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Medicare Physician Fee Schedule Effective Locality 01112-62 CMS RVU26D Updated

CPT 64483 Medicare rate in Riverside, CA

Lumbar or sacral transforaminal epidural injection in ZIPs including 92501, 92401, and 91761

The Medicare allowed amount is $284.10 in the Office (non-facility) setting and $102.89 in a facility, under the Q4 2026 Physician Fee Schedule. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied—not necessarily what a specific claim pays.

64483 Q4 2026
Locality-adjusted allowed amount
$284.10
in a doctor’s own office or clinic

Riverside, CA flag Riverside, CA (Locality 01112-62)

7.3% above the national baseline ($264.87)

CMS RVU26DOctober 1 – December 31, 2026revision 2

( Work1.85 × 1.018 + Practice exp.5.91 × 1.096 + Malpractice0.17 × 0.853 ) × Conv. factor$33.4009 = $284.10

row 7,128

F Work RVU

1.85

G Non‑facility PE RVU

5.91

K MP RVU

0.17

Z Conversion factor

33.4009

row 20

E Work GPCI

1.018

F PE GPCI

1.096

G MP GPCI

0.853

The Medicare allowed amount is $284.10 in the Office (non-facility) setting and $102.89 in a facility, under the Q4 2026 Physician Fee Schedule. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied—not necessarily what a specific claim pays.

Assumes a participating provider, no modifiers, the whole service, before sequestration.

Customize service date, participation, and modifiers Check service-location ZIP CMS sources and method

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What Medicare locality is Riverside, CA in? Copy link

Riverside, CA is in CMS payment locality Riverside-San Bernardino-Ontario. The same amount applies across the whole locality, including San Bernardino and Ontario.

Confirm the locality before using this amount. A split ZIP needs ZIP+4 for an exact match.

ZIP codes in this payment locality (228)

The CMS ZIP-to-locality crosswalk maps 228 ZIP codes to this payment locality. Use this amount only after you confirm the service location is in this locality. Of these, 3 span more than one locality and need ZIP+4 for an exact match.

91701 91708 91709 91710 91718 91719 91720 91729 91730 91737 91739 91743 91752 91758 91759 91760 91761 91762 91763 91764 91784 91785 91786 91798 92201 92202 92203 92210 92211 92220 92223 92225 92226 92230 92234 92235 92236 92239 92240 92241 92242 92247 92248 92252 92253 92254 92255 92256 92258 92260 92261 92262 92263 92264 92267 92268 92270 92274 92276 92277 92278 92280 92282 92284 92285 92286 92292 92301 92304 92305 92307 92308 92309 92310 92311 92312 92313 92314 92315 92316 92317 92318 92320 92321 92322 92323 92324 92325 92326 92327 92329 92331 92332 92333 92334 92335 92336 92337 92338 92339

128 more ZIP codes map to this locality. The Riverside, CA locality page lists the full set.

Which ZIP codes does the Riverside, CA rate for 64483 cover?

The CMS ZIP-to-locality crosswalk maps 228 ZIP codes to this payment locality, and 64483 has the same amount in every one of them. Examples include 91701, 91708, 91709, 91710, 91718, 91719. Of these, 3 span more than one payment locality and need ZIP+4 for an exact match.

Which cities does the Riverside, CA rate for 64483 cover?

This payment locality also covers San Bernardino and Ontario. 64483 has the same amount everywhere in it—the label names the largest metro, not a city-specific amount.

How locality affects the amount Copy link

Office (non-facility) · Q4 2026 · Participating · Whole service

Riverside, CA (this locality)
$284.10
National PFS baseline (GPCI 1.000)
$264.87

Each of this locality's geographic practice cost indices (GPCIs) scales one RVU component before the conversion factor is applied. Together they put Riverside, CA 7.3% above the national baseline.

Work GPCI
1.018
Practice expense GPCI
1.096
Malpractice GPCI
0.853
2026 conversion factor
$33.4009

CMS RVU26DOctober 1 – December 31, 2026revision 2 See file rows

Why is the 64483 rate in Riverside, CA different from the national amount?

The national figure is a GPCI 1.000 baseline, not an amount any provider is paid. This locality's geographic practice cost indices—work 1.018, practice expense 1.096, malpractice 0.853—scale each RVU component before the conversion factor is applied, which is why the Riverside, CA amount is higher than the $264.87 baseline.

Formula and inputs Copy link

For the office (non-facility) amount, each of 64483's RVU components is multiplied by its Riverside, CA GPCI; the products are summed and multiplied by the conversion factor.

Code
64483
DOS
Not selected; uses this release’s rates
Locality
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)
Setting
Office (non-facility)
Participation
Participating provider
Modifiers
None
Units
1
Release
Q4 2026, revision 2
Sequestration
Shown separately from the allowed amount

Formula

(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor

Localis calculated this from CMS’s published inputs. Select an underlined value to see where it comes from.

RVU × GPCI components of Riverside, CA allowed amount for 64483
Component RVU × GPCI = Adjusted
Work 1.85 × 1.018 1.8833
Practice expense · Office (non-facility) 5.91 × 1.096 6.4774
Malpractice 0.17 × 0.853 0.1450
Sum of adjusted RVUs 8.5057
× 33.4009 conversion factor = formula amount $284.10

Component subtotals show four decimals. The formula amount is rounded to cents before any later adjustment.

  1. Locality-adjusted allowed amount $284.10

    After applicable fee-schedule adjustments; sequestration excluded

Citations

  • 64483’s RVUs, PFS status and conversion factor

    Physician relative value file (PPRRVU)CMS RVU26DOctober 1 – December 31, 2026revision 2

    PPRRVU2026_Oct_nonQPP.csv row 7,128 in rvu26d-updated-08-26-2026.zip

    A HCPCS
    64483
    B Modifier
    blank
    D Status code
    A
    F Work RVU
    1.85
    G Non-facility PE RVU
    5.91
    K MP RVU
    0.17
    Z Conversion factor
    33.4009
    In the CMS file

    Loading rows 7,126–7,130 of PPRRVU2026_Oct_nonQPP.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

  • Locality 01112-62’s GPCIs

    Geographic practice cost indices (GPCI)CMS RVU26DOctober 1 – December 31, 2026revision 2

    GPCI2026.csv row 20 in rvu26d-updated-08-26-2026.zip

    A MAC
    01112
    C Locality number
    62
    E Work GPCI
    1.018
    F PE GPCI
    1.096
    G MP GPCI
    0.853
    In the CMS file

    Loading rows 18–22 of GPCI2026.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 7850e2987d12e46930e49033f96829b5ae11f60dd1f19965329b38cf08b05264

CMS RVU26DOctober 1 – December 31, 2026revision 2

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient department or ASC), the allowed amount for 64483 in Riverside, CA is $102.89, versus $284.10 in the Office (non-facility) setting. Only the practice-expense RVU changes with the setting: the facility bills its own fee for overhead, so the professional amount is lower. See which setting applies to your place of service.

What is the Facility amount for 64483 in Riverside, CA?

$102.89 in a facility, versus $284.10 in the Office (non-facility) setting—a $181.21 difference. Only the practice-expense RVU changes with the setting: in the Office (non-facility) setting the practice carries the overhead, so the professional amount is higher; in a hospital or ASC the facility bills its own fee.

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in Riverside, CA. Medicare pays part of the allowed amount and the patient pays the rest; the rows below show each figure. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for 64483 in Riverside, CA
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $284.10
Non-participating allowed amount 95% of the participating amount. $269.90
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim—115% of the non-participating amount. $310.38
Medicare share 80% of the allowed amount, once the annual Part B deductible is met. $227.28
Patient coinsurance The remaining 20%. $56.82
Sequestration adjustment Reduces only Medicare's share—never the allowed amount or the patient's coinsurance. $4.55
Net Medicare payment Medicare's share after the sequestration reduction. $222.73
What is the non-participating amount and limiting charge for 64483 in Riverside, CA?

A non-participating provider is paid $269.90—95% of the $284.10 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $310.38, which is 115% of the non-participating amount.

How much of the Riverside, CA 64483 rate does Medicare actually pay?

Medicare pays 80% of the allowed amount ($227.28) once the annual Part B deductible is met, and the beneficiary owes 20% ($56.82). Sequestration reduces Medicare's share by about 2% ($4.55), leaving $222.73. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Contracted rate: % of Medicare in Riverside, CA Copy link

Commercial contracts are often written as a percentage of the Medicare fee schedule. The part that gets misread is which Medicare amount: a contract benchmarked to the fee schedule prices off this locality's allowed amount—$284.10 in the office (non-facility) setting—not the $264.87 national baseline.

Opens the calculator set to Riverside, CA and your selected setting, where you can also compare what a payer paid against the expected amount. See how to find your contract's actual percentage.

64483 in nearby payment localities Copy link

Payment localities in the same region as Riverside, CA, nearest first. Each amount is that locality's own GPCI-adjusted Office (non-facility) figure for 64483. Neighboring localities often differ.

Percentages are against Riverside, CA. Every payment locality nationwide is on the CPT 64483 rate map.

Other codes priced in Riverside, CA Copy link

Office (non-facility) allowed amounts in this same payment locality, Q4 2026.

Other curated codes and their allowed amounts in Riverside, CA
Code and service Allowed vs. national
20610 Major Joint Injection or Aspiration $72.35 +5.1%
96372 Therapeutic Injection Administration $16.32 +6.3%
62323 Lumbar or Sacral Epidural Injection $293.48 +7.4%
20605 Injections and pain management $60.23 +5.4%
20600 Injections and pain management $59.18 +5.5%
99213 Routine Follow-Up Office Visit $100.21 +5.3%
99214 Long Follow-Up Office Visit $142.49 +5.1%
66984 Cataract Surgery $483.95 +4.6%
92014 Full Eye Exam, Returning Patient $135.45 +6.4%
99204 Long New Patient Office Visit $185.66 +4.7%
99212 Brief Follow-Up Office Visit $62.85 +5.7%
99215 Longest Follow-Up Office Visit $201.86 +4.9%

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q4 2026 release: this code's RVUs from the relative value file, multiplied by payment locality 01112-62's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q4 2026 release. Past releases are never edited, so an amount for an earlier quarter always matches what CMS published for it. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q4 2026) · rvu26d-updated-08-26-2026.zip (PPRRVU2026_Oct_nonQPP.csv row 7,128)
Geographic practice cost indices (Q4 2026) · rvu26d-updated-08-26-2026.zip (GPCI2026.csv row 20)
ZIP code to carrier locality crosswalk (Q4 2026) · zip-code-carrier-locality-file-updated-08-13-2026.zip (ZIP5_OCT2026.txt)

Working a claim with an earlier date of service? The calculator prices 64483 in Riverside, CA against the release in effect on that date. Dates of service this quarter don't need an account; earlier dates need a free account.

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