$413.58
Choose 62263 for adhesiolysis performed over multiple sessions; 62264 describes the same general treatment completed in one day.
On this page
CMS RVU26D · Effective 2026-10-01
62263 Epidural adhesiolysis Medicare reimbursement rates in Iowa
Reports fluoroscopically localized lumbar epidural adhesiolysis performed over multiple sessions to treat pain associated with epidural scarring. Compare 62263 office and facility rates across CMS payment localities in Iowa.
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 62263 in Iowa?
Iowa 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
$614.08
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$278.81
1 of 1 localities have a supported rate.
Payment area: Iowa
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 62263: Multi-session lumbar epidural adhesiolysis
Reports fluoroscopically localized lumbar epidural adhesiolysis performed over multiple sessions to treat pain associated with epidural scarring.
This service treats lumbar epidural adhesions that can tether nerve roots and contribute to persistent pain, often after spine surgery. A pain medicine physician, anesthesiologist, or other qualified proceduralist advances an epidural catheter toward the adhesions and delivers solutions as part of a staged treatment course. Fluoroscopic localization, including contrast when used, is part of the service. The sessions are spread over more than one day, unlike the single-day service in the same code family.
Report 62263 once for the multi-session course, not once for each injection or visit. The record should support the lumbar adhesions being treated, catheter placement and localization, the solutions used, and the staged treatment. Medicare includes related postoperative visits for 10 days in the global period. 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 for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 62263
- 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 RVU4.88 · 25%
- Practice expense (office) RVU14.56 · 73%
- Malpractice RVU0.46 · 2%
264
Medicare services in 2024 · #4092 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.
62263 compared with similar codes
Office rates for Iowa, from the same CMS release.
$252.05
62323 reports a lumbar or sacral epidural injection for medication delivery. It does not represent the staged catheter-based treatment of epidural adhesions reported with 62263.
$159.72
62273 is an epidural blood patch, commonly used to treat a cerebrospinal fluid leak. It is not a treatment for epidural adhesions.
Compare 62263 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
Iowa →
Office / nonfacility
$614.08
Facility
$278.81
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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 62263 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
6,943
- Code
- 62263
- Physician work
- 4.88
- Practice expense
- 14.56
- Malpractice
- 0.46
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.88 | × 1.000 | 4.8800 |
| Practice expense | 14.56 | × 0.915 | 13.3224 |
| Malpractice | 0.46 | × 0.397 | 0.1826 |
| Total RVUs | 18.3850 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$614.08
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.88 | 1 |
| Practice expense | 14.56 | 0.915 |
| Malpractice | 0.46 | 0.397 |
(4.88 × 1 + 14.56 × 0.915 + 0.46 × 0.397) × $33.4009 = $614.08
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.88 | 1 |
| Practice expense | 3.59 | 0.915 |
| Malpractice | 0.46 | 0.397 |
(4.88 × 1 + 3.59 × 0.915 + 0.46 × 0.397) × $33.4009 = $278.81
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.
62263 billing questions
When should 62263 be chosen instead of 62264?
Use 62263 when lumbar epidural adhesiolysis is performed over multiple sessions. Use 62264 when the treatment is completed in a single day.
How many units should be reported for the treatment course?
Report one unit of 62263 for the multi-session course, rather than a unit for each injection or session.
Can fluoroscopic guidance be billed separately?
Radiologic localization, including contrast when performed, is included in 62263. Do not separately report fluoroscopic guidance for that same localization.
Does modifier 50 apply when adhesiolysis is performed on both sides?
No. Medicare's bilateral adjustment does not apply to 62263, and modifier 50 is inappropriate for this service.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in the procedure's payment.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 62263. Co-surgeons and team surgery are not permitted for this service.
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.
6,94062252,TC,Csf shunt reprogram,A,,0.00,1.62,,1.62,NA,0.01,1.63,1.63,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136