$181.73
Use 64493 for the first lumbar/sacral facet level. Add 64494 for the second level in the same procedure.
On this page
CMS RVU26D · Effective 2026-10-01
64494 Facet joint injection Medicare reimbursement rates in Utah
Report this add-on for the second lumbar or sacral facet level treated with image-guided injection after the first level is coded. Compare 64494 office and facility rates across CMS payment localities in Utah.
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 64494 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$91.96
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$42.98
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
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 64494: Second-level lumbar facet joint injection
Report this add-on for the second lumbar or sacral facet level treated with image-guided injection after the first level is coded.
Clinicians use this code for an image-guided injection at the second lumbar or sacral facet-joint level, or its innervating medial branch, commonly to evaluate or treat axial low-back pain attributed to facet joints. Interventional pain physicians, anesthesiologists, physiatrists, and other qualified clinicians perform the procedure in office-based or hospital outpatient settings, using fluoroscopic or CT guidance.
Report 64494 only with 64493 for the first lumbar/sacral level. It represents the second level, not another needle or joint treated at the first level. Documentation should identify the treated level and side, target, imaging guidance, injectate, and clinical rationale. This add-on is paid within the primary procedure's global period. For bilateral service, CMS pays 150% when modifier 50 is reported. The imaging guidance is included in the facet-injection service and is not separately reported.
CMS billing rules for 64494
- 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 RVU0.98 · 34%
- Practice expense (office) RVU1.81 · 63%
- Malpractice RVU0.08 · 3%
383.1K
Medicare services in 2024 · #266 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.
64494 compared with similar codes
Office rates for Utah, from the same CMS release.
$94.79
Use 64494 for the second lumbar/sacral level and 64495 for the third level.
$97.87
64491 is for a second facet level in the cervical or thoracic region; 64494 is for the lumbar or sacral region.
$252.45
64483 describes a lumbar/sacral transforaminal epidural injection targeting a nerve root, not a facet joint or its innervating medial branch.
Compare 64494 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.
1 of 1 payment localities
Utah →
Office / nonfacility
$91.96
Facility
$42.98
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64494 in Utah.
PPRRVU2026_Oct_nonQPP.csv
7,138
- Code
- 64494
- Physician work
- 0.98
- Practice expense
- 1.81
- Malpractice
- 0.08
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.98 | × 1.000 | 0.9800 |
| Practice expense | 1.81 | × 0.940 | 1.7014 |
| Malpractice | 0.08 | × 0.898 | 0.0718 |
| Total RVUs | 2.7532 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$91.96
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1 |
| Practice expense | 1.81 | 0.94 |
| Malpractice | 0.08 | 0.898 |
(0.98 × 1 + 1.81 × 0.94 + 0.08 × 0.898) × $33.4009 = $91.96
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1 |
| Practice expense | 0.25 | 0.94 |
| Malpractice | 0.08 | 0.898 |
(0.98 × 1 + 0.25 × 0.94 + 0.08 × 0.898) × $33.4009 = $42.98
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
64494 billing questions
Can 64494 be reported by itself?
No. It is an add-on for the second lumbar or sacral level and is reported with 64493 for the first level.
How is 64494 different from 64495?
64494 represents the second lumbar/sacral level; 64495 represents the third. Select the code according to the number of distinct levels treated.
How should bilateral treatment be reported?
For bilateral service, report modifier 50. CMS pays the bilateral procedure at 150%.
Are fluoroscopy or CT guidance separately reportable?
No. Image guidance is included in this facet-injection service.
What should the procedure note support?
Document the second level treated, laterality, injection target, imaging guidance, injectate, and clinical rationale. The record should distinguish the second level from the first level reported with 64493.
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.
7,13564491,,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
7,14064505,,N block spenopalatine gangl,A,,1.33,2.79,,1.21,,0.38,4.50,2.92,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14164510,,N block stellate ganglion,A,,1.19,3.31,,0.79,,0.11,4.61,2.09,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985