How much does Medicare pay for CPT 64480?

Medicare allowed an average of $105.06 per service and paid $83.17 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $781.06, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does 64480 pay differently in an office than a hospital?

Yes. The allowed amount averaged $145.13 in an office setting and $62.03 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 64480 most?

Physical Medicine and Rehabilitation, with 1,980 services from 61 clinicians. Next are Interventional Pain Management, Pain Management, Anesthesiology.

CPT 64480

Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, each additional level

$105.06Medicare-allowed amount per service, averaged across 6,622 services

Providers submitted

$781.06

Asking price, not received

Medicare allowed

$105.06

The fee schedule figure

Medicare paid

$83.17

Balance is patient coinsurance

Providers submitted an average of $781.06 for this code and Medicare allowed $105.06 — 7.4× 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 $83.17 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $145.13
Hospital / facility: $62.03

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. 3,429 services were billed in an office setting and 3,193 in a facility.

Services: 6,622
Beneficiaries: 4,834
Providers billing it: 191
Total allowed: $695,707

What Medicare pays for CPT 64480

Across 6,622 services billed by 191 providers to 4,834 beneficiaries, Medicare allowed an average of $105.06 per service. That is 1.4 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 64480

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Medicine and Rehabilitation	1,980	1,523	$104.36	61
Interventional Pain Management	1,576	1,082	$115.37	37
Pain Management	1,519	1,121	$108.19	46
Anesthesiology	1,146	818	$95.04	36
Neurology	220	156	$86.08	4
Orthopedic Surgery	73	42	$75.02	3
Diagnostic Radiology	54	44	$71.95	2
Sports Medicine	29	26	$67.62	1
Internal Medicine	25	22	$149.62	1

64480 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
California	984	$114.12	$83.72	29
Florida	850	$131.87	$101.15	19
New York	563	$142.48	$103.22	11
Texas	546	$86.06	$69.18	13
Maryland	387	$84.85	$65.56	12
Pennsylvania	384	$120.04	$92.88	11
Ohio	342	$77.48	$63.66	8
Nevada	308	$63.49	$52.45	11
Louisiana	275	$61.77	$53.21	10
North Carolina	247	$126.75	$105.54	8
Virginia	179	$146.16	$122.40	4
Mississippi	170	$64.32	$54.77	2
New Jersey	144	$90.88	$70.32	6
Delaware	133	$95.18	$73.75	5
Arizona	125	$93.90	$76.99	6
Oregon	116	$83.92	$66.57	4
Georgia	109	$132.10	$105.25	1
Massachusetts	104	$150.88	$105.21	1
Colorado	101	$86.08	$68.16	6
Alabama	93	$75.17	$63.42	3
Missouri	71	$61.37	$47.74	3
Tennessee	69	$76.40	$63.04	3
South Carolina	42	$133.45	$113.09	2
Rhode Island	41	$83.09	$67.49	1
Alaska	32	$156.02	$105.17	1
Indiana	31	$55.88	$46.17	2
Minnesota	30	$57.11	$47.19	1
Kansas	27	$58.01	$47.13	1
Utah	19	$125.87	$105.25	1
Illinois	19	$155.83	$113.58	1
Arkansas	17	$57.11	$45.01	1
Montana	17	$58.59	$47.15	1
Kentucky	17	$120.67	$105.13	1
Washington	17	$52.97	$45.78	1
Connecticut	13	$141.48	$104.77	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.