CPT 64492
Global ZZZ ActiveInj paravert f jnt c/t 3 lev
CPT 64492 Billing & Documentation Guide
CPT code 64492 (Inj paravert f jnt c/t 3 lev) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.13, a non-facility practice expense RVU of 1.84, and a malpractice RVU of 0.09, a total non-facility RVU of 3.06 and facility RVU of 1.53. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $105.23, though rates vary from $92.08 to $132.13 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64492, 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 64492 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 64492 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 64492
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.13 | 1.13 |
| Practice Expense RVU | 1.84 | 0.31 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 3.06 | 1.53 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64492
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 | $113.45 | $52.98 | $107.35 - $132.13 | 29 |
| Florida | $105.25 | $53.98 | $101.01 - $109.32 | 3 |
| Georgia | $100.03 | $51.28 | $96.15 - $103.91 | 2 |
| Illinois | $103 | $53.62 | $98.55 - $106.67 | 4 |
| Michigan | $99.69 | $51.7 | $97.25 - $102.12 | 2 |
| North Carolina | $97 | $49.32 | $97 - $97 | 1 |
| New York | $112.18 | $55.17 | $98.24 - $118.81 | 5 |
| Ohio | $96.88 | $50.23 | $96.88 - $96.88 | 1 |
| Pennsylvania | $101.5 | $51.44 | $97 - $105.99 | 2 |
| Texas | $101.25 | $50.94 | $96.46 - $105.5 | 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 64492
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64492 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0214T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0215T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0216T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0217T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0218T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0282T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0283T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0284T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0285T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 64492
What does CPT code 64492 mean? +
CPT code 64492 represents: Inj paravert f jnt c/t 3 lev. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 64492? +
The 2026 Medicare national average non-facility payment for CPT 64492 is $105.23. Rates range from $92.08 to $132.13 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64492? +
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 64492? +
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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