$717.43–$753.80
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 New Jersey
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 New Jersey.
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 New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$480.24–$502.77
2 of 2 localities have a supported rate.
Facility setting
$226.38–$233.10
2 of 2 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.
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 New Jersey, from the same CMS release.
$295.33–$310.71
62264 involves epidural adhesiolysis using catheter-based disruption, injectate, or both. 62323 describes a lumbar or sacral epidural injection without adhesiolysis.
$298.73–$314.10
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.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
$502.77
Facility
$233.10
Rest Of New Jersey →
Office / nonfacility
$480.24
Facility
$226.38
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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