Medicare rate for CPT 64483 in 2026

Epidural steroid injection, lumbar, first level

Medicare’s 2026 allowed amount for CPT 64483 is $264.87 when the service is performed in a physician’s office and $99.53 when it is performed in a hospital or other facility. Both are national amounts before geographic adjustment. What a specific provider is actually paid depends on the Medicare locality they practise in.

Office (non-facility)$264.87The practice bears the overhead
Hospital (facility)$99.53The facility is paid separately for it

CMS short descriptor: Njx aa&/strd tfrm epi l/s 1 · Status A: Active, payable · Source: CMS 2026 July (RVU26C, non-QP conversion factor), effective 7/2026.

One of the widest office-versus-hospital gaps on any common code, because the non-facility practice expense carries the cost of the drug and the suite.

How the $264.87 is built

Work RVU 1.85, practice-expense RVU 5.91 in an office and 0.96 in a facility, malpractice RVU 0.17. Each is multiplied by its geographic index, added together, then multiplied by the 2026 conversion factor of $33.4009. With every index at 1.000 that gives $264.87 in an office and $99.53 in a facility.

This is the allowed amount for one unit, before the 2% sequestration reduction and before any multiple-procedure reduction. It is what Medicare allows, not what a commercial carrier or an auto policy allows, and not what the provider billed.

What CPT 64483 pays in New Jersey

New Jersey has 2 Medicare localities, so there is no single New Jersey rate. In an office the allowed amount runs from $286.05 to $300.73, a spread of 5.1% across the state.

LocalityOfficeFacility
Northern NJ$300.73$108.94
Rest Of New Jersey$286.05$105.51

CPT 64483 by fee-schedule year, 2023 to 2026

A bill is priced under the schedule in force on its date of service, not the one in force when it is reviewed. Note that 2024 has two entries: Congress changed the conversion factor on 9 March 2024, so a January 2024 date of service and a June 2024 date of service price differently.

Fee-schedule yearConversion factorOfficeFacility
2026$33.4009$264.87$99.53
2025$32.3465$236.13$107.71
2024 (Mar 9 to Dec 31)$33.2875$246.33$110.51
2024 (Jan 1 to Mar 8)$32.7442$242.31$108.71
2023$33.8872$249.41$110.81

National amounts, every geographic index at 1.000, so the year-to-year movement here is the fee schedule changing and not a change of location.

CPT 64483 in every state

The office allowed amount in each state, highest locality to lowest. Where a state shows one figure it has a single Medicare locality.

StateHighestLowestLocalities
California$356.28$282.2429
Washington$311.73$274.782
New York$311.00$253.315
Alaska$306.05-1
Massachusetts$305.07$275.172
District of Columbia$303.98-1
New Jersey$300.73$286.052
Hawaii / Guam$289.52-1
Oregon$286.32$262.392
Connecticut$282.50-1
Florida$281.64$259.043
Maryland$281.61$267.392
Colorado$277.00-1
Texas$275.79$246.708
Pennsylvania$275.17$248.372
Illinois$275.01$250.894
New Hampshire$272.25-1
Rhode Island$271.94-1
Georgia$269.35$244.642
Puerto Rico$266.96-1
Virgin Islands$266.96-1
Minnesota$266.60-1
Montana$264.86-1
Nevada$264.12-1
Wyoming$263.39-1
Delaware$262.24-1
Michigan$261.86$248.432
North Dakota$261.50-1
South Dakota$261.10-1
Maine$261.00$246.932
Vermont$260.09-1
Virginia$259.84-1
Arizona$257.93-1
Missouri$255.41$237.483
Louisiana$253.99$241.932
Wisconsin$252.65-1
Utah$252.45-1
New Mexico$249.63-1
North Carolina$249.59-1
South Carolina$249.02-1
Ohio$247.74-1
Indiana$247.54-1
Nebraska$246.14-1
Idaho$246.08-1
Iowa$244.67-1
Tennessee$244.28-1
Kansas$243.10-1
Oklahoma$242.48-1
Kentucky$242.48-1
West Virginia$241.46-1
Alabama$237.73-1
Mississippi$235.95-1
Arkansas$234.28-1

Checking a different code, state or year

The Medicare rate lookup prices all 17,000-plus codes in the Physician Fee Schedule for any state and any fee-schedule year from 2023 to 2026. Ambulance codes are priced separately on the ambulance fee schedule, because Medicare does not pay for ambulance transport under this schedule at all.

Other codes with a rate page

Medicare rates are a benchmark, not an allowance. What a no-fault, workers’ compensation or commercial carrier owes for CPT 64483 is set by the fee schedule or policy that governs the claim, which is frequently a multiple of the figure above. Talk to us about pricing a bill against the schedule that actually applies to it.