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Medicare Physician Fee Schedule · Q4 2026 release

CPT 64483 in Charlotte, NC

Lumbar or sacral transforaminal epidural injection in ZIPs including 28202, 27601, and 27701

64483 Q4 2026 · Charlotte, NC flag11502-00
Locality-adjusted allowed amount
$249.59
in a doctor’s own office or clinic

94.2% of the $264.87 national baseline

( Work1.85 × 1.000 + Practice exp.5.91 × 0.933 + Malpractice0.17 × 0.639 ) × Conv. factor$33.4009 = $249.59

The Medicare allowed amount is $249.59 in the Office (non-facility) setting and $95.34 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.

Q4 2026 · Locality 11502-00 · Participating · Whole service · Sequestration excluded

CMS sources and method · Calculation inputs

Calculate with this locality Check service-location ZIP

What Medicare locality is Charlotte, NC in? Copy link

CMS prices all of North Carolina as one Medicare payment locality, so this amount applies statewide, including Raleigh, Durham, Greensboro and Winston-Salem—not only in Charlotte, NC.

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

ZIP codes in this payment locality (1,102)

The CMS ZIP-to-locality crosswalk maps 1,102 ZIP codes to this payment locality. Use this amount only after you confirm the service location is in this locality.

27006 27007 27009 27010 27011 27012 27013 27014 27016 27017 27018 27019 27020 27021 27022 27023 27024 27025 27027 27028 27030 27031 27040 27041 27042 27043 27045 27046 27047 27048 27049 27050 27051 27052 27053 27054 27055 27094 27098 27099 27101 27102 27103 27104 27105 27106 27107 27108 27109 27110 27111 27113 27114 27115 27116 27117 27120 27127 27130 27150 27151 27152 27155 27156 27157 27198 27199 27201 27202 27203 27204 27205 27207 27208 27209 27212 27213 27214 27215 27216 27217 27220 27228 27229 27230 27231 27233 27235 27237 27239 27242 27243 27244 27247 27248 27249 27252 27253 27256 27258

1,002 more ZIP codes map to this locality. The Charlotte, NC locality page lists the full set.

Which ZIP codes does the Charlotte, NC rate for 64483 cover?

The CMS ZIP-to-locality crosswalk maps 1,102 ZIP codes to this payment locality, and 64483 has the same amount in every one of them. Examples include 27006, 27007, 27009, 27010, 27011, 27012.

Does this 64483 rate apply everywhere in North Carolina?

Yes. CMS prices North Carolina as a single Medicare payment locality, so the same GPCIs—and the same allowed amount—apply statewide, not only in Charlotte, NC. That includes Raleigh, Durham, Greensboro and Winston-Salem. The city name here is a search-facing label for a statewide payment locality, not a city-specific rate.

How locality affects the amount Copy link

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

Charlotte, NC (this locality)
$249.59
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 Charlotte, NC 5.8% below the national baseline.

Work GPCI
1.000
Practice expense GPCI
0.933
Malpractice GPCI
0.639
2026 conversion factor
$33.4009
Why is the 64483 rate in Charlotte, NC 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 1.000, practice expense 0.933, malpractice 0.639—scale each RVU component before the conversion factor is applied, which is why the Charlotte, NC amount is lower 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 Charlotte, NC GPCI; the products are summed and multiplied by the conversion factor.

Code
64483
DOS
Not selected; uses this release’s rates
Locality
NORTH CAROLINA (NC)
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 Charlotte, NC allowed amount for 64483
Component RVU × GPCI = Adjusted
Work 1.85 × 1.000 1.8500
Practice expense · Office (non-facility) 5.91 × 0.933 5.5140
Malpractice 0.17 × 0.639 0.1086
Sum of adjusted RVUs 7.4727
× 33.4009 conversion factor = formula amount $249.59

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

  1. Locality-adjusted allowed amount $249.59

    After applicable fee-schedule adjustments; sequestration excluded

Citations

  • Supplies the RVUs and PFS status for this code and component.

    Physician relative value file (PPRRVU)

    Q4 2026 · revision 2

    Latest revision of this release

    Release period: October 1 – December 31, 2026

    Record details PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip (row 7,128)
    hcpcs (col 1)
    64483
    modifier (col 2)
    blank
    status_code (col 4)
    A
    work_rvu (col 6)
    1.85
    pe_rvu_nonfacility (col 7)
    5.91
    pe_rvu_facility (col 9)
    0.96
    mp_rvu (col 11)
    0.17

    SHA-256: 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

    Original source file

  • Supplies the geographic adjustment factors for this locality.

    Geographic practice cost indices (GPCI)

    Q4 2026 · revision 2

    Latest revision of this release

    Release period: October 1 – December 31, 2026

    Record details GPCI2026.csv in rvu26d-updated-08-26-2026.zip (row 83)
    mac (col 1)
    11502
    locality_code (col 3)
    00
    work_gpci (col 5)
    1
    pe_gpci (col 6)
    0.933
    mp_gpci (col 7)
    0.639

    SHA-256: 7850e2987d12e46930e49033f96829b5ae11f60dd1f19965329b38cf08b05264

    Original source file

  • Supplies the dollar conversion factor used in the formula.

    Physician relative value file (PPRRVU)

    Q4 2026 · revision 2

    Latest revision of this release

    Release period: October 1 – December 31, 2026

    Record details PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip (row 11)
    conversion_factor (col 26)
    33.4009

    SHA-256: 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

    Original source file

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient department or ASC), the allowed amount for 64483 in Charlotte, NC is $95.34, versus $249.59 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 Charlotte, NC?

$95.34 in a facility, versus $249.59 in the Office (non-facility) setting—a $154.25 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 Charlotte, NC. 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 Charlotte, NC
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $249.59
Non-participating allowed amount 95% of the participating amount. $237.11
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim—115% of the non-participating amount. $272.68
Medicare share 80% of the allowed amount, once the annual Part B deductible is met. $199.67
Patient coinsurance The remaining 20%. $49.92
Sequestration adjustment Reduces only Medicare's share—never the allowed amount or the patient's coinsurance. $3.99
Net Medicare payment Medicare's share after the sequestration reduction. $195.68
What is the non-participating amount and limiting charge for 64483 in Charlotte, NC?

A non-participating provider is paid $237.11—95% of the $249.59 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $272.68, which is 115% of the non-participating amount.

How much of the Charlotte, NC 64483 rate does Medicare actually pay?

Medicare pays 80% of the allowed amount ($199.67) once the annual Part B deductible is met, and the beneficiary owes 20% ($49.92). Sequestration reduces Medicare's share by about 2% ($3.99), leaving $195.68. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Contracted rate: % of Medicare in Charlotte, NC 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—$249.59 in the office (non-facility) setting—not the $264.87 national baseline.

Opens the calculator set to Charlotte, NC 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.

Compare 64483 in nearby payment localities

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

64483 allowed amount in payment localities near Charlotte, NC
Metro Allowed amount vs. Charlotte, NC
Charleston, SC $249.02 -0.2%
Richmond, VA $259.84 +4.1%
Atlanta, GA $269.35 +7.9%
Nashville, TN $244.28 -2.1%
Washington, DC $303.98 +21.8%
Birmingham, AL $237.73 -4.8%

Every payment locality nationwide is on the CPT 64483 rate map.

Other codes priced in Charlotte, NC Copy link

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

Other curated codes and their allowed amounts in Charlotte, NC
Code and service Allowed vs. national
20610 Major Joint Injection or Aspiration $64.64 -6.1%
96372 Therapeutic Injection Administration $14.62 -4.8%
62323 Lumbar or Sacral Epidural Injection $257.18 -5.9%
20605 Injections and pain management $53.98 -5.5%
20600 Injections and pain management $53.00 -5.5%
99213 Routine Follow-Up Office Visit $90.84 -4.6%
99214 Long Follow-Up Office Visit $129.44 -4.5%
66984 Cataract Surgery $442.35 -4.4%
92014 Full Eye Exam, Returning Patient $121.52 -4.5%
99204 Long New Patient Office Visit $168.94 -4.7%
99212 Brief Follow-Up Office Visit $56.45 -5.0%
99215 Longest Follow-Up Office Visit $183.70 -4.5%

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 11502-00'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 83)
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 Charlotte, NC 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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