How much does Medicare pay for CPT 64451?

Medicare allowed an average of $232.40 per service and paid $180.10 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1107.09, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64451?

Injection of anesthetic agent and/or steroid into spine and pelvis nerve using imaging guidance. It was billed 4,983 times to 3,416 Medicare beneficiaries by 121 providers in 2024.

Does 64451 pay differently in an office than a hospital?

Yes. The allowed amount averaged $269.24 in an office setting and $197.92 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 64451 most?

Ambulatory Surgical Center, with 1,350 services from 23 clinicians. Next are Anesthesiology, Pain Management, Interventional Pain Management.

CPT 64451

Injection of anesthetic agent and/or steroid into spine and pelvis nerve using imaging guidance

$232.40Medicare-allowed amount per service, averaged across 4,983 services

Providers submitted

$1107.09

Asking price, not received

Medicare allowed

$232.40

The fee schedule figure

Medicare paid

$180.10

Balance is patient coinsurance

Providers submitted an average of $1107.09 for this code and Medicare allowed $232.40 — 4.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $180.10 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $269.24
Hospital / facility: $197.92

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 2,409 services were billed in an office setting and 2,574 in a facility.

Services: 4,983
Beneficiaries: 3,416
Providers billing it: 121
Total allowed: $1,158,049

What Medicare pays for CPT 64451

Across 4,983 services billed by 121 providers to 3,416 beneficiaries, Medicare allowed an average of $232.40 per service. That is 1.5 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 64451

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	1,350	681	$284.04	23
Anesthesiology	1,070	768	$212.56	25
Pain Management	796	663	$206.59	23
Interventional Pain Management	789	594	$223.53	18
Physical Medicine and Rehabilitation	571	425	$202.28	18
Neurosurgery	99	65	$211.83	3
Certified Registered Nurse Anesthetist (CRNA)	77	68	$135.30	3
Family Practice	72	34	$339.31	1
Orthopedic Surgery	70	56	$260.12	3
Nurse Practitioner	30	14	$173.77	1
Osteopathic Manipulative Medicine	23	16	$105.65	1
Obstetrics & Gynecology	20	16	$258.55	1
Preventive Medicine	16	16	$249.54	1

64451 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	881	$263.10	$212.08	26
Maryland	641	$217.87	$171.59	8
Texas	619	$242.85	$199.08	14
California	449	$242.92	$173.95	9
Oklahoma	391	$253.45	$218.88	8
Louisiana	266	$207.38	$181.55	5
Arkansas	218	$248.99	$213.03	5
Mississippi	204	$153.29	$135.68	7
Massachusetts	159	$183.72	$137.75	5
Ohio	151	$123.13	$96.58	4
Kentucky	94	$271.04	$229.83	2
Arizona	92	$210.59	$160.85	3
New Mexico	91	$169.80	$137.15	2
Virginia	87	$374.71	$260.93	1
Pennsylvania	74	$278.67	$208.13	2
Connecticut	67	$264.28	$189.70	1
North Carolina	64	$105.59	$83.48	1
Rhode Island	62	$221.50	$174.80	2
New Jersey	61	$274.24	$198.77	2
Alabama	54	$162.63	$139.80	2
Colorado	50	$335.06	$250.71	2
Georgia	48	$211.29	$181.89	2
Puerto Rico	34	$283.96	$203.19	1
Wisconsin	29	$241.32	$197.06	1
Nevada	27	$211.56	$158.38	2
Tennessee	26	$101.56	$65.06	1
New York	15	$332.97	$212.79	1
West Virginia	15	$99.91	$72.10	1
Oregon	14	$281.94	$206.39	1

Related codes

64483Injection of anesthetic and/or steroid drug into sacral spine nerve ro$263.09
64493Injection of lower or sacral spine facet joint$243.14
64494Injection of lower or sacral spine facet joint$96.60
64450Injection of anesthetic agent and/or steroid into other nerve or branc$44.99
64447Injection of anesthetic agent and/or steroid into thigh nerve (femoral$58.78
64484Injection of anesthetic and/or steroid drug into sacral spine nerve ro$84.15
64490Injection of upper or middle spine facet joint$259.70
64415Injection of anesthetic agent and/or steroid into arm nerve bundle (br$67.89
64491Injection of upper or middle spine facet joint$100.48
64445Injection of anesthetic agent and/or steroid into lower back and leg n$173.06
64405Injection of anesthetic agent and/or steroid into upper neck and back$71.75
64479Injection of anesthetic and/or steroid drug into upper or middle spine$275.58

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.