Summary & Overview
CPT 64483: Lumbar or Sacral Transforaminal Epidural Injection with Imaging
CPT code 64483 is a widely utilized billing code for transforaminal epidural injections in the lumbar or sacral region, performed with imaging guidance. This procedure is a cornerstone in the management of chronic low back pain and radiculopathy, providing targeted relief for patients suffering from nerve root inflammation. The code is relevant across the United States, reflecting its importance in both clinical practice and medical billing.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, recognize and reimburse for this service, underscoring its broad acceptance and clinical value. The procedure is typically performed in ambulatory surgical centers, aligning with current trends toward outpatient pain management.
Readers will gain insight into the clinical context of 64483, including its role in pain medicine and anesthesiology, typical sites of service, and associated billing practices. The publication also covers related codes, common modifiers, and ICD-10 diagnoses frequently linked to this procedure. Policy updates, payer coverage details, and benchmarks are provided to inform stakeholders about current reimbursement and utilization patterns. This summary offers a comprehensive overview for clinicians, administrators, and policy analysts seeking to understand the national landscape for lumbar and sacral transforaminal epidural injections.
CPT Code Overview
CPT code 64483 describes the injection of anesthetic agent(s) and/or steroid into the transforaminal epidural space of the lumbar or sacral region at a single level, performed with imaging guidance such as fluoroscopy or CT. This procedure is commonly used in the management of pain related to nerve root irritation or inflammation in the lower back. The service falls under Anesthesiology and is typically performed in an Ambulatory Surgical Center (POS 24), offering patients a minimally invasive option for pain relief in an outpatient setting.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting with persistent low back pain and/or radicular symptoms such as sciatica, often due to intervertebral disc disorders or lumbar radiculopathy. The patient has not responded adequately to conservative treatments like physical therapy or oral medications. The provider, typically an anesthesiologist, pain medicine physician, or spine surgeon, evaluates the patient and determines that a transforaminal epidural injection with imaging guidance is appropriate to deliver anesthetic and/or steroid medication directly to the affected nerve root. The procedure is performed in an ambulatory surgical center (Place of Service 24), using fluoroscopy or CT imaging to ensure accurate needle placement at a single lumbar or sacral level.
Coding Specifications
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Modifiers:
Modifier Code Description When Used 50Bilateral Procedure When the injection is performed on both sides 59Distinct Procedural Service When a separate and distinct procedure is performed in addition to the primary service -
Provider Taxonomies:
Taxonomy Code Specialty Name 207L00000XAnesthesiology 208VP0000XPain Medicine Physician 207XS0117XOrthopaedic Surgery of the Spine
These taxonomies represent providers specializing in pain management, anesthesiology, and spine surgery who are qualified to perform the procedure.
Related Diagnoses
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M54.5- Low back pain- Indicates the patient is experiencing pain localized to the lower back, a common indication for lumbar epidural injections.
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M51.16- Intervertebral disc disorders with radiculopathy, lumbar region- Represents disc pathology causing nerve root irritation or compression, often leading to radicular pain and warranting targeted epidural injection.
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M54.16- Radiculopathy, lumbar region- Refers to nerve root dysfunction in the lumbar spine, typically presenting as radiating leg pain, which is a primary indication for transforaminal epidural injections.
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G89.29- Other chronic pain- Used for patients with chronic pain syndromes not otherwise specified, supporting the medical necessity for pain management interventions.
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M54.30- Sciatica, unspecified side- Describes radiating pain along the sciatic nerve, often due to lumbar nerve root irritation, and is a frequent reason for performing this procedure.
Related CPT Codes
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64484- Injection(s), anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, each additional level- Used when injections are performed at more than one lumbar or sacral level during the same session. Commonly billed together with
64483for multi-level procedures.
- Used when injections are performed at more than one lumbar or sacral level during the same session. Commonly billed together with
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62323- Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid), not including neurolytic substances, with or without contrast, lumbar or sacral- Alternative procedure for epidural injections in the lumbar or sacral region, not specifically transforaminal. May be used in different clinical scenarios.
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77003- Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures- Used for imaging guidance during injection procedures. Often reported in conjunction with
64483to document fluoroscopic guidance.
- Used for imaging guidance during injection procedures. Often reported in conjunction with
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20552- Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)- Used for trigger point injections, which are distinct from epidural injections. May be performed in patients with muscular pain in addition to radicular symptoms.
National Reimbursement Benchmarks
For CPT code 64483, the national mean rate for Medicare is $275.34, while the average commercial benchmark (BUCA) is $261.61. This places Medicare slightly above the commercial average, with UnitedHealth Group and Cigna showing notably higher mean rates among commercial payers.
Rate dispersion varies significantly across payers. UnitedHealth Group exhibits the widest spread, with a difference of $179.06 between the 75th and 25th percentiles, indicating substantial variability in contracted rates. In contrast, Medicare has the tightest range, with only $31.00 separating its 75th and 25th percentiles, reflecting more consistent reimbursement levels.
The table and chart below present a detailed breakdown of national mean rates and percentile values for each payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.