Summary & Overview
CPT 62323: Lumbar or Sacral Epidural Injection with Imaging Guidance
CPT code 62323 is a widely utilized billing code for interlaminar epidural or subarachnoid injections in the lumbar or sacral region, performed with imaging guidance. This procedure is a cornerstone in pain management and interventional radiology, offering relief for patients with conditions such as radiculopathy, spinal stenosis, and neoplasm-related pain. The code encompasses the injection of various therapeutic substances, excluding neurolytic agents, and includes both needle or catheter placement and imaging guidance.
Nationally, CPT 62323 is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare. Coverage policies and reimbursement benchmarks for this code are critical for providers and facilities delivering pain management services in ambulatory surgery centers and office settings.
This publication provides an in-depth overview of CPT 62323, including payer coverage, clinical indications, and related billing codes. Readers will gain insight into current policy updates, typical sites of service, and the clinical context for use of this procedure. The analysis also highlights common modifiers and associated provider taxonomies, equipping stakeholders with essential information for accurate coding and compliance.
CPT Code Overview
CPT 62323 describes the injection of diagnostic or therapeutic substances, such as anesthetics, antispasmodics, opioids, steroids, or other solutions, into the lumbar or sacral (caudal) region via an interlaminar epidural or subarachnoid approach. This procedure includes needle or catheter placement and is performed with imaging guidance, such as fluoroscopy or CT.
Pain management and interventional radiology are the primary service types for this code. The procedure is typically conducted in an ambulatory surgery center (ASC) or as an office-based procedure (place of service codes 11 and 24).
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting with chronic lumbar or sacral pain, often due to conditions such as radiculopathy, spondylosis, spinal stenosis, or postherpetic neuralgia. The patient has not responded adequately to conservative treatments like physical therapy or oral medications. The provider, typically a pain medicine physician, anesthesiologist, or spine specialist, determines that an interlaminar epidural injection of a therapeutic substance (such as a steroid or anesthetic) is indicated. The procedure is performed in an ambulatory surgery center or office setting, using imaging guidance (fluoroscopy or CT) to ensure accurate needle placement. The goal is to reduce pain and inflammation, improve function, and potentially delay or avoid surgical intervention.
Coding Specifications
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Modifiers:
Modifier Description Usage KXRequirements specified in the medical policy have been met Used when documentation supports medical necessity as per payor policy 50Bilateral procedure Not typical for 62323as it is not a bilateral procedureLTLeft side Used if the injection is performed on the left side RTRight side Used if the injection is performed on the right side -
Provider Taxonomies:
Taxonomy Code Specialty 207L00000XAnesthesiology 208VP0000XPain Medicine Physician 207XS0117XOrthopaedic Surgery of the Spine 208D00000XGeneral Practice 207R00000XInternal Medicine Physician
These specialties are typically involved in pain management and interventional spine procedures.
Related Diagnoses
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B02.23- Postherpetic polyneuropathy- Relevant for patients with nerve pain following herpes zoster infection, often treated with epidural injections for pain relief.
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B02.7- Disseminated zoster- Indicates widespread herpes zoster, which can cause severe neuropathic pain managed with epidural injections.
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B02.8- Zoster with other complications- Used when herpes zoster leads to complications such as neuralgia, justifying interventional pain procedures.
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B02.9- Zoster without complications- For uncomplicated herpes zoster cases where pain management is required.
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G89.3- Neoplasm related pain (acute) (chronic)- For patients experiencing pain due to cancer, where epidural injections may be part of the pain management strategy.
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M47.22- Other spondylosis with radiculopathy, cervical region- Indicates cervical spondylosis with nerve root involvement; relevant for epidural injections if pain extends to lumbar/sacral regions.
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M47.23- Other spondylosis with radiculopathy, cervicothoracic region- Similar relevance as above, for cervicothoracic involvement.
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M47.24- Other spondylosis with radiculopathy, thoracic region- Thoracic spondylosis with radiculopathy; may be treated with epidural injections.
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M47.25- Other spondylosis with radiculopathy, thoracolumbar region- Thoracolumbar spondylosis with nerve root pain; supports use of lumbar/sacral epidural injections.
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M47.26- Other spondylosis with radiculopathy, lumbar region- Directly relevant for lumbar epidural injections for radiculopathy.
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M47.27- Other spondylosis with radiculopathy, lumbosacral region- Indicates lumbosacral spondylosis with radiculopathy; common indication for this procedure.
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M48.062- Spinal stenosis, lumbar region with neurogenic claudication- Lumbar spinal stenosis causing nerve pain and claudication; epidural injections may alleviate symptoms.
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M50.121- Cervical disc disorder at C4‑C5 level with radiculopathy- Cervical disc disease with nerve root involvement; relevant if pain extends to lumbar/sacral regions.
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M50.122- Cervical disc disorder at C5‑C6 level with radiculopathy- Similar relevance as above.
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M50.123- Cervical disc disorder at C6‑C7 level with radiculopathy- Similar relevance as above.
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M50.13- Cervical disc disorder with radiculopathy, cervicothoracic region- Cervicothoracic disc disease with radiculopathy; may be considered for epidural injections.
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M51.14- Intervertebral disc disorders with radiculopathy, thoracic region- Thoracic disc disease with nerve root pain; supports use of epidural injections.
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M51.15- Intervertebral disc disorders with radiculopathy, thoracolumbar region- Thoracolumbar disc disease with radiculopathy; relevant for lumbar/sacral injections.
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M51.16- Intervertebral disc disorders with radiculopathy, lumbar region- Directly relevant for lumbar epidural injections.
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M51.17- Intervertebral disc disorders with radiculopathy, lumbosacral region- Lumbosacral disc disease with radiculopathy; common indication for this procedure.
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M54.12- Radiculopathy, cervical region- Cervical radiculopathy; relevant if pain extends to lumbar/sacral regions.
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M54.13- Radiculopathy, cervicothoracic region- Cervicothoracic radiculopathy; similar relevance.
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M54.14- Radiculopathy, thoracic region- Thoracic radiculopathy; may be treated with epidural injections.
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M54.15- Radiculopathy, thoracolumbar region- Thoracolumbar radiculopathy; relevant for lumbar/sacral injections.
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M54.16- Radiculopathy, lumbar region- Directly relevant for lumbar epidural injections.
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M54.17- Radiculopathy, lumbosacral region- Lumbosacral radiculopathy; common indication for this procedure.
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M54.18- Radiculopathy, sacral and sacrococcygeal region- Sacral radiculopathy; supports use of caudal epidural injections.
Related CPT Codes
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62321- Injection(s), of diagnostic or therapeutic substance(s), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance- Used for similar procedures in the cervical or thoracic regions; alternative to
62323when the anatomical site differs.
- Used for similar procedures in the cervical or thoracic regions; alternative to
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64483- Injection(s), anesthetic agent and/or steroid, transforaminal epidural, lumbar or sacral, single level; with imaging guidance- Used for transforaminal epidural injections in the lumbar or sacral region; may be used as an alternative or in conjunction with
62323depending on clinical indication.
- Used for transforaminal epidural injections in the lumbar or sacral region; may be used as an alternative or in conjunction with
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64484- Injection(s), anesthetic agent and/or steroid, transforaminal epidural, lumbar or sacral, each additional level; with imaging guidance- Used for additional levels in transforaminal epidural injections; often paired with
64483.
- Used for additional levels in transforaminal epidural injections; often paired with
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64479- Injection(s), anesthetic agent and/or steroid, transforaminal epidural, cervical or thoracic, single level; with imaging guidance- Used for transforaminal epidural injections in the cervical or thoracic region; alternative to
62321for different approach.
- Used for transforaminal epidural injections in the cervical or thoracic region; alternative to
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64480- Injection(s), anesthetic agent and/or steroid, transforaminal epidural, cervical or thoracic, each additional level; with imaging guidance- Used for additional levels in cervical or thoracic transforaminal epidural injections; often paired with
64479.
- Used for additional levels in cervical or thoracic transforaminal epidural injections; often paired with
These codes represent alternative approaches or anatomical sites for epidural injections and may be used in similar clinical workflows depending on patient needs.
National Reimbursement Benchmarks
Nationally, the mean rate for CPT code 62323 under Medicare is $284.07, while the BUCA (average commercial) mean rate is $262.23. This places Medicare's average reimbursement above the commercial benchmark for BUCA, but below UnitedHealth Group ($362.63) and Cigna ($300.48), and above Aetna ($228.13) and Blue Cross Blue Shield ($243.01).
Rate dispersion, measured as the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare shows the tightest range at $33.00, indicating relatively consistent rates nationally. In contrast, UnitedHealth Group exhibits the widest spread at $182.33, followed by Cigna at $147.00, reflecting greater variability in commercial reimbursement. Aetna and Blue Cross Blue Shield have moderate dispersion at $97.33 and $124.25, respectively.
The table and chart below present the full breakdown of national benchmarks for each payer, including mean rates and percentile values.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.