$185.57–$198.36
64490 identifies the first cervical or thoracic facet level. Use 64492 only for a third or further level in the same region.
On this page
CMS RVU26D · Effective 2026-10-01
64492 Facet injection Medicare reimbursement rates in Missouri
Reports an additional cervical or thoracic facet-joint injection level when diagnostic or therapeutic medication is delivered to the joint or its supplying nerve. Compare 64492 office and facility rates across CMS payment localities in Missouri.
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 64492 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$93.65–$99.26
3 of 3 localities have a supported rate.
Facility setting
$49.60–$50.61
3 of 3 localities have a supported rate.
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.
Where 64492 pays more and less in Missouri
3 payment localities
$93.65 to $99.26
Spinal injection
About 64492: Cervical or thoracic facet injection, third level
Reports an additional cervical or thoracic facet-joint injection level when diagnostic or therapeutic medication is delivered to the joint or its supplying nerve.
This service covers the third or a further cervical or thoracic paravertebral facet-joint level treated with diagnostic or therapeutic medication, or a block of the nerve supplying that joint. An interventional pain physician, anesthesiologist, or other qualified clinician typically performs it with fluoroscopic or CT guidance for evaluation or treatment of axial neck or upper-back pain. The code is for facet joints or their innervating nerves, not an epidural injection.
Report 64492 only as an add-on in the cervical/thoracic level series: 64490 identifies the first level, 64491 the second, and 64492 the third or further level. Document the spinal region, each treated level, side, target, indication, and image-guided technique. CMS pays this add-on within the primary procedure’s global period; it is not submitted alone. For bilateral procedures, CMS pays modifier 50 at 150%.
CMS billing rules for 64492
- 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) RVU1.84 · 60%
- Malpractice RVU0.09 · 3%
418
Medicare services in 2024 · #3700 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.
64492 compared with similar codes
Office rates for Missouri, from the same CMS release.
$93.43–$98.98
64491 identifies the second cervical or thoracic facet level; 64492 identifies the third or further level.
$171.46–$183.85
64493 is for the first lumbar or sacral facet level. Choose the 64490–64492 series for cervical or thoracic levels.
Compare 64492 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$98.39
Facility
$50.40
Metropolitan St. Louis →
Office / nonfacility
$99.26
Facility
$50.61
Rest Of Missouri →
Office / nonfacility
$93.65
Facility
$49.60
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64492 billing questions
Can 64492 be reported by itself?
No. It is an add-on for a third or further cervical or thoracic facet level and must be reported with the applicable primary facet procedure.
How does 64492 differ from 64491?
64491 identifies the second cervical or thoracic level. Use 64492 for the third or a further level in that region.
Is image guidance included?
The facet injection service includes fluoroscopic or CT guidance. Document the guidance and treated levels; 64492 is not a separate image-guidance service.
How is bilateral work reported?
When the procedure is bilateral, CMS applies modifier 50 and pays 150%.
Can 64492 be used for lumbar facet levels?
No. It is for cervical or thoracic facet levels; lumbar or sacral facet levels use the corresponding lumbar/sacral code series.
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.
7,13364489,,Tap block bi by infusion,A,,1.71,10.21,,0.26,,0.15,12.07,2.12,0,000,0.00,0.00,0.00,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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