How much does Medicare pay for CPT 64493?

Medicare allowed an average of $243.14 per service and paid $189.66 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1906.67, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64493?

Injection of lower or sacral spine facet joint using imaging guidance, single level. It was billed 583,299 times to 324,920 Medicare beneficiaries by 7,453 providers in 2024.

Does 64493 pay differently in an office than a hospital?

Yes. The allowed amount averaged $229.08 in an office setting and $251.50 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 64493 most?

Ambulatory Surgical Center, with 196,234 services from 1,247 clinicians. Next are Pain Management, Physical Medicine and Rehabilitation, Anesthesiology.

CPT 64493

Injection of lower or sacral spine facet joint using imaging guidance, single level

$243.14Medicare-allowed amount per service, averaged across 583,299 services

Providers submitted

$1906.67

Asking price, not received

Medicare allowed

$243.14

The fee schedule figure

Medicare paid

$189.66

Balance is patient coinsurance

Providers submitted an average of $1906.67 for this code and Medicare allowed $243.14 — 7.8× 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 $189.66 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $229.08
Hospital / facility: $251.50

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 217,574 services were billed in an office setting and 365,725 in a facility.

Services: 583,299
Beneficiaries: 324,920
Providers billing it: 7,453
Total allowed: $141,823,319

What Medicare pays for CPT 64493

Across 583,299 services billed by 7,453 providers to 324,920 beneficiaries, Medicare allowed an average of $243.14 per service. That is 1.8 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 64493

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	196,234	73,076	$363.79	1,247
Pain Management	109,577	71,240	$180.98	1,695
Physical Medicine and Rehabilitation	98,522	65,341	$178.35	1,687
Anesthesiology	85,527	55,521	$180.04	1,419
Interventional Pain Management	69,082	43,694	$188.25	954
Orthopedic Surgery	6,521	4,477	$202.92	120
Neurosurgery	2,823	1,772	$182.79	41
Neurology	2,753	1,759	$213.09	50
Diagnostic Radiology	2,260	1,611	$196.20	56
Certified Registered Nurse Anesthetist (CRNA)	1,735	1,098	$161.49	35
Family Practice	1,686	1,141	$183.75	28
Internal Medicine	1,302	766	$215.12	21
Emergency Medicine	976	609	$149.66	18
Sports Medicine	930	602	$144.81	18
Interventional Radiology	828	514	$185.25	13

64493 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	65,109	$245.54	$198.20	697
California	59,424	$300.37	$202.21	684
Texas	46,272	$240.49	$195.93	652
Georgia	27,169	$257.42	$210.54	334
New York	23,663	$255.44	$182.09	368
Maryland	23,594	$274.82	$219.09	221
Arizona	21,973	$250.61	$200.13	230
Pennsylvania	20,343	$224.45	$178.80	306
South Carolina	17,229	$226.03	$187.64	134
Illinois	16,454	$227.84	$175.60	233
Ohio	15,779	$205.95	$170.90	265
New Jersey	15,693	$280.26	$205.35	269
Tennessee	15,179	$235.83	$203.62	157
Virginia	14,029	$212.99	$164.25	141
North Carolina	12,746	$206.22	$168.02	210
Indiana	12,079	$238.46	$197.83	172
Louisiana	11,808	$224.94	$194.57	122
Colorado	10,930	$247.44	$194.10	137
Massachusetts	10,887	$205.52	$149.94	168
Mississippi	10,063	$224.24	$201.45	72
Arkansas	10,022	$226.01	$195.36	101
Alabama	8,988	$210.39	$187.68	106
Washington	8,463	$249.13	$185.56	117
Wisconsin	8,023	$209.96	$171.88	156
Michigan	7,894	$224.61	$180.34	171
Oklahoma	7,647	$198.01	$165.99	86
Minnesota	7,600	$242.20	$189.38	123
Kentucky	7,377	$218.68	$185.19	95
Oregon	7,234	$275.78	$208.86	84
Missouri	6,860	$179.29	$147.13	108
Nevada	6,266	$273.39	$210.19	76
Kansas	5,719	$218.71	$180.34	76
Utah	4,455	$224.87	$180.57	73
Connecticut	4,163	$270.09	$196.46	61
New Hampshire	3,560	$231.99	$187.22	46
New Mexico	3,549	$228.22	$188.39	47
Delaware	3,537	$265.09	$208.41	35
Nebraska	3,152	$216.65	$181.55	48
Iowa	3,079	$214.82	$181.82	40
Idaho	2,699	$208.56	$175.91	39
West Virginia	2,292	$152.90	$123.88	29
Montana	2,092	$221.73	$178.33	30
Rhode Island	1,474	$236.12	$181.20	17
South Dakota	1,196	$151.41	$125.52	22
Wyoming	1,109	$264.27	$216.11	11
Maine	1,079	$155.84	$118.53	22
Alaska	985	$301.71	$189.74	16
North Dakota	811	$198.88	$162.56	13
Vermont	559	$155.36	$118.31	9
District of Columbia	498	$200.77	$139.15	9
Puerto Rico	215	$194.05	$186.15	7
Hawaii	210	$226.72	$184.81	5
U.S. Virgin Islands	57	$217.28	$191.83	2
Guam	12	$285.43	$208.66	1

Related codes

64483Injection of anesthetic and/or steroid drug into sacral spine nerve ro$263.09
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
64455Injection of anesthetic and/or steroid drug into foot nerve$48.08

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.