CPT 64495
Global ZZZ ActiveInj paravert f jnt l/s 3 lev
CPT 64495 Billing & Documentation Guide
CPT code 64495 (Inj paravert f jnt l/s 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 0.98, a non-facility practice expense RVU of 1.9, and a malpractice RVU of 0.08, a total non-facility RVU of 2.96 and facility RVU of 1.35. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $101.92, though rates vary from $88.62 to $129.28 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64495, 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 64495 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 64495 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 64495
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.98 | 0.98 |
| Practice Expense RVU | 1.9 | 0.29 |
| Malpractice RVU | 0.08 | 0.08 |
| Total RVU | 2.96 | 1.35 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64495
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 | $110.45 | $46.82 | $104.28 - $129.28 | 29 |
| Florida | $101.61 | $47.65 | $97.42 - $105.55 | 3 |
| Georgia | $96.53 | $45.22 | $92.53 - $100.52 | 2 |
| Illinois | $99.27 | $47.31 | $94.85 - $102.87 | 4 |
| Michigan | $96.09 | $45.59 | $93.69 - $98.48 | 2 |
| North Carolina | $93.65 | $43.48 | $93.65 - $93.65 | 1 |
| New York | $108.72 | $48.72 | $94.9 - $115.25 | 5 |
| Ohio | $93.37 | $44.27 | $93.37 - $93.37 | 1 |
| Pennsylvania | $98.04 | $45.37 | $93.52 - $102.57 | 2 |
| Texas | $97.87 | $44.93 | $92.97 - $102.31 | 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 64495
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64495 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 64495
What does CPT code 64495 mean? +
CPT code 64495 represents: Inj paravert f jnt l/s 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 64495? +
The 2026 Medicare national average non-facility payment for CPT 64495 is $101.92. Rates range from $88.62 to $129.28 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64495? +
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 64495? +
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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