How much does Medicare pay for CPT 64494?

Medicare allowed an average of $96.60 per service and paid $76.45 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $715.68, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64494?

Injection of lower or sacral spine facet joint using imaging guidance, second level. It was billed 352,249 times to 229,024 Medicare beneficiaries by 5,885 providers in 2024.

Does 64494 pay differently in an office than a hospital?

Yes. The allowed amount averaged $118.39 in an office setting and $68.18 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 64494 most?

Pain Management, with 102,987 services from 1,641 clinicians. Next are Physical Medicine and Rehabilitation, Anesthesiology, Interventional Pain Management.

CPT 64494

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

$96.60Medicare-allowed amount per service, averaged across 352,249 services

Providers submitted

$715.68

Asking price, not received

Medicare allowed

$96.60

The fee schedule figure

Medicare paid

$76.45

Balance is patient coinsurance

Providers submitted an average of $715.68 for this code and Medicare allowed $96.60 — 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 $76.45 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $118.39
Hospital / facility: $68.18

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. 199,361 services were billed in an office setting and 152,888 in a facility.

Services: 352,249
Beneficiaries: 229,024
Providers billing it: 5,885
Total allowed: $34,027,253

What Medicare pays for CPT 64494

Across 352,249 services billed by 5,885 providers to 229,024 beneficiaries, Medicare allowed an average of $96.60 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 64494

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pain Management	102,987	66,935	$96.14	1,641
Physical Medicine and Rehabilitation	85,146	56,507	$94.78	1,578
Anesthesiology	78,955	51,199	$95.60	1,356
Interventional Pain Management	64,950	41,097	$99.73	921
Orthopedic Surgery	5,101	3,558	$106.19	102
Neurology	2,540	1,608	$113.36	47
Neurosurgery	2,151	1,388	$95.74	34
Diagnostic Radiology	1,688	1,132	$102.10	38
Certified Registered Nurse Anesthetist (CRNA)	1,568	1,001	$86.17	32
Family Practice	1,423	954	$100.20	27
Internal Medicine	1,145	670	$115.45	18
Emergency Medicine	865	554	$80.61	17
Sports Medicine	767	493	$80.43	17
Interventional Radiology	727	443	$94.44	11
Psychiatry	444	257	$86.73	4

64494 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	44,063	$110.34	$87.22	575
California	28,072	$95.67	$71.24	470
Texas	27,232	$95.73	$77.84	518
New York	16,987	$113.00	$80.28	322
Arizona	13,554	$102.31	$83.14	185
Pennsylvania	12,866	$91.15	$72.22	244
Virginia	12,668	$108.28	$85.65	136
South Carolina	12,318	$102.19	$86.03	121
Georgia	11,536	$81.53	$66.27	220
Illinois	11,471	$97.34	$75.17	199
North Carolina	10,964	$105.79	$88.60	194
Ohio	10,029	$81.83	$66.94	213
Massachusetts	9,131	$99.09	$73.69	155
Maryland	8,914	$83.99	$64.19	133
Tennessee	8,124	$91.48	$79.05	120
New Jersey	8,115	$102.66	$75.48	182
Oklahoma	6,968	$99.21	$85.43	81
Indiana	6,354	$84.80	$71.91	127
Louisiana	5,969	$79.98	$66.85	91
Alabama	5,757	$90.88	$79.46	86
Arkansas	5,739	$83.40	$71.91	80
Michigan	5,694	$104.65	$83.98	145
Kentucky	5,641	$101.24	$87.22	85
Colorado	5,435	$93.72	$73.55	102
Missouri	5,341	$80.08	$65.42	94
Washington	4,729	$94.04	$73.00	90
Wisconsin	4,667	$75.25	$62.94	119
Mississippi	4,547	$76.30	$64.92	55
Utah	3,688	$110.84	$90.77	67
Minnesota	3,675	$75.56	$61.56	94
Nevada	3,198	$97.03	$78.60	54
Oregon	3,024	$90.00	$72.83	60
Kansas	2,990	$72.31	$60.28	59
Connecticut	2,937	$119.34	$88.27	51
Nebraska	2,228	$93.62	$81.50	39
New Mexico	2,144	$86.63	$72.52	40
New Hampshire	2,077	$80.54	$63.42	38
Iowa	2,024	$87.51	$74.03	33
West Virginia	1,951	$72.10	$56.55	27
Delaware	1,732	$94.41	$75.14	28
Idaho	1,466	$73.69	$61.63	28
Montana	935	$87.76	$68.67	19
Maine	934	$84.33	$65.68	20
South Dakota	927	$72.45	$59.94	16
Rhode Island	708	$91.85	$71.31	14
Alaska	629	$134.63	$88.20	11
North Dakota	549	$65.98	$52.76	10
Vermont	481	$80.10	$63.80	9
District of Columbia	374	$93.97	$68.64	8
Wyoming	262	$73.06	$57.82	5
Puerto Rico	214	$99.41	$99.25	7
Hawaii	182	$114.78	$97.65	4
U.S. Virgin Islands	23	$65.48	$49.52	1
Guam	12	$119.92	$106.87	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
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.