62323 covers an interlaminar or caudal approach into the lumbar or sacral epidural space. Report 64483 when the needle enters through a neural foramen.
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CMS RVU26D · Effective 2026-10-01
64483 Transforaminal epidural injection Medicare reimbursement rates in Texas
Image-guided injection of anesthetic and/or steroid through a lumbar or sacral neural foramen into the epidural space, reported for the first level treated. Compare 64483 office and facility rates across CMS payment localities in Texas.
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 64483 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$246.70–$275.79
8 of 8 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 64483 pays more and less in Texas
8 payment localities
$246.70 to $275.79
Spine pain management
About 64483: Lumbar or sacral transforaminal epidural injection, single level
Image-guided injection of anesthetic and/or steroid through a lumbar or sacral neural foramen into the epidural space, reported for the first level treated.
At a lumbar or sacral neural foramen, the clinician advances a needle under fluoroscopy or CT to deliver local anesthetic, corticosteroid, or both near the affected nerve root and epidural space. Typical indications include radicular leg pain associated with a herniated lumbar disc or foraminal stenosis; an S1 foraminal injection is a sacral example. Interventional pain physicians, anesthesiologists, and physiatrists perform these injections in offices, ambulatory surgery centers, and hospital outpatient departments. Contrast may be used to confirm needle position and epidural spread.
Report one unit of 64483 for the first lumbar or sacral level, whether unilateral or bilateral; report 64484 for each additional level. Fluoroscopic or CT guidance is included. Document the treated level, side, guidance method, contrast findings when contrast is used, and injectate. For both sides at the same level, report 64483 with modifier 50; CMS pays bilateral procedures at 150% of the unilateral amount. The 0-day global includes routine same-day preoperative and postoperative care. When multiple procedures are performed in one session, CMS pays the highest-valued procedure in full and other eligible procedures at 50%. CMS does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 64483
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 procedure with modifier 50 is paid at 150%.
- 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 RVU1.85 · 23%
- Practice expense (office) RVU5.91 · 75%
- Malpractice RVU0.17 · 2%
898K
Medicare services in 2024 · #155 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.
64483 compared with similar codes
Office rates for Texas, from the same CMS release.
64479 is the first-level transforaminal code for the cervical or thoracic spine. Use 64483 for lumbar levels and sacral foramina.
64484 is an add-on for each additional lumbar or sacral transforaminal level and cannot be reported alone. Report 64483 for the first level.
64493 targets a lumbar facet joint or its medial branch nerves. 64483 delivers medication into the epidural space through a neural foramen.
Compare 64483 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $275.79 | Facility $100.87 |
| Beaumont | Office $246.70 | Facility $96.25 |
| Brazoria | Office $262.34 | Facility $98.49 |
| Dallas | Office $263.83 | Facility $99.16 |
| Fort Worth | Office $261.93 | Facility $98.91 |
| Galveston | Office $263.01 | Facility $98.83 |
| Houston | Office $266.12 | Facility $101.94 |
| Rest Of Texas | Office $254.25 | Facility $97.35 |
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64483 billing questions
How are two lumbar levels reported?
Report one unit of 64483 for the first level and one unit of 64484 for the additional level. Document the side treated at each level.
How is a bilateral injection at one level billed?
Report 64483 with modifier 50 when the same level is injected on both the left and right. CMS pays the bilateral procedure at 150% of the unilateral amount.
Can fluoroscopy or CT guidance be billed separately?
No. Fluoroscopic or CT guidance is included in 64483, so codes such as 77003 or 77012 are not reported separately for the same injection.
What if the injection is done under ultrasound guidance only?
64483 describes an injection performed with fluoroscopic or CT guidance. For ultrasound-guided lumbar or sacral transforaminal injections, 0230T describes the first level and 0231T describes each additional level.
Is an S1 transforaminal injection reported with this code?
Yes. An injection through the S1 foramen is sacral and falls under 64483 rather than the cervical or thoracic first-level code 64479.
Is a same-day E/M visit separately reportable?
Routine same-day preoperative and postoperative care is included in the 0-day global. A significant, separately identifiable E/M service beyond that care may be reported with modifier 25.
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.
