$617.68
Both describe epidural adhesiolysis; 62264 is for a single-day session, while 62263 is for a treatment course across multiple days.
On this page
CMS RVU26D · Effective 2026-10-01
62264 Epidural adhesiolysis Medicare reimbursement rates in Idaho
A single-day percutaneous epidural adhesiolysis session uses catheter-based disruption and injectate delivery to address selected epidural scarring associated with persistent spinal pain. Compare 62264 office and facility rates across CMS payment localities in Idaho.
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 62264 in Idaho?
Idaho 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
$416.09
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
$202.22
1 of 1 localities have a supported rate.
Payment area: Idaho
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 62264: Single-day epidural adhesiolysis
A single-day percutaneous epidural adhesiolysis session uses catheter-based disruption and injectate delivery to address selected epidural scarring associated with persistent spinal pain.
This procedure treats epidural adhesions that may contribute to persistent back or radiating leg pain. A pain-management physician, anesthesiologist, or other physician experienced in spinal interventions advances a catheter into the epidural space, often with fluoroscopic localization, and uses mechanical disruption, injected solution, or both. It is typically performed in an outpatient procedure setting when a one-day adhesiolysis session is planned.
Report 62264 for the single-day treatment course, rather than for each injection or catheter maneuver during that session. The operative note should support the adhesiolysis technique, epidural location, and treatment date; the number of treatment days distinguishes this service from 62263. Related postoperative visits during the 10-day global period are included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 62264
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU4.31 · 32%
- Practice expense (office) RVU8.64 · 65%
- Malpractice RVU0.42 · 3%
5.1K
Medicare services in 2024 · #1858 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.
62264 compared with similar codes
Office rates for Idaho, from the same CMS release.
$253.53
62264 involves epidural adhesiolysis using catheter-based disruption, injectate, or both. 62323 describes a lumbar or sacral epidural injection without adhesiolysis.
$256.82
62264 is an adhesiolysis service. 62321 is an epidural injection service for the cervical or thoracic region.
Compare 62264 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
Idaho →
Office / nonfacility
$416.09
Facility
$202.22
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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 62264 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
6,944
- Code
- 62264
- Physician work
- 4.31
- Practice expense
- 8.64
- Malpractice
- 0.42
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.31 | × 1.000 | 4.3100 |
| Practice expense | 8.64 | × 0.920 | 7.9488 |
| Malpractice | 0.42 | × 0.473 | 0.1987 |
| Total RVUs | 12.4575 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$416.09
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.31 | 1 |
| Practice expense | 8.64 | 0.92 |
| Malpractice | 0.42 | 0.473 |
(4.31 × 1 + 8.64 × 0.92 + 0.42 × 0.473) × $33.4009 = $416.09
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.31 | 1 |
| Practice expense | 1.68 | 0.92 |
| Malpractice | 0.42 | 0.473 |
(4.31 × 1 + 1.68 × 0.92 + 0.42 × 0.473) × $33.4009 = $202.22
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.
62264 billing questions
How do I choose between 62264 and 62263?
Use 62264 for a single-day adhesiolysis treatment. Use 62263 when the treatment course extends across multiple days.
Can 62264 be reported for each injection or catheter maneuver?
No. Report the code for the single-day treatment session, not separately for each injection or maneuver within it.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for this procedure.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure.
What documentation supports reporting 62264?
Document the epidural adhesiolysis technique, the treatment location, and that the service was performed as a single-day session.
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.
6,94162256,,Remove brain cavity shunt,A,,7.20,8.98,NA,8.98,,2.98,19.16,19.16,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94262258,,Replace brain cavity shunt,A,,15.25,11.77,NA,11.77,,6.07,33.09,33.09,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94362263,,Epidural lysis mult sessions,A,,4.88,14.56,,3.59,,0.46,19.90,8.93,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94462264,,Epidural lysis on single day,A,,4.31,8.64,,1.68,,0.42,13.37,6.41,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94562267,,Interdiscal perq aspir dx,A,,2.93,4.49,,0.78,,0.33,7.75,4.04,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94662268,,Drain spinal cord cyst,A,,4.61,2.98,NA,2.98,,1.94,9.53,9.53,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94762269,,Needle biopsy spinal cord,A,,4.88,1.31,NA,1.31,,0.46,6.65,6.65,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772