CPT 62304
Global 000 ActiveMyelography lumbar injection
CPT 62304 Billing & Documentation Guide
CPT code 62304 (Myelography lumbar injection) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.19, a non-facility practice expense RVU of 4.85, and a malpractice RVU of 0.22, a total non-facility RVU of 7.26 and facility RVU of 3.02. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $250, though rates vary from $216.09 to $318.73 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 62304, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 62304 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 62304 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 62304
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.19 | 2.19 |
| Practice Expense RVU | 4.85 | 0.61 |
| Malpractice RVU | 0.22 | 0.22 |
| Total RVU | 7.26 | 3.02 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 62304
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $271.44 | $103.86 | $255.88 - $318.73 | 29 |
| Florida | $249.99 | $107.89 | $239.06 - $260.37 | 3 |
| Georgia | $236.6 | $101.49 | $226.41 - $246.78 | 2 |
| Illinois | $243.97 | $107.14 | $232.53 - $253.33 | 4 |
| Michigan | $235.6 | $102.63 | $229.34 - $241.86 | 2 |
| North Carolina | $228.98 | $96.85 | $228.98 - $228.98 | 1 |
| New York | $267.33 | $109.34 | $232.21 - $284.09 | 5 |
| Ohio | $228.46 | $99.16 | $228.46 - $228.46 | 1 |
| Pennsylvania | $240.34 | $101.62 | $228.8 - $251.87 | 2 |
| Texas | $239.86 | $100.44 | $227.39 - $251.19 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 62304
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 62304 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00630 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01935 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01936 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01937 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01938 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01939 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01940 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01941 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01942 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 62304
What does CPT code 62304 mean? +
CPT code 62304 represents: Myelography lumbar injection. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 62304? +
The 2026 Medicare national average non-facility payment for CPT 62304 is $250. Rates range from $216.09 to $318.73 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 62304? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 62304? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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