Specialty rate rollup
Pain Management
Office evaluation, epidural and facet procedures, radiofrequency treatment, and drug monitoring.
This is a curated starter set for comparison. It doesn't claim that every specialty bills every code, and it isn't a utilization-weighted average.
At a glance
Q1 2016 compared with the prior available PFS release.
Conversion factor: -0.4% decrease
Payable codes
7 / 7
Changed this release
7
Largest increase
64635 +1.1%
Office
Largest decrease
99214 -0.7%
Office
See the rates where you practice
Enter a ZIP code to apply that Medicare locality’s work, practice-expense, and malpractice adjustments to every row.
Current national rates Copy link
Q1 2016 releaseOffice (non-facility) and facility professional amounts, GPCI 1.000, before sequestration.
| Code and service | Status | Office (non-facility) | Facility |
|---|---|---|---|
| Visits and evaluation | |||
| 99213 Routine Follow-Up Office Visit | Active |
$73.40
No price history
|
$51.56
No price history
|
| 99214 Long Follow-Up Office Visit | Active |
$108.13
No price history
|
$79.13
No price history
|
| Office and procedural services | |||
| 64483 Lumbar or Sacral Transforaminal Epidural Injection | Active |
$224.13
No price history
|
$116.36
No price history
|
| 64484 | Active |
$89.51
No price history
|
$53.71
No price history
|
| 64490 | Active |
$194.42
No price history
|
$109.92
No price history
|
| 64493 Lumbar or Sacral Facet Joint Injection | Active |
$176.52
No price history
|
$94.17
No price history
|
| 64635 Lumbar or Sacral Facet Nerve Ablation | Active |
$426.79
No price history
|
$230.94
No price history
|
Every code links to its contracted-rate (% of Medicare) table and a full RVU breakdown, plus billing-policy context and rate history.
How often these codes appear in Medicare Copy link
Across Original Medicare nationally in CY2024, the covered codes on this page accounted for the activity below. It counts use by clinicians of every specialty, not just Pain Management, and CMS publishes it on a different cycle from the fee schedule.
Services
175.4M
Times these codes were billed
Allowed dollars
$18.6B
Across covered Medicare FFS services
Most used in this set
99214
103.7M services
Coverage: 7 of 7 displayed codes. HCPCS Level II and excluded drug codes may not appear in this utilization dataset.
What this specialty actually bills Medicare
Observed CY2024 Medicare fee-for-service billing by Pain Medicine clinicians, grouped by CMS rendering-provider specialty. That grouping differs from this page's Pain Management label, so treat it as context for the curated list above.
| Top codes by allowed dollars | Share of allowed | Allowed |
|---|---|---|
| 99214 | 23.3% | $190.8M |
| 99213 | 9.1% | $75.0M |
| 64483 | 6.0% | $48.9M |
| 64635 | 5.5% | $45.0M |
| 99204 not in the list above | 4.6% | $37.6M |
| 62323 not in the list above | 4.4% | $36.2M |
| 64493 | 4.0% | $32.8M |
| 64636 not in the list above | 2.5% | $20.7M |
| 27096 not in the list above | 2.4% | $19.4M |
| 80307 | 2.1% | $17.3M |
| Top codes by services | Share of services | Services |
|---|---|---|
| J1010 not in the list above | 29.5% | 6.0M |
| J1100 not in the list above | 8.6% | 1.7M |
| 99214 | 7.7% | 1.6M |
| J3301 not in the list above | 5.3% | 1.1M |
| 99213 | 4.3% | 861,657 |
| Q9966 not in the list above | 3.8% | 773,891 |
| J0585 not in the list above | 3.5% | 708,168 |
| J3300 not in the list above | 2.5% | 507,790 |
| J0665 not in the list above | 2.0% | 396,541 |
| 80307 | 1.4% | 288,658 |
Localis can price 26% of this cohort's observed services (81% of allowed dollars) under the Q1 2016 release. The rest is clinical lab, drugs, or services paid outside the PFS under other fee schedules, not $0.
Established patient office visits—Office (non-facility)
Visit levels as shares of the 2024 services observed in this family, across 3,607 clinicians.
New patient office visits—Office (non-facility)
Visit levels as shares of the 2024 services observed in this family, across 3,127 clinicians.
Also high-volume for this cohort (observed, not yet in the curated list above)
This is observed billing only. The curated table above is still this page's rate list.
CY2024 Medicare fee-for-service only. Codes billed by fewer than 30 observed clinicians in a single setting are not shown, so shares may not total 100%. CMS publishes only a facility vs non-facility split, not exact places of service. Observed use adds context to the curated table above. It doesn't weight or change any rate on this page.
Turn the list into contract math
Analyze a payer offer using these Pain Management codes
We’ll preload the code set in Contract Check. Add your annual volumes and ZIP to see the volume-weighted percentage of Medicare and annual-dollar difference.
Get notified when Pain Management rates change
Medicare updates the fee schedule every quarter. We'll email you only when a release moves one of the 9 Pain Management codes on this page.
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Source & method Copy link
Amounts are computed from the CMS Medicare Physician Fee Schedule Q1 2016 release, GPCI 1.000, before the ~2% sequestration cut. The grouping by common clinical scenario is our own, not the AMA’s code-family taxonomy, and it’s a curated starter set, not a utilization-weighted specialty mix. A code with no amount is either not separately payable under the PFS or absent from the release. It never means $0.