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Medicare Physician Fee Schedule · Q4 2026 release

CPT 64483 in Richmond, VA

Lumbar or sacral transforaminal epidural injection in ZIPs including 23219, 23451, and 23510

64483 Q4 2026 · Richmond, VA flag11302-00
Locality-adjusted allowed amount
$259.84
in a doctor’s own office or clinic

98.1% of the $264.87 national baseline

( Work1.85 × 1.000 + Practice exp.5.91 × 0.983 + Malpractice0.17 × 0.706 ) × Conv. factor$33.4009 = $259.84

The Medicare allowed amount is $259.84 in the Office (non-facility) setting and $97.32 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 11302-00 · Participating · Whole service · Sequestration excluded

CMS sources and method · Calculation inputs

Calculate with this locality Check service-location ZIP

What Medicare locality is Richmond, VA in? Copy link

CMS prices all of Virginia as one Medicare payment locality, so this amount applies statewide, including Virginia Beach, Norfolk, Chesapeake and Roanoke—not only in Richmond, VA.

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

ZIP codes in this payment locality (1,145)

The CMS ZIP-to-locality crosswalk maps 1,145 ZIP codes to this payment locality. Use this amount only after you confirm the service location is in this locality. Of these, 1 span more than one locality and need ZIP+4 for an exact match.

00303 00304 00323 00353 20101 20102 20103 20104 20105 20106 20107 20108 20109 20110 20111 20112 20113 20115 20116 20117 20118 20119 20128 20129 20130 20131 20132 20134 20135 20136 20137 20138 20139 20140 20141 20142 20143 20144 20146 20147 20148 20149 20152 20155 20156 20158 20159 20160 20163 20164 20165 20166 20167 20168 20169 20175 20176 20177 20178 20180 20181 20182 20184 20185 20186 20187 20188 20189 20197 20198 20199 20598 22002 22025 22026 22093 22125 22134 22135 22172 22191 22192 22193 22194 22195 22401 22402 22403 22404 22405 22406 22407 22408 22412 22427 22428 22430 22432 22433 22435

1,045 more ZIP codes map to this locality. The Richmond, VA locality page lists the full set.

Which ZIP codes does the Richmond, VA rate for 64483 cover?

The CMS ZIP-to-locality crosswalk maps 1,145 ZIP codes to this payment locality, and 64483 has the same amount in every one of them. Examples include 00303, 00304, 00323, 00353, 20101, 20102. Of these, 1 span more than one payment locality and need ZIP+4 for an exact match.

Does this 64483 rate apply everywhere in Virginia?

Yes. CMS prices Virginia as a single Medicare payment locality, so the same GPCIs—and the same allowed amount—apply statewide, not only in Richmond, VA. That includes Virginia Beach, Norfolk, Chesapeake and Roanoke. 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

Richmond, VA (this locality)
$259.84
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 Richmond, VA 1.9% below the national baseline.

Work GPCI
1.000
Practice expense GPCI
0.983
Malpractice GPCI
0.706
2026 conversion factor
$33.4009
Why is the 64483 rate in Richmond, VA 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 0.983, malpractice 0.706—scale each RVU component before the conversion factor is applied, which is why the Richmond, VA 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 Richmond, VA GPCI; the products are summed and multiplied by the conversion factor.

Code
64483
DOS
Not selected; uses this release’s rates
Locality
VIRGINIA (VA)
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 Richmond, VA allowed amount for 64483
Component RVU × GPCI = Adjusted
Work 1.85 × 1.000 1.8500
Practice expense · Office (non-facility) 5.91 × 0.983 5.8095
Malpractice 0.17 × 0.706 0.1200
Sum of adjusted RVUs 7.7796
× 33.4009 conversion factor = formula amount $259.84

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

  1. Locality-adjusted allowed amount $259.84

    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 106)
    mac (col 1)
    11302
    locality_code (col 3)
    00
    work_gpci (col 5)
    1
    pe_gpci (col 6)
    0.983
    mp_gpci (col 7)
    0.706

    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 Richmond, VA is $97.32, versus $259.84 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 Richmond, VA?

$97.32 in a facility, versus $259.84 in the Office (non-facility) setting—a $162.52 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 Richmond, VA. 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 Richmond, VA
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $259.84
Non-participating allowed amount 95% of the participating amount. $246.85
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim—115% of the non-participating amount. $283.88
Medicare share 80% of the allowed amount, once the annual Part B deductible is met. $207.87
Patient coinsurance The remaining 20%. $51.97
Sequestration adjustment Reduces only Medicare's share—never the allowed amount or the patient's coinsurance. $4.16
Net Medicare payment Medicare's share after the sequestration reduction. $203.71
What is the non-participating amount and limiting charge for 64483 in Richmond, VA?

A non-participating provider is paid $246.85—95% of the $259.84 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $283.88, which is 115% of the non-participating amount.

How much of the Richmond, VA 64483 rate does Medicare actually pay?

Medicare pays 80% of the allowed amount ($207.87) once the annual Part B deductible is met, and the beneficiary owes 20% ($51.97). Sequestration reduces Medicare's share by about 2% ($4.16), leaving $203.71. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Contracted rate: % of Medicare in Richmond, VA 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—$259.84 in the office (non-facility) setting—not the $264.87 national baseline.

Opens the calculator set to Richmond, VA 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 Richmond, VA, 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 Richmond, VA
Metro Allowed amount vs. Richmond, VA
Washington, DC $303.98 +17.0%
Baltimore, MD $281.61 +8.4%
Charlotte, NC $249.59 -3.9%
Charleston, SC $249.02 -4.2%
Philadelphia, PA $275.17 +5.9%
Pittsburgh, PA $248.37 -4.4%

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

Other codes priced in Richmond, VA Copy link

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

Other curated codes and their allowed amounts in Richmond, VA
Code and service Allowed vs. national
20610 Major Joint Injection or Aspiration $66.87 -2.8%
96372 Therapeutic Injection Administration $15.11 -1.6%
62323 Lumbar or Sacral Epidural Injection $268.00 -1.9%
20605 Injections and pain management $55.78 -2.3%
20600 Injections and pain management $54.78 -2.4%
99213 Routine Follow-Up Office Visit $93.48 -1.8%
99214 Long Follow-Up Office Visit $133.10 -1.9%
66984 Cataract Surgery $453.81 -1.9%
92014 Full Eye Exam, Returning Patient $125.53 -1.4%
99204 Long New Patient Office Visit $173.60 -2.1%
99212 Brief Follow-Up Office Visit $58.29 -2.0%
99215 Longest Follow-Up Office Visit $188.77 -1.9%

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 11302-00'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 106)
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 Richmond, VA against the release in effect on that date. Dates in the last 12 months don't need an account; older dates of service need a free account.

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