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Medicare Physician Fee Schedule · Q3 2026 release

CPT 64483 in Milwaukee, WI 06302-00

Lumbar or sacral transforaminal epidural injection in ZIPs including 53202, 53703, and 53211

64483 2026 C · Milwaukee, WI flag06302-00 A Active
Allowed amount
$252.65
in a doctor’s own office or clinic

95.4% of the $264.87 national baseline

Medicare payment
$202.12
Patient / secondary
$50.53
Expected total to provider
$252.65

Patient / secondary and expected total to provider assume the Part B annual deductible is already met. If it isn't, the patient owes more than the amount shown here.

Locality-adjusted Physician Fee Schedule pricing

How much does Medicare allow for CPT 64483 in Milwaukee, WI? Copy link

The Medicare allowed amount is $252.65 in the office (non-facility) setting and $94.26 in a facility, under the Q3 2026 Physician Fee Schedule. The office amount is 4.6% below the national baseline, and the facility amount is 5.3% below the national baseline. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied — not necessarily what a specific claim pays.

What Medicare locality is Milwaukee, WI in? Copy link

CMS prices all of Wisconsin as one Medicare payment locality, so this amount applies statewide, including Madison, Green Bay and Kenosha — not only in Milwaukee, WI.

Why Milwaukee, WI differs from the national amount Copy link

Milwaukee, WI (this locality)
$252.65
National PFS baseline (GPCI 1.000)
$264.87

The national figure is a baseline, not an amount any provider is paid. This locality's geographic practice cost indices scale each RVU component before the conversion factor is applied, which puts Milwaukee, WI at 4.6% below the national baseline.

Work GPCI
1.000
Practice expense GPCI
0.958
Malpractice GPCI
0.308
2026 conversion factor
$33.4009

Formula and inputs Copy link

The office (non-facility) amount for 64483 in Milwaukee, WI: each component's RVU times its GPCI, summed, then multiplied by the conversion factor.

RVU and GPCI components of the Milwaukee, WI allowed amount for 64483
Component RVU × GPCI = Adjusted RVU
Work 1.85 1.000 1.8500
Practice expense 5.91 0.958 5.6618
Malpractice 0.17 0.308 0.0524
Sum of adjusted RVUs 7.5641
× $33.4009 2026 conversion factor $252.65

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient or ASC), Milwaukee, WI allows $94.26 for 64483, versus $252.65 in the office. Only the practice-expense RVU changes with the setting. In a facility, the hospital bills its own fee, so the professional payment is lower. Which setting applies to your place of service.

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in Milwaukee, WI. The allowed amount is not the program payment — the rows below separate them. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for 64483 in Milwaukee, WI
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $252.65
Non-participating allowed amount 95% of the participating amount. $240.02
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount. $276.02
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met. $202.12
Beneficiary coinsurance The remaining 20%. $50.53
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share. $4.04
Medicare pays after sequestration Program payment net of the sequestration reduction. $198.08

Contracted rate: % of Medicare in Milwaukee, WI Copy link

Commercial contracts are usually written as a percentage of the Medicare fee schedule. Which Medicare amount they mean is the part that gets misread: a contract benchmarked to the fee schedule prices off this locality's allowed amount — $252.65 in the office (non-facility) setting — not the $264.87 national baseline.

Opens the calculator already set to Milwaukee, WI and the office (non-facility) setting. It also compares what a payer actually paid against the expected amount. See how to find your contract's actual percentage.

ZIP codes this Milwaukee, WI rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 919 ZIP codes to this payment locality. 64483 prices identically in every one of them. 1 of them span more than one locality and need ZIP+4 for an exact match.

53001 53002 53003 53004 53005 53006 53007 53008 53009 53010 53011 53012 53013 53014 53015 53016 53017 53018 53019 53020 53021 53022 53023 53024 53026 53027 53029 53031 53032 53033 53034 53035 53036 53037 53038 53039 53040 53042 53044 53045 53046 53047 53048 53049 53050 53051 53052 53056 53057 53058 53059 53060 53061 53062 53063 53064 53065 53066 53069 53070 53072 53073 53074 53075 53076 53078 53079 53080 53081 53082 53083 53085 53086 53088 53089 53090 53091 53092 53093 53094 53095 53097 53098 53099 53101 53102 53103 53104 53105 53108 53109 53110 53114 53115 53118 53119 53120 53121 53122 53125

819 more ZIP codes map to this locality. The Milwaukee, WI locality page lists the full set.

Resolves the ZIP to its payment locality, so you can confirm whether this amount applies.

64483 in nearby payment localities Copy link

Payment localities in the same region as Milwaukee, WI, nearest first. Each amount is that locality's own GPCI-adjusted office (non-facility) figure for 64483. Proximity doesn't imply similar pricing — neighbouring localities often differ.

64483 allowed amount in payment localities near Milwaukee, WI
Metro Allowed amount vs. Milwaukee, WI
Chicago, IL $273.64 +8.3%
Suburban Chicago, IL $275.01 +8.9%
Minneapolis, MN $266.60 +5.5%
Des Moines, IA $244.67 -3.2%
Detroit, MI $261.86 +3.6%
Indianapolis, IN $247.54 -2.0%

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

Other codes priced in Milwaukee, WI Copy link

Office (non-facility) allowed amounts in this same payment locality, Q3 2026.

Other curated codes and their allowed amounts in Milwaukee, WI
Code Service Milwaukee, WI vs. national
20610 Major Joint Injection or Aspiration $64.17 -6.7%
96372 Therapeutic Injection Administration $14.74 -4.0%
62323 Lumbar or Sacral Epidural Injection $260.52 -4.6%
20605 Injections and pain management $53.91 -5.6%
20600 Injections and pain management $52.92 -5.7%
99213 Routine Follow-Up Office Visit $91.06 -4.3%
99214 Long Follow-Up Office Visit $129.57 -4.5%
66984 Cataract Surgery $441.51 -4.6%
92014 Full Eye Exam, Returning Patient $123.04 -3.3%
99204 Long New Patient Office Visit $168.35 -5.1%
99212 Brief Follow-Up Office Visit $56.64 -4.7%
99215 Longest Follow-Up Office Visit $183.68 -4.5%

Common questions Copy link

Which ZIP codes does the Milwaukee, WI rate for 64483 cover?
The CMS ZIP-to-locality crosswalk maps 919 ZIP codes to this payment locality, and every one of them prices 64483 identically. Examples include 53001, 53002, 53003, 53004, 53005, 53006. 1 of them span more than one payment locality, so those need ZIP+4 for an exact match.
Why is the 64483 rate in Milwaukee, WI 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 0.958, malpractice 0.308 — scale each RVU component before the conversion factor is applied, which is why Milwaukee, WI allows less than the $264.87 baseline.
Does this 64483 rate apply everywhere in Wisconsin?
Yes. CMS prices Wisconsin as a single Medicare payment locality, so the same GPCIs — and the same allowed amount — apply statewide, not only in Milwaukee, WI. That includes Madison, Green Bay and Kenosha. The city name here is a search-facing label for a statewide payment locality, not a city-specific rate.
What is the facility rate for 64483 in Milwaukee, WI?
$94.26 in a facility, versus $252.65 in the office (non-facility) setting — a $158.39 difference. Only the practice-expense RVU changes with the setting: in an office the practice carries the overhead, so the professional payment is higher; in a hospital or ASC the facility bills its own fee.
What is the non-participating amount and limiting charge for 64483 in Milwaukee, WI?
A non-participating provider is paid $240.02 — 95% of the $252.65 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $276.02, which is 115% of the non-participating amount.
How much of the Milwaukee, WI 64483 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($202.12) once the annual Part B deductible is met, and the beneficiary owes 20% ($50.53). Sequestration reduces Medicare's share by about 2% ($4.04), leaving $198.08. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q3 2026 release : this code's RVUs from the relative value file, multiplied by payment locality 06302-00's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q3 2026 release . Releases are immutable: an amount retrieved for a past quarter always reflects that PFS release. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 7,068)
Geographic practice cost indices (Q3 2026) · rvu26c-updated-06-30-2026.zip (GPCI2026.csv row 111)
ZIP code to carrier locality crosswalk (Q3 2026) · zip-code-carrier-locality-file-updated-05-13-2026.zip (ZIP5_JUL2026.txt)

Working a claim with an earlier date of service? The calculator prices 64483 in Milwaukee, WI against the release that governed that date. Past releases need a free account; today's rate does not.

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