49 | Facility $117.08 |
| San Luis Obispo-Paso Robles | Office $290.72 | Facility $102.41 |
| Santa Cruz-Watsonville | Office $305.97 | Facility $105.09 |
| Santa Maria-Santa Barbara | Office $296.73 | Facility $103.95 |
| Santa Rosa-Petaluma | Office $309.10 | Facility $106.06 |
| Seattle (King Cnty) | Office $311.73 | Facility $108.86 |
| South Carolina | Office $249.02 | Facility $96.25 |
| South Dakota** | Office $261.10 | Facility $95.76 |
| Southern Maine | Office $261.00 | Facility $97.15 |
| Stockton | Office $282.24 | Facility $101.03 |
| Suburban Chicago | Office $275.01 | Facility $105.22 |
| Tennessee | Office $244.28 | Facility $93.99 |
| Utah | Office $252.45 | Facility $97.03 |
| Vallejo | Office $328.46 | Facility $110.55 |
| Vermont | Office $260.09 | Facility $96.41 |
| Virgin Islands | Office $266.96 | Facility $99.80 |
| Virginia | Office $259.84 | Facility $97.32 |
| Visalia | Office $282.24 | Facility $101.03 |
| West Virginia | Office $241.46 | Facility $97.78 |
| Wisconsin | Office $252.65 | Facility $94.26 |
| Wyoming** | Office $263.39 | Facility $98.06 |
| Yuba City | Office $282.24 | Facility $101.03 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,12564474,,Lwr xtr fscl pln blk uni nfs,A,,1.63,6.19,,0.26,,0.15,7.97,2.04,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,12664479,,Njx aa&/strd tfrm epi c/t 1,A,,2.23,6.11,,1.06,,0.20,8.54,3.49,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,12764480,,Njx aa&/strd tfrm epi c/t ea,A,,1.17,3.00,,0.31,,0.11,4.28,1.59,0,ZZZ,0.00,0.00,0.00,0,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,12864483,,Njx aa&/strd tfrm epi l/s 1,A,,1.85,5.91,,0.96,,0.17,7.93,2.98,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,12964484,,Njx aa&/strd tfrm epi l/s ea,A,,0.98,2.46,,0.25,,0.08,3.52,1.31,0,ZZZ,0.00,0.00,0.00,0,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,13064486,,Tap block unil by injection,A,,1.17,2.50,,0.19,,0.09,3.76,1.45,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,13164487,,Tap block uni by infusion,A,,1.36,5.88,,0.21,,0.11,7.35,1.68,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00