$310.39
64479 covers the initial cervical or thoracic transforaminal level; 64480 covers each additional level and is reported with 64479.
On this page
CMS RVU26D · Effective 2026-10-01
64480 Epidural injection Medicare reimbursement rates in Guam
Reports an additional cervical or thoracic transforaminal epidural level beyond the first when treating a targeted spinal nerve root. Compare 64480 office and facility rates across CMS payment localities in Guam.
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 64480 in Guam?
Guam 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
$155.14
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$52.98
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 64480: Additional cervical thoracic nerve root level
Reports an additional cervical or thoracic transforaminal epidural level beyond the first when treating a targeted spinal nerve root.
This add-on represents an injection at another cervical or thoracic spinal level, using a transforaminal approach to deliver anesthetic and/or steroid near a targeted nerve root. Interventional pain physicians, anesthesiologists, physiatrists, and radiologists may perform it for conditions such as cervical or thoracic radicular pain. Imaging guidance, such as fluoroscopy or CT, is part of the service; the code does not represent a separate imaging service.
Report 64480 for each additional level treated after the first, with 64479 for the initial cervical or thoracic level. The record should identify the treated spinal levels, approach, injectate, and guidance used; another injection or needle pass at the same level is not another level. CMS classifies 64480 as an add-on code, so it must be billed with its primary procedure and is paid within that procedure’s global period. For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.
CMS billing rules for 64480
- 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 RVU1.17 · 27%
- Practice expense (office) RVU3.00 · 70%
- Malpractice RVU0.11 · 3%
11K
Medicare services in 2024 · #1428 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.
64480 compared with similar codes
Office rates for Guam, from the same CMS release.
$127.70
64484 covers additional lumbar or sacral transforaminal levels. Choose the add-on code according to the spinal region treated.
$221.91
64490 targets a cervical or thoracic facet joint. 64480 targets an additional nerve-root level through a transforaminal approach.
Compare 64480 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
Hawaii, Guam →
Office / nonfacility
$155.14
Facility
$52.98
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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 64480 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
7,127
- Code
- 64480
- Physician work
- 1.17
- Practice expense
- 3.00
- Malpractice
- 0.11
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.17 | × 1.000 | 1.1700 |
| Practice expense | 3.00 | × 1.137 | 3.4110 |
| Malpractice | 0.11 | × 0.579 | 0.0637 |
| Total RVUs | 4.6447 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$155.14
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.17 | 1 |
| Practice expense | 3 | 1.137 |
| Malpractice | 0.11 | 0.579 |
(1.17 × 1 + 3 × 1.137 + 0.11 × 0.579) × $33.4009 = $155.14
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.17 | 1 |
| Practice expense | 0.31 | 1.137 |
| Malpractice | 0.11 | 0.579 |
(1.17 × 1 + 0.31 × 1.137 + 0.11 × 0.579) × $33.4009 = $52.98
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.
64480 billing questions
When is 64480 reported instead of 64479?
Use 64479 for the initial cervical or thoracic transforaminal level. Report 64480 for each additional level treated in the same procedure.
Can 64480 be billed by itself?
No. It is an add-on code and must be reported with the primary procedure, 64479.
Does another injection at the same level support another unit?
No. The add-on is based on an additional spinal level, not additional needle passes or injections at the same level.
How is bilateral treatment reported under the CMS rule?
For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.
What distinguishes 64480 from 64484?
64480 is for each additional cervical or thoracic transforaminal level. 64484 is for each additional lumbar or sacral level.
What documentation supports the additional-level code?
Document the cervical or thoracic levels treated, the transforaminal approach, the injectate, and the imaging guidance used.
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.
7,12464473,,Lwr xtr fscl pln blk uni njx,A,,1.31,2.60,,0.21,,0.12,4.03,1.64,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,12564474,,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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014