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CMS RVU26D · Effective 2026-10-01

64491 in Beaumont

Office / nonfacility

$96.17

Base rate per service

Facility setting

$49.67

Base rate per service

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.

Pain management

About 64491: Cervical or thoracic facet injection, second level

Reports an additional cervical or thoracic facet-joint injection level performed with a primary-level procedure during the same treatment session.

This add-on code covers injection at a second cervical or thoracic paravertebral facet-joint level, or the nerves supplying that joint, commonly for diagnostic evaluation or treatment of suspected facet-mediated neck or upper-back pain. Pain-management physicians and other qualified practitioners perform the procedure, often using imaging to guide needle placement. The code is specific to the cervical or thoracic region; lumbar facet levels are reported from a separate code family.

Report 64491 with the primary-level code 64490 when a second level is treated; it is not reported by itself. Documentation should identify the spinal region, each treated level and side, and the procedure performed. Imaging guidance is included in the facet-injection service. CMS treats 64491 as an add-on paid within the primary procedure’s global period. For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.

CMS billing rules for 64491

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.

Where the value comes from

  • Work RVU1.13 · 37%
  • Practice expense (office) RVU1.81 · 59%
  • Malpractice RVU0.11 · 4%

134K

Medicare services in 2024 · #477 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.

64491 compared with similar codes

Office rates for Beaumont, from the same CMS release.

64490

Facet injection

Cervical or thoracic, one level

$192.05

Use 64490 for the primary cervical or thoracic facet level. Use 64491 only for an additional second level and report it with the primary-level service.

64492

Facet injection

Third cervical/thoracic level

$96.46

64492 represents an additional cervical or thoracic level beyond the second; 64491 represents the second level.

64494

Facet joint injection

Lumbar/sacral, second level

$90.23

64494 is the additional second-level code for lumbar or sacral facet injections. Choose 64491 when the treated levels are cervical or thoracic.

The same code, a different location

How does Beaumont compare?

In Austin, the office rate for 64491 is $105.04—$8.87 higher than the $96.17 rate in Beaumont. Both use the same code, release and participation basis.

64491 across payment areas

Same release and payment basis · bars start at $0

  1. Beaumont · This locality

    $96.17

  2. Austin

    $105.04

    $8.87 higher than Beaumont

  3. Brazoria

    $100.82

    $4.65 higher than Beaumont

  4. Dallas

    $101.45

    $5.28 higher than Beaumont

  5. Fort Worth

    $100.89

    $4.72 higher than Beaumont

  6. Galveston

    $101.12

    $4.95 higher than Beaumont

  7. Houston

    $103.13

    $6.96 higher than Beaumont

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 64491 ranges from $91.57 in Arkansas to $131.04 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 64491

    Office

    $98.43

    Facility

    $49.94

    $2.26 higher than Beaumont for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 64491

    Office

    $113.25

    Facility

    $52.79

    $17.08 higher than Beaumont for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 64491

    Office

    $115.09

    Facility

    $54.89

    $18.92 higher than Beaumont for the office setting.

  • Miami

    Florida · 64491

    Office

    $109.97

    Facility

    $56.77

    $13.80 higher than Beaumont for the office setting.

  • Chicago

    Illinois · 64491

    Office

    $107.20

    Facility

    $55.84

    $11.03 higher than Beaumont for the office setting.

  • Manhattan

    New York · 64491

    Office

    $116.24

    Facility

    $56.85

    $20.07 higher than Beaumont for the office setting.

  • Alaska*

    Alaska · 64491

    Office

    $123.02

    Facility

    $68.60

    $26.85 higher than Beaumont for the office setting.

  • Alabama

    Alabama · 64491

    Office

    $92.72

    Facility

    $48.01

    $3.45 lower than Beaumont for the office setting.

  • Arkansas

    Arkansas · 64491

    Office

    $91.57

    Facility

    $47.67

    $4.60 lower than Beaumont for the office setting.

  • Arizona

    Arizona · 64491

    Office

    $99.47

    Facility

    $49.95

    $3.30 higher than Beaumont for the office setting.

  • Bakersfield

    California · 64491

    Office

    $106.96

    Facility

    $50.95

    $10.79 higher than Beaumont for the office setting.

  • Chico

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • El Centro

    California · 64491

    Office

    $106.63

    Facility

    $50.62

    $10.46 higher than Beaumont for the office setting.

  • Fresno

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Hanford-Corcoran

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Madera

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Merced

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Modesto

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Napa

    California · 64491

    Office

    $121.67

    Facility

    $54.31

    $25.50 higher than Beaumont for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 64491

    Office

    $112.55

    Facility

    $52.14

    $16.38 higher than Beaumont for the office setting.

  • Redding

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Rest Of California

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 64491

    Office

    $107.82

    Facility

    $51.81

    $11.65 higher than Beaumont for the office setting.

  • Sacramento-Roseville-Folsom

    California · 64491

    Office

    $111.38

    Facility

    $51.95

    $15.21 higher than Beaumont for the office setting.

  • Salinas

    California · 64491

    Office

    $110.95

    Facility

    $51.72

    $14.78 higher than Beaumont for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 64491

    Office

    $113.17

    Facility

    $52.05

    $17.00 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 64491

    Office

    $128.26

    Facility

    $56.20

    $32.09 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 64491

    Office

    $128.13

    Facility

    $56.08

    $31.96 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 64491

    Office

    $131.04

    Facility

    $57.35

    $34.87 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 64491

    Office

    $130.53

    Facility

    $56.84

    $34.36 higher than Beaumont for the office setting.

  • San Luis Obispo-Paso Robles

    California · 64491

    Office

    $109.21

    Facility

    $51.01

    $13.04 higher than Beaumont for the office setting.

  • Santa Cruz-Watsonville

    California · 64491

    Office

    $113.96

    Facility

    $51.87

    $17.79 higher than Beaumont for the office setting.

  • Santa Maria-Santa Barbara

    California · 64491

    Office

    $111.26

    Facility

    $51.67

    $15.09 higher than Beaumont for the office setting.

  • Santa Rosa-Petaluma

    California · 64491

    Office

    $115.08

    Facility

    $52.33

    $18.91 higher than Beaumont for the office setting.

  • Stockton

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Vallejo

    California · 64491

    Office

    $121.49

    Facility

    $54.13

    $25.32 higher than Beaumont for the office setting.

  • Visalia

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Yuba City

    California · 64491

    Office

    $106.61

    Facility

    $50.60

    $10.44 higher than Beaumont for the office setting.

  • Colorado

    Colorado · 64491

    Office

    $105.39

    Facility

    $51.02

    $9.22 higher than Beaumont for the office setting.

  • Connecticut

    Connecticut · 64491

    Office

    $108.05

    Facility

    $53.02

    $11.88 higher than Beaumont for the office setting.

  • Delaware

    Delaware · 64491

    Office

    $100.96

    Facility

    $50.47

    $4.79 higher than Beaumont for the office setting.

  • Fort Lauderdale

    Florida · 64491

    Office

    $105.63

    Facility

    $53.86

    $9.46 higher than Beaumont for the office setting.

  • Rest Of Florida

    Florida · 64491

    Office

    $101.06

    Facility

    $52.21

    $4.89 higher than Beaumont for the office setting.

  • Atlanta

    Georgia · 64491

    Office

    $103.69

    Facility

    $51.77

    $7.52 higher than Beaumont for the office setting.

  • Rest Of Georgia

    Georgia · 64491

    Office

    $96.05

    Facility

    $50.46

    $0.12 lower than Beaumont for the office setting.

  • Hawaii, Guam

    Hawaii · 64491

    Office

    $108.61

    Facility

    $50.50

    $12.44 higher than Beaumont for the office setting.

  • Iowa

    Iowa · 64491

    Office

    $94.52

    Facility

    $47.76

    $1.65 lower than Beaumont for the office setting.

  • Idaho

    Idaho · 64491

    Office

    $95.10

    Facility

    $48.08

    $1.07 lower than Beaumont for the office setting.

  • East St. Louis

    Illinois · 64491

    Office

    $100.76

    Facility

    $53.75

    $4.59 higher than Beaumont for the office setting.

  • Rest Of Illinois

    Illinois · 64491

    Office

    $98.68

    Facility

    $52.02

    $2.51 higher than Beaumont for the office setting.

  • Suburban Chicago

    Illinois · 64491

    Office

    $106.61

    Facility

    $54.12

    $10.44 higher than Beaumont for the office setting.

  • Indiana

    Indiana · 64491

    Office

    $95.57

    Facility

    $48.20

    $0.60 lower than Beaumont for the office setting.

  • Kansas

    Kansas · 64491

    Office

    $94.25

    Facility

    $48.05

    $1.92 lower than Beaumont for the office setting.

  • Kentucky

    Kentucky · 64491

    Office

    $94.85

    Facility

    $49.42

    $1.32 lower than Beaumont for the office setting.

  • New Orleans

    Louisiana · 64491

    Office

    $98.81

    Facility

    $50.72

    $2.64 higher than Beaumont for the office setting.

  • Rest Of Louisiana

    Louisiana · 64491

    Office

    $94.77

    Facility

    $49.54

    $1.40 lower than Beaumont for the office setting.

  • Metropolitan Boston

    Massachusetts · 64491

    Office

    $114.74

    Facility

    $53.73

    $18.57 higher than Beaumont for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 64491

    Office

    $104.93

    Facility

    $51.12

    $8.76 higher than Beaumont for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 64491

    Office

    $107.76

    Facility

    $52.93

    $11.59 higher than Beaumont for the office setting.

  • Rest Of Maryland

    Maryland · 64491

    Office

    $102.67

    Facility

    $50.96

    $6.50 higher than Beaumont for the office setting.

  • Rest Of Maine

    Maine · 64491

    Office

    $95.65

    Facility

    $48.63

    $0.52 lower than Beaumont for the office setting.

  • Southern Maine

    Maine · 64491

    Office

    $99.97

    Facility

    $49.33

    $3.80 higher than Beaumont for the office setting.

  • Detroit

    Michigan · 64491

    Office

    $102.28

    Facility

    $52.96

    $6.11 higher than Beaumont for the office setting.

  • Rest Of Michigan

    Michigan · 64491

    Office

    $97.09

    Facility

    $50.43

    $0.92 higher than Beaumont for the office setting.

  • Minnesota

    Minnesota · 64491

    Office

    $101.04

    Facility

    $48.45

    $4.87 higher than Beaumont for the office setting.

  • Metropolitan Kansas City

    Missouri · 64491

    Office

    $98.10

    Facility

    $50.11

    $1.93 higher than Beaumont for the office setting.

  • Metropolitan St. Louis

    Missouri · 64491

    Office

    $98.98

    Facility

    $50.33

    $2.81 higher than Beaumont for the office setting.

  • Rest Of Missouri

    Missouri · 64491

    Office

    $93.43

    Facility

    $49.38

    $2.74 lower than Beaumont for the office setting.

  • Mississippi

    Mississippi · 64491

    Office

    $92.51

    Facility

    $48.51

    $3.66 lower than Beaumont for the office setting.

  • Montana**

    Montana · 64491

    Office

    $101.87

    Facility

    $50.76

    $5.70 higher than Beaumont for the office setting.

  • North Carolina

    North Carolina · 64491

    Office

    $96.50

    Facility

    $48.82

    $0.33 higher than Beaumont for the office setting.

  • North Dakota**

    North Dakota · 64491

    Office

    $99.69

    Facility

    $48.59

    $3.52 higher than Beaumont for the office setting.

  • Nebraska

    Nebraska · 64491

    Office

    $94.93

    Facility

    $47.76

    $1.24 lower than Beaumont for the office setting.

  • New Hampshire

    New Hampshire · 64491

    Office

    $103.89

    Facility

    $50.69

    $7.72 higher than Beaumont for the office setting.

  • Northern Nj

    New Jersey · 64491

    Office

    $114.17

    Facility

    $54.89

    $18.00 higher than Beaumont for the office setting.

  • Rest Of New Jersey

    New Jersey · 64491

    Office

    $109.30

    Facility

    $53.50

    $13.13 higher than Beaumont for the office setting.

  • New Mexico

    New Mexico · 64491

    Office

    $97.59

    Facility

    $50.73

    $1.42 higher than Beaumont for the office setting.

  • Nevada**

    Nevada · 64491

    Office

    $101.32

    Facility

    $50.17

    $5.15 higher than Beaumont for the office setting.

  • Nyc Suburbs/Long Island

    New York · 64491

    Office

    $118.86

    Facility

    $58.10

    $22.69 higher than Beaumont for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 64491

    Office

    $110.09

    Facility

    $54.13

    $13.92 higher than Beaumont for the office setting.

  • Queens

    New York · 64491

    Office

    $116.92

    Facility

    $56.51

    $20.75 higher than Beaumont for the office setting.

  • Rest Of New York

    New York · 64491

    Office

    $97.76

    Facility

    $49.21

    $1.59 higher than Beaumont for the office setting.

  • Ohio

    Ohio · 64491

    Office

    $96.64

    Facility

    $49.99

    $0.47 higher than Beaumont for the office setting.

  • Oklahoma

    Oklahoma · 64491

    Office

    $94.58

    Facility

    $48.95

    $1.59 lower than Beaumont for the office setting.

  • Portland

    Oregon · 64491

    Office

    $108.25

    Facility

    $51.47

    $12.08 higher than Beaumont for the office setting.

  • Rest Of Oregon

    Oregon · 64491

    Office

    $100.54

    Facility

    $49.64

    $4.37 higher than Beaumont for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 64491

    Office

    $105.74

    Facility

    $52.54

    $9.57 higher than Beaumont for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 64491

    Office

    $96.71

    Facility

    $49.80

    $0.54 higher than Beaumont for the office setting.

  • Puerto Rico

    Puerto Rico · 64491

    Office

    $102.48

    Facility

    $50.82

    $6.31 higher than Beaumont for the office setting.

  • Rhode Island

    Rhode Island · 64491

    Office

    $104.19

    Facility

    $51.40

    $8.02 higher than Beaumont for the office setting.

  • South Carolina

    South Carolina · 64491

    Office

    $96.73

    Facility

    $49.51

    $0.56 higher than Beaumont for the office setting.

  • South Dakota**

    South Dakota · 64491

    Office

    $99.43

    Facility

    $48.33

    $3.26 higher than Beaumont for the office setting.

  • Tennessee

    Tennessee · 64491

    Office

    $94.67

    Facility

    $48.22

    $1.50 lower than Beaumont for the office setting.

  • Utah

    Utah · 64491

    Office

    $97.87

    Facility

    $49.83

    $1.70 higher than Beaumont for the office setting.

  • Virginia

    Virginia · 64491

    Office

    $99.76

    Facility

    $49.53

    $3.59 higher than Beaumont for the office setting.

  • Virgin Islands

    United States Virgin Islands · 64491

    Office

    $102.48

    Facility

    $50.82

    $6.31 higher than Beaumont for the office setting.

  • Vermont

    Vermont · 64491

    Office

    $99.45

    Facility

    $48.86

    $3.28 higher than Beaumont for the office setting.

  • Rest Of Washington

    Washington · 64491

    Office

    $104.69

    Facility

    $50.88

    $8.52 higher than Beaumont for the office setting.

  • Seattle (King Cnty)

    Washington · 64491

    Office

    $116.81

    Facility

    $54.11

    $20.64 higher than Beaumont for the office setting.

  • Wisconsin

    Wisconsin · 64491

    Office

    $96.79

    Facility

    $47.83

    $0.62 higher than Beaumont for the office setting.

  • West Virginia

    West Virginia · 64491

    Office

    $95.54

    Facility

    $51.13

    $0.63 lower than Beaumont for the office setting.

  • Wyoming**

    Wyoming · 64491

    Office

    $100.92

    Facility

    $49.81

    $4.75 higher than Beaumont for the office setting.

See how rates vary across the country

64491 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$91.57

$123.02

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$123.021
AL$92.721
AR$91.571
AZ$99.471
CA$106.61–$131.0429
CO$105.391
CT$108.051
DC$115.091
DE$100.961
FL$101.06–$109.973
GA$96.05–$103.692
GU$108.611
HI$108.611
IA$94.521
ID$95.101
IL$98.68–$107.204
IN$95.571
KS$94.251
KY$94.851
LA$94.77–$98.812
MA$104.93–$114.742
MD$102.67–$115.093
ME$95.65–$99.972
MI$97.09–$102.282
MN$101.041
MO$93.43–$98.983
MS$92.511
MT$101.871
NC$96.501
ND$99.691
NE$94.931
NH$103.891
NJ$109.30–$114.172
NM$97.591
NV$101.321
NY$97.76–$118.865
OH$96.641
OK$94.581
OR$100.54–$108.252
PA$96.71–$105.742
PR$102.481
RI$104.191
SC$96.731
SD$99.431
TN$94.671
TX$96.17–$105.048
UT$97.871
VA$99.76–$115.092
VI$102.481
VT$99.451
WA$104.69–$116.812
WI$96.791
WV$95.541
WY$100.921

Explore 64491 on the national rate map →

Where does this rate apply?

Beaumont is a Medicare payment area. Our Census mapping connects it to 13 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 64491 in Beaumont, the physician’s office rate is $96.17 and the facility-setting rate is $49.67: a difference of $46.50.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 64491 in Beaumont. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$105.79

$96.17 × 110% = $105.79

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64491 in Beaumont.

PPRRVU2026_Oct_nonQPP.csv

7,135

Code
64491
Physician work
1.13
Practice expense
1.81
Malpractice
0.11

GPCI2026.csv

97

Locality
Beaumont
Physician work
1.000
Practice expense
0.910
Malpractice
0.929
Office / nonfacility calculation for 64491 in Beaumont
ComponentRVULocality factorAdjusted
Physician work1.13× 1.0001.1300
Practice expense1.81× 0.9101.6471
Malpractice0.11× 0.9290.1022
Total RVUs2.8793
Conversion factor× 33.4009

Office / nonfacility rate, Beaumont$96.17

Open 64491 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.131
Practice expense1.810.91
Malpractice0.110.929

(1.13 × 1 + 1.81 × 0.91 + 0.11 × 0.929) × $33.4009 = $96.17

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.131
Practice expense0.280.91
Malpractice0.110.929

(1.13 × 1 + 0.28 × 0.91 + 0.11 × 0.929) × $33.4009 = $49.67

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

64491 · Office / nonfacility

$96.17

Effective 2026-10-01

The base rate is $6.76 higher than on 2025-10-01, moving from $89.41 to $96.17 (7.6%).

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

    $89.41changed to$96.17

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.16 changed to 1.13
    • Practice expense RVU 1.64 changed to 1.81
    • Malpractice RVU 0.13 changed to 0.11
    • Practice expense GPCI 0.903 changed to 0.910
    • Malpractice GPCI 0.947 changed to 0.929

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $89.41

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$96.17$49.67RVU26D
2026-07-01$96.17$49.67RVU26C
2026-04-01$96.17$49.67RVU26B
2026-01-01$96.17$49.67RVU26A
2025-10-01$89.41$55.82RVU25D
2025-07-01$89.41$55.82RVU25C
2025-04-01$89.41$55.82RVU25B
2025-01-01$89.41$55.82RVU25A

64491 billing questions

When is 64491 reported with 64490?

Report 64491 for a second cervical or thoracic facet-joint level in the same session as the primary-level service reported with 64490. It cannot be reported alone.

How does 64491 differ from 64490?

64490 represents the primary level; 64491 represents the additional second level. The documentation should show that a distinct second level was treated.

Can 64491 be reported with 64492?

When a third cervical or thoracic level is treated, 64492 is the additional-level code for that level, alongside the primary-level service. The record should support each treated level.

How is bilateral treatment handled?

For a bilateral procedure, CMS pays 150% when modifier 50 is used. Document the treated side or sides and levels.

Is imaging guidance separately reported?

Imaging guidance is included in the facet-injection service. Do not separately report guidance for the injection represented by 64491.

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.

RVUs for 64491PPRRVU2026_Oct_nonQPP.csv, line 7,135 (RVU26D)
Geographic factors for BeaumontGPCI2026.csv, line 97 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet