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CPT Codes by Procedure
| Procedure | Primary CPT | Add-On CPT | Key Modifier | Imaging Bundled | Notes |
|---|---|---|---|---|---|
| Lumbar TFESI (L3-L4, L5-S1) | 64483 | +64484 | -50 if bilateral | Yes | Max 2 levels/session; max 4 ESI sessions per rolling 12 mo |
| Cervical TFESI | 64479 | +64480 | -50 if bilateral | Yes | Dexamethasone mandatory (non-particulate only) |
| Thoracic TFESI | 64479 | +64480 | -50 if bilateral | Yes | Same codes as cervical; shares 4-session ESI limit |
| Interlaminar ESI (Cervical/Thoracic) | 62321 | -- | NOT bilateral | Yes | Do not use modifier -50 |
| Interlaminar ESI (Lumbar) | 62323 | -- | NOT bilateral | Yes | Do not use modifier -50 |
| Caudal ESI | 62323 | -- | NOT bilateral | Yes | Same code as lumbar interlaminar; shares 4-session limit |
| MBB / Facet Injection (Cervical/Thoracic) - 1st level | 64490 | -- | -50 if bilateral | Yes | Covers both intra-articular and MBB |
| MBB / Facet Injection (Cervical/Thoracic) - 2nd level | -- | +64491 | -50 if bilateral | Yes | Add-on to 64490 |
| MBB / Facet Injection (Cervical/Thoracic) - 3rd+ level | -- | +64492 | -50 if bilateral | Yes | Add-on to 64490; single code for 3rd and beyond |
| MBB / Facet Injection (Lumbar/Thoracic) - 1st level | 64493 | -- | -50 if bilateral | Yes | Covers both intra-articular and MBB |
| MBB / Facet Injection (Lumbar/Thoracic) - 2nd level | -- | +64494 | -50 if bilateral | Yes | Add-on to 64493 |
| MBB / Facet Injection (Lumbar/Thoracic) - 3rd+ level | -- | +64495 | -50 if bilateral | Yes | Add-on to 64493; single code for 3rd and beyond |
| Facet RFA (Cervical/Thoracic) - 1st joint | 64633 | -- | -50 if bilateral | Yes | Bill per joint, not per nerve |
| Facet RFA (Cervical/Thoracic) - 2nd joint | -- | +64634 | -50 if bilateral | Yes | Add-on to 64633 |
| Facet RFA (Cervical/Thoracic) - each additional joint | -- | +64634 | -50 if bilateral | Yes | Same add-on code for each additional joint |
| Facet RFA (Lumbar/Thoracic) - 1st joint | 64635 | -- | -50 if bilateral | Yes | Bill per joint, not per nerve |
| Facet RFA (Lumbar/Thoracic) - 2nd joint | -- | +64636 | -50 if bilateral | Yes | Add-on to 64635 |
| Facet RFA (Lumbar/Thoracic) - each additional joint | -- | +64636 | -50 if bilateral | Yes | Same add-on code for each additional joint |
| SI Joint Injection | 27096 | -- | -50 if bilateral | Check payer | Cannot bill with 64451 on same side, same date |
| Sacral Lateral Branch Block | 64451 | -- | -50 if bilateral | Bill 77003 if allowed | L5 dorsal ramus + S1-S3 lateral branches |
| SI Joint RFA | 64625 | -- | Once per side | Yes | Cannot report multiple times on same side |
| BVN Ablation (Intracept) | 64628 | +64629 | -- | Yes | 64628 covers first 2 vertebral bodies (L3-S1); device-intensive |
| SCS Trial (Percutaneous) | 63650 | -- | -- | -- | Lead removal included; max 2 leads per DOS |
| SCS Permanent (Percutaneous + Generator) | 63650 + 63685 | -- | -- | -- | 1 permanent SCS per patient per lifetime (Medicare) |
| SCS Permanent (Paddle + Generator) | 63655 + 63685 | -- | -- | -- | Laminectomy approach; report 63655 only if laminectomy performed |
| DRG Stimulator | 0784T | -- | -- | Category III | Coverage varies widely; FDA-approved for CRPS I/II lower extremity |
| Stellate Ganglion Block | 64510 | -- | -- | -- | Single code per session regardless of injection count |
| Celiac Plexus Block | 64530 | -- | -- | -- | Do not bill with 64680 on same date unless -59/XS justified |
| Celiac Plexus Neurolysis | 64680 | -- | -- | -- | Phenol/alcohol neurolysis; distinct from diagnostic block |
| Lumbar Sympathetic Block | 64520 | -- | -- | -- | Single code per session |
| Superior Hypogastric Plexus Block | 64517 | -- | -- | -- | Chronic pelvic pain; single code per session |
| Ganglion Impar Block | 64520 | -- | -- | -- | Uses lumbar sympathetic code; for RFA consider 64999 (unlisted) |
| Provocative Discography (Lumbar) | 62290 + 72295 | Per level | -- | Yes (in 72295) | Bill both codes per level; many payers consider investigational |
Notes
- 1. Bilateral modifier -50: report one line item with -50; reimbursed at 150% of unilateral rate (not 200%).
- 2. Medicare 4-session ESI limit: max 4 ESI sessions per rolling 12 months across ALL ESI types and regions.
- 3. MBB requirement before RFA: 2 separate diagnostic MBBs each with >= 80% relief, spaced >= 2 weeks apart.
- 4. Since 2017 CPT restructuring, most spine injection codes bundle imaging guidance -- do NOT bill 77003 separately (NCCI edit denial).
- 5. Repeat RFA requires documentation of >= 50% pain improvement for >= 6 months from prior RFA; max 2 RFA per region per 12 mo.
- 6. Pulsed RF / non-thermal denervation: report 64999 (unlisted), NOT the standard RFA codes.
Source: CMS, AAPC, ASIPP 2025-2026 | Updated: 2026-04-03
Printed from Interventional Pain Trainer | CPT Codes by Procedure | 2026-04-03