$189.17
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.
On this page
CMS RVU26D · Effective 2026-10-01
64495 Facet injection Medicare reimbursement rates in Wyoming
Image-guided lumbar or sacral facet joint injections at the third and subsequent levels are reported with the corresponding primary-level procedure. Compare 64495 office and facility rates across CMS payment localities in Wyoming.
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 64495 in Wyoming?
Wyoming 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
$98.17
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$44.40
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 64495: Lumbar facet joint injection, third level
Image-guided lumbar or sacral facet joint injections at the third and subsequent levels are reported with the corresponding primary-level procedure.
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.
CMS billing rules for 64495
- 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 · 33%
- Practice expense (office) RVU1.90 · 64%
- Malpractice RVU0.08 · 3%
887
Medicare services in 2024 · #3058 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.
64495 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$95.17
64494 applies to the second lumbar or sacral facet level. Use 64495 for the third and any additional level.
$101.43
64492 is the third-and-additional-level code for cervical or thoracic facet injections; 64495 is for lumbar or sacral levels.
$263.39
64483 describes a lumbar transforaminal epidural injection, targeting the epidural space through a foramen rather than a facet joint or its innervating nerves.
Compare 64495 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
Wyoming** →
Office / nonfacility
$98.17
Facility
$44.40
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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 64495 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,139
- Code
- 64495
- Physician work
- 0.98
- Practice expense
- 1.90
- Malpractice
- 0.08
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.98 | × 1.000 | 0.9800 |
| Practice expense | 1.90 | × 1.000 | 1.9000 |
| Malpractice | 0.08 | × 0.740 | 0.0592 |
| Total RVUs | 2.9392 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$98.17
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1 |
| Practice expense | 1.9 | 1 |
| Malpractice | 0.08 | 0.74 |
(0.98 × 1 + 1.9 × 1 + 0.08 × 0.74) × $33.4009 = $98.17
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1 |
| Practice expense | 0.29 | 1 |
| Malpractice | 0.08 | 0.74 |
(0.98 × 1 + 0.29 × 1 + 0.08 × 0.74) × $33.4009 = $44.40
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.
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 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.
7,13664492,,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
7,14264517,,N block inj hypogas plxs,A,,2.15,3.72,,1.06,,0.20,6.07,3.41,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,