CPT 64483: Transforaminal Epidural Injection, Lumbar/Sacral
CPT 64483 reports a transforaminal epidural injection of anesthetic and/or steroid at a single lumbar or sacral level, with imaging guidance included. In 2026 Medicare pays about $264.87 non-facility and $99.53 facility, with a 000-day global period.
- Code type
- Surgical - transforaminal epidural injection, single level
- 2026 non-facility
- $264.87
- 2026 facility
- $99.53
- Global period
- 000 days
What is CPT 64483 used for?
CPT 64483 reports an injection of anesthetic and/or steroid, transforaminal epidural, with imaging guidance, at a single lumbar or sacral level. It is a core pain-management code for radicular low back pain, where the drug is placed at a specific nerve root through the neural foramen under fluoroscopy or CT.
The cervical and thoracic version is 64479. The lumbar/sacral 64483 is for the first level treated; additional levels use the add-on code. Selecting it correctly hinges on the spinal region and the number of levels.
How much does 64483 pay in 2026?
Under the 2026 Medicare fee schedule, 64483 allows about $264.87 non-facility and $99.53 facility. The office rate is far higher because it includes the imaging equipment and supply cost.
| Setting | 2026 Medicare allowed |
|---|---|
| Non-facility (office) | ~$264.87 |
| Facility (ASC/hospital) | ~$99.53 |
Example: a pain physician performs a single-level left L5 transforaminal epidural in the office under fluoroscopy. You bill 64483-LT at about $264.87. Check your locality figure with the Medicare fee calculator.
Why can't you bill imaging separately?
The imaging guidance is written into the code descriptor, so it is already paid inside the procedure. Reporting fluoroscopy 77003 alongside 64483 is a classic bundling error:
- Perform the injection under fluoroscopic or CT guidance.
- Report 64483 for the single-level procedure, imaging included.
- Do not add 77003 or any separate guidance code.
How do you code multiple levels and both sides?
Report the first level with 64483 and each additional level with add-on +64484. For a bilateral single-level injection, use modifier 50, or LT and RT depending on payer rules, instead of two units. Because these injections are elective, most payers require prior authorization and clear medical necessity documentation showing conservative therapy first. With a 000 global period, no post-op days are bundled.
Frequently asked questions
In 2026 the national non-facility allowed amount is about $264.87, and the facility rate is about $99.53. The large gap reflects the imaging and supply cost the office absorbs when the injection is done in-office rather than in a facility. Medicare pays 80 percent after the deductible.
No. Imaging guidance (fluoroscopy or CT) is bundled into 64483 and cannot be reported separately. Billing 77003 alongside 64483 is a duplicate charge that will be denied. The imaging is already valued inside the procedure code.
For each additional level, add +64484. For a bilateral single-level injection, report 64483 with modifier 50 (or LT and RT per payer rules) rather than billing it twice. Many payers also require prior authorization for epidural steroid injections.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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