CPT Code 64484
Injection into lumbar or sacral epidural space, each additional
Source: CMS 2026 Physician Fee Schedule. Maintained by the D3rx Clinical Billing Team.
2026 Medicare national rate
Office (non-facility)
$117.57
Performed in a physician office
Facility
$43.76
Hospital / ASC setting
Total RVUs (office)
3.52
1.31 facility
Conversion factor
$33.4009
2026 PFS
Medicare payment = total RVUs × GPCI (locality adjustment) × conversion factor. At the national level (GPCI = 1.0), 3.52 × 33.4009 = $117.57 (office). Facility rates are lower because the facility separately bills its overhead.
RVU breakdown
Work RVU
0.98
Office PE RVU
2.46
Facility PE RVU
0.25
Malpractice RVU
0.08
PC/TC: Physician service — not subject to a professional/technical split.
Billing notes
- Medicare pays $73.81 more for 64484 in an office ($117.57) than in a facility ($43.76). The office (non-facility) rate carries the practice-expense overhead a hospital or ASC bills separately, so the place-of-service code you submit directly changes the allowable.
- The national allowable is built from 3.52 total office RVUs × the $33.4009 conversion factor; multiply by your locality GPCIs (above) to reconcile a specific remittance.
Billing & payment rules
- Bilateral surgery
- Conditional bilateral — 150% adjustment applies when performed bilaterally (modifier 50).
- Assistant surgeon
- Assistant surgeon may not be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgeons
- Team surgeons not permitted.
- Global period
- Add-on code — bundled into the global period of the primary procedure it is reported with.
2026 rate by locality
| Locality | Office | Facility |
|---|---|---|
| National (GPCI 1.0) | $117.57 | $43.76 |
| Manhattan, NY | $134.54 | $48.77 |
| Los Angeles, CA | $133.05 | $45.73 |
| Houston, TX | $118.26 | $44.96 |
| Chicago, IL | $121.67 | $47.49 |
| Miami, FL | $125.03 | $48.18 |
| Atlanta, GA | $119.52 | $44.52 |
Computed from CMS 2026 GPCIs: (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × $33.4009. Your MAC's locality may differ.
Related Surgery codes
Related guides
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Medical billing disclaimer
Rates shown are 2026 Medicare Physician Fee Schedule amounts and are for educational reference. Commercial payers, locality, and plan rules vary. Always verify current rates and coverage with the payer before billing. D3rx is not responsible for claim outcomes.