# CPT 64490

> Medicare paid $197.26 for CPT 64490 in the office (non-facility) setting and $107.28 in a facility under the Q4 2022 Physician Fee Schedule, effective October 2022. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2022, when it decreased 1.2%.

## What it is

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.

## Selected release

- Release: Q4 2022 (2022 D)
- Effective: October 1 – December 31, 2022
- Status indicator: A
- Office (non-facility) national allowed amount: $197.26
- Facility national allowed amount: $107.28
- Sequestration: not applied

## RVUs and formula

- Work RVU: 1.82
- Office (non-facility) practice expense RVU: 3.68
- Facility practice expense RVU: 1.08
- Malpractice RVU: 0.20
- Conversion factor: 34.6062
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q4 2022)
- CMS file: https://www.cms.gov/files/zip/rvu22d.zip
- Parsed file: PPRRVU22_OCT.csv, row 11,838
- Canonical page: https://localishealth.com/cpt/64490/2022/A
- Release-specific citation URL: https://localishealth.com/cpt/64490/2022/D
- Last significant update: 2026-08-04T03:12:03+00:00