Billing code 64480: Epidural injectionMedicare rate & RVUs in Utah

Reports an additional cervical or thoracic transforaminal epidural level beyond the first when treating a targeted spinal nerve root.

CMS RVU26DEffective Oct 1, 20261 payment locality11K Medicare services in 2024

Medicare pays $136.57 for 64480 in the office in Utah (Utah). Which amount applies depends on the service address.

$136.57Office (non-facility)
$52.11Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 64480 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 64480 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 64480 covers

This add-on represents an injection at another cervical or thoracic spinal level, using a transforaminal approach to deliver anesthetic and/or steroid near a targeted nerve root. Interventional pain physicians, anesthesiologists, physiatrists, and radiologists may perform it for conditions such as cervical or thoracic radicular pain. Imaging guidance, such as fluoroscopy or CT, is part of the service; the code does not represent a separate imaging service.

Report 64480 for each additional level treated after the first, with 64479 for the initial cervical or thoracic level. The record should identify the treated spinal levels, approach, injectate, and guidance used; another injection or needle pass at the same level is not another level. CMS classifies 64480 as an add-on code, so it must be billed with its primary procedure and is paid 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.

64480 in Utah

64480 office and facility rates by payment locality
Payment localityOfficeFacility
Utah$136.57$52.11

How the 64480 rate is calculated

Each of 64480’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 · 64480

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.17Practice expense 3.00Malpractice 0.11

4.2800 adjusted RVUs×$33.4009 conversion factor=$142.96

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 64480

The CMS indicators that decide how 64480 is paid alongside other services.

CMS payment indicators · 64480

Epidural injection

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

64480 without 50 · national office

$142.96

Epidural injection

64480-50 · Bilateral: 150%

$214.44

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).

When to use modifier 50

64480 compared with similar codes

Compare codes

64480 vs 64479 vs 64484 vs 64490: national Medicare rates

Swap in your local Medicare rate.

  • 64480
    Epidural injection · 1.17 wRVU
    $142.96
  • 64479
    Epidural injection · 2.23 wRVU
    $285.24+$142.28
  • 64484
    Epidural injection · 0.98 wRVU
    $117.57−$25.39
  • 64490
    Facet injection · 1.77 wRVU
    $205.08+$62.12

How to choose

64479Epidural injection
64479 covers the initial cervical or thoracic transforaminal level; 64480 covers each additional level and is reported with 64479.
64484Epidural injection
64484 covers additional lumbar or sacral transforaminal levels. Choose the add-on code according to the spinal region treated.
64490Facet injection
64490 targets a cervical or thoracic facet joint. 64480 targets an additional nerve-root level through a transforaminal approach.

64480 billing questions

When is 64480 reported instead of 64479?

Use 64479 for the initial cervical or thoracic transforaminal level. Report 64480 for each additional level treated in the same procedure.

Can 64480 be billed by itself?

No. It is an add-on code and must be reported with the primary procedure, 64479.

Does another injection at the same level support another unit?

No. The add-on is based on an additional spinal level, not additional needle passes or injections at the same level.

How is bilateral treatment reported under the CMS rule?

For a bilateral procedure reported with modifier 50, CMS pays 150% of the applicable amount.

What distinguishes 64480 from 64484?

64480 is for each additional cervical or thoracic transforaminal level. 64484 is for each additional lumbar or sacral level.

What documentation supports the additional-level code?

Document the cervical or thoracic levels treated, the transforaminal approach, the injectate, and the imaging guidance used.

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
RVUs for 64480PPRRVU2026_Oct_nonQPP.csv, line 7,127 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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