Common surgery & pain management

64493 - RVUs & Medicare payment (2026)

Facet joint injection, lumbar/sacral, first level.

Component	Non-facility	Facility
Work RVU	1.48	1.48
Practice expense RVU	4.08	0.82
Malpractice RVU	0.14	0.14
Total RVUs	5.70	2.44
National payment (CF $33.4009)	$190.39	$81.50
Qualifying APM payment (CF $33.5675)	$191.33	$81.90

How 64493 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 64493 ranges from $168.90 in Arkansas (AR) to $253.89 in San Jose-Sunnyvale-Santa Clara (CA); calculate 64493 for your locality.

San Jose-Sunnyvale-Santa Clara (CA) $253.89 San Jose-Sunnyvale-Santa Clara (CA) $253.24 San Francisco-Oakland-Berkeley (CA) $248.42 San Francisco-Oakland-Berkeley (CA) $248.27 Napa (CA) $234.53 Vallejo (CA) $234.31 NYC Suburbs/Long Island (NY) $223.31 Seattle (WA) $222.94 National average $190.39 … 97 more localities between … Rest Of Missouri (MO) $171.46 Alabama (AL) $171.32 Mississippi (MS) $170.22 Arkansas (AR) $168.90

Non-facility payment for 64493 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: 000

Same-day global period: related visits on the day of the procedure are included in the payment.

Related codes - common surgery & pain management

29881 · knee arthroscopy with meniscectomy
27447 · total knee arthroplasty (knee replacement)
27130 · total hip arthroplasty (hip replacement)
47562 · laparoscopic cholecystectomy (gallbladder removal)
49505 · open repair of inguinal hernia, initial
19120 · excision of breast lesion
63030 · lumbar discectomy, single level
62323 · lumbar/caudal epidural injection with imaging guidance
64483 · transforaminal epidural injection, lumbar/sacral, first level
59400 · vaginal delivery with antepartum and postpartum care

Frequently asked questions

How much does Medicare pay for 64493 in 2026?

The national non-facility payment is $190.39 and the facility payment is $81.50, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 64493?

The 2026 work RVU for 64493 is 1.48. Total RVUs are 5.70 in the non-facility setting and 2.44 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.