{
    "code": "64490",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/64490/2018/A",
    "release_specific_url": "https://localishealth.com/cpt/64490/2018/B",
    "description": "An injection of steroid or numbing medication into a facet joint of the neck or mid-back, or onto the small nerve branches that carry sensation from that joint. Facet joints are the paired hinges at the back of the spine that let it bend and twist, and they wear out with arthritis just like a knee or hip. Imaging guidance is part of the service, since these joints are small and sit close to nerves. This entry is the first joint level treated on one side; additional levels are reported with their own codes.",
    "answer": {
        "question": "How much did Medicare pay for CPT 64490 in Q2 2018?",
        "text": "Medicare paid $193.68 for CPT 64490 in the office (non-facility) setting and $109.44 in a facility under the Q2 2018 Physician Fee Schedule, effective April 2018. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2018, when it increased 0.9%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2018,
        "quarter": "B",
        "label": "Q2 2018",
        "effective": "April 1 – June 30, 2018",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 193.68,
        "facility": 109.44,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 1.82,
        "practice_expense_non_facility": 3.4,
        "practice_expense_facility": 1.06,
        "malpractice": 0.16
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.9996,
    "source": {
        "label": "Physician relative value file (Q2 2018)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18b.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2018/B",
        "file": "PPRRVU18_APR.csv",
        "row": 10983,
        "sha256": "6a692625dad07579d7e9946e9b59265acc1cff8c6ed48d4391949735be04024b"
    },
    "modified_at": "2026-08-04T03:08:19+00:00"
}