Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (list separately in addition to code for primary procedure)

CPT 64493 is the billing code for "Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (list separately in addition to code for primary procedure)". Paravertebral facet joint injection at single lumbar or sacral level

Medicare pays approximately $172.08 for CPT 64493 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 64493 has a total RVU of 3.62, broken down as: Work RVU 1.50, Practice Expense RVU 2.00, and Malpractice RVU 0.12. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 64493 include: Level of injection documented; Facet joint injected documented; Anesthetic/steroid documented; Patient response to procedure. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 64493: Single level only. Facet joint injection Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 64493 include: 59 (Distinct procedural service when multiple procedures performed), 50 (Bilateral procedure), LT (Left side). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 64493 is Typically 15-20 minutes. Time-based codes require documentation of the actual time spent providing the service.