CPT 64493
Global 000 ActiveInj paravert f jnt l/s 1 lev
CPT 64493 Billing & Documentation Guide
CPT code 64493 (Inj paravert f jnt l/s 1 lev) 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 1.48, a non-facility practice expense RVU of 4.08, and a malpractice RVU of 0.14, a total non-facility RVU of 5.7 and facility RVU of 2.44. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $196.67, though rates vary from $168.9 to $253.89 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64493, 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 64493 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 64493 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 64493
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.48 | 1.48 |
| Practice Expense RVU | 4.08 | 0.82 |
| Malpractice RVU | 0.14 | 0.14 |
| Total RVU | 5.7 | 2.44 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64493
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 | $214.99 | $86.15 | $202.14 - $253.89 | 29 |
| Florida | $195.27 | $86.02 | $186.74 - $203.12 | 3 |
| Georgia | $185.11 | $81.23 | $176.57 - $193.65 | 2 |
| Illinois | $190.22 | $85.01 | $181.16 - $198.02 | 4 |
| Michigan | $183.98 | $81.74 | $179.13 - $188.82 | 2 |
| North Carolina | $179.57 | $77.98 | $179.57 - $179.57 | 1 |
| New York | $210.16 | $88.69 | $182.18 - $223.31 | 5 |
| Ohio | $178.57 | $79.15 | $178.57 - $178.57 | 1 |
| Pennsylvania | $188.36 | $81.71 | $178.95 - $197.76 | 2 |
| Texas | $188.21 | $81.01 | $177.79 - $197.85 | 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 64493
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64493 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0178T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0179T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0180T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 01991 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01992 | 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 | 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 |
Frequently Asked Questions, CPT 64493
What does CPT code 64493 mean? +
CPT code 64493 represents: Inj paravert f jnt l/s 1 lev. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 64493? +
The 2026 Medicare national average non-facility payment for CPT 64493 is $196.67. Rates range from $168.9 to $253.89 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64493? +
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 64493? +
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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