Billing code 64495: Facet injectionMedicare rate & RVUs in Nevada
Image-guided lumbar or sacral facet joint injections at the third and subsequent levels are reported with the corresponding primary-level procedure.
Medicare pays $98.48 for 64495 in the office in Nevada (Nevada**). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 64495 covers
This code represents an image-guided injection of a diagnostic or therapeutic agent into lumbar or sacral facet joints, or the nerves that supply them, at the third and any additional treated level. Pain physicians, anesthesiologists, physiatrists, and other qualified clinicians commonly perform these procedures in outpatient procedure settings to evaluate or treat pain attributed to facet joints. Fluoroscopy or CT guidance is part of the service described by the code.
Select the code by the number of lumbar or sacral levels treated in the same session: report 64493 for the first level, 64494 for the second, and 64495 for the third and any additional level. The procedure note should identify the treated levels and side, injection target, agent, and imaging guidance. This is an add-on code and must be billed with a primary procedure; CMS pays it within that procedure’s global period. For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.
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.
64495 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $98.48 | $44.65 |
How the 64495 rate is calculated
Each of 64495’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 64495
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.98Practice expense 1.90Malpractice 0.08
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64495
The CMS indicators that decide how 64495 is paid alongside other services.
CMS payment indicators · 64495
Facet injection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
64495 without 50 · national office
$98.87
Facet injection
64495-50 · Bilateral: 150%
$148.31
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
64495 compared with similar codes
Compare codes
64495 vs 64493 vs 64494 vs 64492 vs 64483: national Medicare rates
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How to choose
- 64493Facet joint injection
- 64493 covers the first lumbar or sacral facet level and serves as the primary procedure; 64495 is used for the third and any additional level.
- 64494Facet joint injection
- 64494 applies to the second lumbar or sacral facet level. Use 64495 for the third and any additional level.
- 64492Facet injection
- 64492 is the third-and-additional-level code for cervical or thoracic facet injections; 64495 is for lumbar or sacral levels.
- 64483Transforaminal epidural injection
- 64483 describes a lumbar transforaminal epidural injection, targeting the epidural space through a foramen rather than a facet joint or its innervating nerves.
64495 billing questions
When is 64495 used instead of 64494?
Use 64494 for the second lumbar or sacral level and 64495 for the third and any additional level treated in the session.
Can 64495 be billed by itself?
No. It is an add-on code and must be reported with a primary procedure, such as 64493 for the first level.
Does the code include imaging guidance?
Yes. The service includes fluoroscopic or CT guidance for the facet joint or the nerves innervating it.
How is a bilateral procedure reported?
Report modifier 50 for the bilateral procedure. CMS pays the code at 150% when modifier 50 is used.
What documentation supports reporting 64495?
Document the lumbar or sacral levels treated, the injection target and agent, the side or sides, and the imaging guidance used.
How is this different from a lumbar transforaminal epidural injection?
64495 targets facet joints or their innervating nerves. A transforaminal epidural injection targets the epidural space through a neural foramen.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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