Summary & Overview
CPT 0217T: Ultrasound-Guided Lumbar/Sacral Facet Joint or Nerve Injection
CPT code 0217T covers ultrasound-guided injection of a diagnostic or therapeutic agent into an additional lumbar or sacral paravertebral facet joint or the nerves that exit the joint. This image-guided interventional pain management procedure is used to relieve axial or radicular pain or to provide regional anesthesia prior to surgery. Nationally, accurate coding of this CPT code matters for appropriate reimbursement, utilization tracking, and quality measurement in pain management and perioperative care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and typical sites of service, benchmarking insights where available, and relevant policy and coding considerations that affect coverage and billing for ultrasound-guided lumbar/sacral facet joint or nerve injections. The publication summarizes common modifiers and administrative details supplied in the input and highlights where data is not available.
This analysis provides clinicians, revenue cycle professionals, and policy analysts with a concise reference to the clinical intent of the procedure, payer landscape, and the operational context needed to support claims submission and payer discussions for CPT code 0217T. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0217T describes injection of a diagnostic or therapeutic agent into an additional lumbar or sacral paravertebral facet joint or the nerves that exit the joint under ultrasound guidance. The procedure may be performed to relieve pain or to administer an anesthetic for a surgical procedure.
Service Type: Image-guided lumbar/sacral paravertebral facet joint or nerve injection
Typical Site of Service: Outpatient procedure suite, ambulatory surgery center, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 56-year-old patient with chronic axial low back pain and focal lumbar facetogenic pain refractory to conservative treatments presents for ultrasound-guided paravertebral facet joint injection. The procedure is performed in an outpatient ambulatory surgery center or pain clinic procedure room under sterile conditions. After history, focused exam, and review of prior imaging, the provider identifies the symptomatic lumbar or sacral paravertebral facet joint(s). Under ultrasound guidance the clinician advances a needle to the targeted facet joint or the dorsal rami exiting the joint, aspirates as indicated, and injects a diagnostic local anesthetic agent or corticosteroid therapeutic agent to confirm the pain generator or provide relief. The patient is monitored in a recovery area for immediate response and possible adverse effects, and post-procedure instructions are given prior to discharge.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | Used when no additional modifier is applicable and the procedure is reported routinely |
22 | Increased procedural services | When work, time, or complexity substantially exceeds usual for 0217T (document justification in operative note) |
23 | Unusual anesthesia | When the procedure requires general anesthesia or deep sedation for reasons unrelated to the procedure itself |
50 | Bilateral procedure | When equivalent facet injections are performed bilaterally during the same session (if applicable to code sequencing rules) |
52 | Reduced services | When the procedure was partially reduced or not completed as planned |
53 | Discontinued procedure | When the procedure is started but terminated due to extenuating circumstances or patient safety |
54 | Surgical care only | When another provider performs only the intraoperative portion and a different clinician manages pre/postoperative care |
55 | Postoperative management only | When the reporting provider only manages postoperative care after the injection procedure |
62 | Two surgeons | When two surgeons of different specialties work together as co-surgeons for a portion of the procedure |
66 | Team surgeon | When a team of surgeons performs the procedure and reporting rules allow this modifier |
78 | Unplanned return to the OR | For related procedures requiring return to the operating room for a related complication within the global period |
80 | Assistant surgeon | When an assistant surgeon is required and documented |
81 | Minimum assistant surgeon | When a minimal assistant surgeon is documented and appropriate |
82 | Assistant not available | When a qualified assistant is not available and another licensed individual assists under supervision |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | Pain Medicine | Interventional pain specialists commonly perform ultrasound-guided facet joint injections |
| 2084P0800X | Physical Medicine & Rehabilitation | PM&R physicians frequently perform diagnostic and therapeutic spinal injections |
| 2086S0112X | Anesthesiology (Interventional Pain) | Anesthesiologists with pain fellowship training commonly perform these procedures |
| 363LP0800X | Family Medicine | Family physicians with procedural pain training may perform injections in ambulatory settings |
| 207L00000X | Neurology | Neurologists with interventional pain credentials may perform or interpret diagnostic facet injections |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M54.16 | Radiculopathy, lumbar region | Radicular symptoms can coexist with facetogenic pain; injections may help distinguish pain sources and provide relief |
M54.5 | Low back pain | A common indication for diagnostic or therapeutic facet injections when facet-mediated pain is suspected |
M47.816 | Spondylosis without myelopathy or radiculopathy, lumbar region | Degenerative facet arthropathy frequently causes lumbar facet joint pain treated with injections |
M48.06 | Spinal stenosis, lumbar region | Facet hypertrophy contributing to stenosis may be addressed diagnostically or therapeutically with injections |
M99.23 | Subluxation stenosis of lumbar region | Mechanical facet joint dysfunction leading to localized pain where diagnostic/therapeutic injection may be used |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27096 | Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) | Alternative or adjunct for sacral region pain when SI joint is suspected; may be used when fluoroscopic guidance preferred over ultrasound |
64493 | Injection, anesthetic agent; lumbar or sacral nerve root, single level, with imaging guidance | Perineural nerve root block for radicular pain; may be performed adjunctively to differentiate facet versus radicular pain |
64483 | Injection, anesthetic agent; paravertebral facet joint (dorsal ramus), single level, lumbar | Closely related lumbar facet joint injection code commonly used for diagnostic or therapeutic facet injections under imaging guidance |
76942 | Ultrasonic guidance for needle placement (eg, vascular access, nerve block) | Reported when real-time ultrasound guidance is used to assist needle placement for the injection |
99213 | Office or other outpatient visit for established patient, moderate complexity | Typical E/M encounter for pre-procedure evaluation when combined with planning for the injection |
77003 | Fluoroscopic guidance/needle localization (eg, for spinal injections) | Used when fluoroscopic rather than ultrasound guidance is employed for the same clinical intent |