$99.54
64493 is the first lumbar or sacral level; 64494 is the add-on for the second level in the same region.
On this page
CMS RVU26D · Effective 2026-10-01
64493 Facet joint injection Medicare reimbursement rates in Colorado
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. Compare 64493 office and facility rates across CMS payment localities in Colorado.
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 64493 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$198.68
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$82.82
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Pain management
About 64493: Lumbar or sacral facet joint injection, one level
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.
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.
CMS billing rules for 64493
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.48 · 26%
- Practice expense (office) RVU4.08 · 72%
- Malpractice RVU0.14 · 2%
620.3K
Medicare services in 2024 · #203 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.
64493 compared with similar codes
Office rates for Colorado, from the same CMS release.
$102.74
64495 is the add-on for a third lumbar or sacral level; it does not replace 64493 for the first level.
$213.53
Both describe a single-level facet-joint injection, but 64490 is for the cervical or thoracic region and 64493 is for the lumbar or sacral region.
$277.00
64483 is a transforaminal epidural injection targeting a nerve root; 64493 targets a lumbar or sacral facet joint or its innervating nerves.
Compare 64493 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
$198.68
Facility
$82.82
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 64493 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
7,137
- Code
- 64493
- Physician work
- 1.48
- Practice expense
- 4.08
- Malpractice
- 0.14
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.48 | × 1.012 | 1.4978 |
| Practice expense | 4.08 | × 1.064 | 4.3411 |
| Malpractice | 0.14 | × 0.781 | 0.1093 |
| Total RVUs | 5.9482 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$198.68
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.48 | 1.012 |
| Practice expense | 4.08 | 1.064 |
| Malpractice | 0.14 | 0.781 |
(1.48 × 1.012 + 4.08 × 1.064 + 0.14 × 0.781) × $33.4009 = $198.68
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.48 | 1.012 |
| Practice expense | 0.82 | 1.064 |
| Malpractice | 0.14 | 0.781 |
(1.48 × 1.012 + 0.82 × 1.064 + 0.14 × 0.781) × $33.4009 = $82.82
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.
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 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.
7,13464490,,Inj paravert f jnt c/t 1 lev,A,,1.77,4.20,,0.88,,0.17,6.14,2.82,0,000,0.00,0.00,0.00,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,13564491,,Inj paravert f jnt c/t 2 lev,A,,1.13,1.81,,0.28,,0.11,3.05,1.52,0,ZZZ,0.00,0.00,0.00,0,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,13664492,,Inj paravert f jnt c/t 3 lev,A,,1.13,1.84,,0.31,,0.09,3.06,1.53,0,ZZZ,0.00,0.00,0.00,0,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,13764493,,Inj paravert f jnt l/s 1 lev,A,,1.48,4.08,,0.82,,0.14,5.70,2.44,0,000,0.00,0.00,0.00,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,13864494,,Inj paravert f jnt l/s 2 lev,A,,0.98,1.81,,0.25,,0.08,2.87,1.31,0,ZZZ,0.00,0.00,0.00,0,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,13964495,,Inj paravert f jnt l/s 3 lev,A,,0.98,1.90,,0.29,,0.08,2.96,1.35,0,ZZZ,0.00,0.00,0.00,0,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14064505,,N block spenopalatine gangl,A,,1.33,2.79,,1.21,,0.38,4.50,2.92,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899