CPT 64483Surgery

Njx aa&/strd tfrm epi l/s 1

CPT 64483 covers an injection of anesthetic and/or steroid medication into the epidural space in the lower back (lumbar) or sacral spine through a transforaminal approach, treating a single level. This is commonly called a transforaminal epidural steroid injection or nerve root block.

Showing rates for

National Average

Base Medicare rate

$236.13

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.9

PE RVU (NF)

5.24

MP RVU

0.16

Total RVU

7.3

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Always bill fluoroscopic guidance separately with CPT 77003 for lumbar/sacral transforaminal epidurals, as imaging guidance is not bundled into 64483
Impact: Adds approximately $45-65 to total reimbursement per case; failure to bill results in $45+ loss per procedure
Verify place of service code accuracy—POS 11 (office) triggers $236.13 rate while POS 22 (outpatient hospital) or 24 (ASC) triggers $107.71 facility rate
Impact: Incorrect POS can result in $128.42 payment difference and potential recoupment audits
Use 64484 as an add-on code for each additional level beyond the first (not a standalone code), and bill only once per additional level per side
Impact: Proper use of 64484 adds $101.26 (non-facility) per additional level; maximum 3 levels typically covered per session
Document the specific spinal level (e.g., L5-S1 right transforaminal) and approach in the procedure note, with confirmation via fluoroscopic imaging saved to report
Impact: Prevents denials for insufficient documentation; approximately 15-20% of initial denials are documentation-related
Check LCD/NCD policies for frequency limitations—most Medicare contractors limit to 3-4 epidural injections per region per rolling 12 months
Impact: Exceeding frequency limits results in automatic denial; tracking prevents $236+ denial per excessive claim
Bill contrast material separately using HCPCS code for non-facility settings (typically Q9967 or similar), as contrast is not included in the procedure code
Impact: Recovers $15-40 in supply costs that are otherwise absorbed; applies only to non-facility settings

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 64483?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT code 64483 in 2025?

Medicare pays $236.13 for CPT 64483 in non-facility settings (office-based procedures) and $107.71 in facility settings (hospital outpatient or ASC) based on the 2025 Physician Fee Schedule. The rate difference reflects that facilities receive separate facility fees, while non-facility rates include practice expense costs.

How many times can you bill CPT 64483 per session?

CPT 64483 is billed once per session for the first lumbar or sacral level injected. For each additional level during the same session, use add-on code 64484. Most payers limit total injections to 2-3 levels per session, and bilateral injections at the same level require modifier 50, not multiple units of 64483.

Does CPT 64483 include fluoroscopic guidance?

No, fluoroscopic guidance is not bundled into CPT 64483. You must separately report CPT 77003 for fluoroscopic guidance for lumbar/sacral transforaminal epidural injections. This typically adds $45-65 to the total reimbursement, and permanent fluoroscopic images must be saved and documented.

What is the difference between CPT 64483 and 62323?

CPT 64483 is for transforaminal epidural injections (targeted nerve root approach) while 62323 is for interlaminar epidural injections (posterior midline approach). The transforaminal approach is more selective and typically reimbursed higher. These should not be billed together at the same level during the same session as they represent different approaches to the same anatomical space.

What diagnosis codes are required for CPT 64483 to be covered?

Common covered diagnoses include lumbar radiculopathy (M54.16), intervertebral disc disorders with radiculopathy (M51.16-M51.17), spinal stenosis with neurogenic claudication (M48.06), and post-laminectomy syndrome (M96.1). Documentation must show correlation between imaging findings, clinical symptoms, and the specific level injected. Failed conservative treatment must also be documented.

Can you bill an E/M visit on the same day as CPT 64483?

Yes, but only if a significant, separately identifiable evaluation and management service is performed and documented, and modifier 25 is appended to the E/M code. The E/M must be beyond the routine pre-procedure assessment. Simply obtaining consent or checking vital signs does not qualify. Many payers scrutinize same-day E/M claims closely, so documentation must clearly show medical necessity for the separate service.

How often can CPT 64483 be performed according to Medicare guidelines?

Most Medicare LCDs limit epidural steroid injections to 3-4 per spinal region per 12-month rolling period. Some contractors specify no more than 3 injections in a 6-month period. Frequency limits vary by MAC jurisdiction, so verify your specific LCD. Exceeding these limits without documentation of exceptional circumstances typically results in automatic denial.