CPT 64479: Transforaminal Epidural Injection, Cervical or Thoracic Single Level

Medicare pays $296 and commercial payers pay $618 on average nationally for this procedure.

CPT code 64479 describes a transforaminal epidural injection of an anesthetic agent and/or steroid at a single cervical or thoracic spinal level; this is an image-guided or non-image-guided interventional pain management procedure typically performed in an outpatient surgical center or hospital outpatient department to deliver medication into the neural foraminal space for diagnosis or treatment of radicular or postprocedural spinal pain.

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National Reimbursement Benchmarks

Medicare’s mean reimbursement of $296.20 sits well below BUCA’s average commercial mean of $618.50, indicating that commercial networks pay roughly double Medicare for CPT 64479 on average. This gap highlights a sizable commercial premium versus the federal baseline, with BUCA’s center-tendency near $576.70 (median) and Medicare’s median at $292 reinforcing the mean divergence.

Examining dispersion using the interquartile range (P75–P25) shows variability is widest for Blue Cross Blue Shield at $786.10 (P75 $1,202.80 minus P25 $429.70) and narrowest for Aetna at $198.00 (P75 $254.30 minus P25 $53.70). UnitedHealth Group ($488.60 − $231.50 = $257.10) and Cigna ($420.70 − $188.60 = $232.10) sit in the mid-range; BUCA’s IQR is $352.40 (P75 $853.60 − P25 $313.20).

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CPT 64479: Transforaminal Epidural Injection, Cervical or Thoracic Single Level

Medicare pays $296 and commercial payers pay $618 on average nationally for this procedure.

Customize your policy alerts

Sign up for cpt 64479 policy alerts

Get alerted when payer policies referencing 64479 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 58-year-old male status post right posterolateral thoracotomy two weeks ago presents with severe, sharp radicular pain along the right T6–T7 dermatome consistent with acute post-thoracotomy neuropathic pain. Conservative measures (oral analgesics, neuropathic agents, and physical therapy) produced inadequate relief and the patient reports functional limitation and poor sleep. After evaluation by a pain medicine physician, imaging (thoracic spine MRI) confirmed no progressive structural compromise but suggested perineural inflammation at the right T6–T7 exiting nerve root. The team recommends a diagnostic and therapeutic transforaminal epidural injection at a single thoracic level using fluoroscopic guidance to deliver a local anesthetic with corticosteroid.

The clinical workflow includes pre-procedure evaluation (history, review of anticoagulation status, informed consent), verification of the indicated single cervical or thoracic level, procedure performed in an ambulatory surgical center or hospital outpatient department under sterile conditions with fluoroscopic guidance, intraprocedural monitoring by an anesthesiology or pain medicine provider, post-procedure recovery and observation for immediate complications, and documentation of level, laterality, agents, volumes, and fluoroscopic confirmation of needle/contrast placement. The typical site of service is an ambulatory surgical center or hospital outpatient department. The service type is a single-level cervical or thoracic transforaminal epidural injection (anesthetic agent and/or steroid) performed for acute postprocedural thoracic pain (e.g., post-thoracotomy pain).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64480`	Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with image guidance (fluoroscopy or CT); cervical or thoracic, each additional level	Billed when more than one cervical or thoracic level is injected at the same session; reported in addition to the primary single-level code `64479` for additional levels.
`64483`	Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with image guidance (fluoroscopy or CT); lumbar or sacral, single level	Equivalent procedure for the lumbar/sacral region; used when the transforaminal injection target is lumbar/sacral rather than cervical/thoracic.
`64484`	Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with image guidance (fluoroscopy or CT); lumbar or sacral, each additional level	Billed for each additional lumbar or sacral level injected during the same session; analogous to `64480` but for lumbosacral levels.

Related Modifiers

9 rows

Modifier	Description	When to Use
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
208VP0000X	Pain Medicine Physician	Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on sc…
207XS0117X	Orthopaedic Surgery of the Spine Physician	Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with th…
1223D0001X	Public Health Dentistry	The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of…
208C00000X	Colon & Rectal Surgery Physician	A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by m…
225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist	General classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesse…
292200000X	Dental Laboratory	A commercial laboratory specializing in the construction of dental appliances that conform to a dentist's specifications including the construction of…

Related ICD-10-CM Codes

27 rows

ICD-10-CM Code	Description
G89.12	Acute post-thoracotomy pain
G89.18	Other acute postprocedural pain
G96.11	Dural tear
M47.21	Other spondylosis with radiculopathy, occipito-atlanto-axial region
M47.22	Other spondylosis with radiculopathy, cervical region
M47.812	Spondylosis without myelopathy or radiculopathy, cervical region
M47.813	Spondylosis without myelopathy or radiculopathy, cervicothoracic region
M48.02	Spinal stenosis, cervical region
M48.04	Spinal stenosis, thoracic region
M50.13	Cervical disc disorder with radiculopathy, cervicothoracic region

Showing 1–10 of 27

Related Payer Policy Updates

Specialty: Anesthesiology1 / 3

10 rows

Policy	Payer	Effective Date
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Elective Inpatient Services (for Idaho Only)	UnitedHealthcare	2026-06-01
Sites of Service	priority health	2026-06-01
Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Services	univerahealthcare	2026-05-21
Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_Blocks	Cigna	2026-05-15
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01

CPT 64400: Injection of Trigeminal Nerve Branch

CPT-64405-GREATER-OCCIPITAL-NERVE-INJECTION

CPT 64405: Greater Occipital Nerve Injection

CPT-64408-VAGUS-NERVE-INJECTION

CPT 64408: Vagus Nerve Injection (Vagal Nerve Block)

CPT-64415-BRACHIAL-PLEXUS-NERVE-BLOCK-INJECTION

CPT 64415: Brachial Plexus Injection for Regional Nerve Block

CPT-64416-BRACHIAL-PLEXUS-CONTINUOUS-INFUSION-CATHETER

CPT 64416: Brachial Plexus Continuous Catheter Infusion

CPT-64417-AXILLARY-NERVE-INJECTION-NERVE-BLOCK

CPT 64417: Axillary Nerve Injection for Regional Anesthesia or Steroid Delivery

CPT-64418-SUPRASCAPULAR-NERVE-INJECTION-SHOULDER

CPT 64418: Suprascapular Nerve Injection, Shoulder

CPT-64420-INTERCOSTAL-NERVE-INJECTION

CPT 64420: Intercostal Nerve Injection, Single Level

CPT-64421-INTERCOSTAL-NERVE-INJECTION-ADDITIONAL-LEVEL

CPT 64421: Intercostal Nerve Injection (Additional Level)

CPT-64425-ILIOINGUINAL-ILIOHYPOGASTRIC-NERVE-INJECTION

CPT 64425: Ilioinguinal/Iliohypogastric Nerve Injection

Showing 1–10 of 37

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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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.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64480`	Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with image guidance (fluoroscopy or CT); cervical or thoracic, each additional level	Billed when more than one cervical or thoracic level is injected at the same session; reported in addition to the primary single-level code `64479` for additional levels.
`64483`	Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with image guidance (fluoroscopy or CT); lumbar or sacral, single level	Equivalent procedure for the lumbar/sacral region; used when the transforaminal injection target is lumbar/sacral rather than cervical/thoracic.
`64484`	Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with image guidance (fluoroscopy or CT); lumbar or sacral, each additional level	Billed for each additional lumbar or sacral level injected during the same session; analogous to `64480` but for lumbosacral levels.

Related Modifiers

9 rows

Modifier	Description	When to Use
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
208VP0000X	Pain Medicine Physician	Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on sc…
207XS0117X	Orthopaedic Surgery of the Spine Physician	Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with th…
1223D0001X	Public Health Dentistry	The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of…
208C00000X	Colon & Rectal Surgery Physician	A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by m…
225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist	General classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesse…
292200000X	Dental Laboratory	A commercial laboratory specializing in the construction of dental appliances that conform to a dentist's specifications including the construction of…

Related ICD-10-CM Codes

27 rows

ICD-10-CM Code	Description
G89.12	Acute post-thoracotomy pain
G89.18	Other acute postprocedural pain
G96.11	Dural tear
M47.21	Other spondylosis with radiculopathy, occipito-atlanto-axial region
M47.22	Other spondylosis with radiculopathy, cervical region
M47.812	Spondylosis without myelopathy or radiculopathy, cervical region
M47.813	Spondylosis without myelopathy or radiculopathy, cervicothoracic region
M48.02	Spinal stenosis, cervical region
M48.04	Spinal stenosis, thoracic region
M50.13	Cervical disc disorder with radiculopathy, cervicothoracic region

Showing 1–10 of 27

Related Payer Policy Updates

Specialty: Anesthesiology1 / 3

10 rows

Policy	Payer	Effective Date
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Elective Inpatient Services (for Idaho Only)	UnitedHealthcare	2026-06-01
Sites of Service	priority health	2026-06-01
Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Services	univerahealthcare	2026-05-21
Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_Blocks	Cigna	2026-05-15
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01

CPT 64400: Injection of Trigeminal Nerve Branch

CPT-64405-GREATER-OCCIPITAL-NERVE-INJECTION

CPT 64405: Greater Occipital Nerve Injection

CPT-64408-VAGUS-NERVE-INJECTION

CPT 64408: Vagus Nerve Injection (Vagal Nerve Block)

CPT-64415-BRACHIAL-PLEXUS-NERVE-BLOCK-INJECTION

CPT 64415: Brachial Plexus Injection for Regional Nerve Block

CPT-64416-BRACHIAL-PLEXUS-CONTINUOUS-INFUSION-CATHETER

CPT 64416: Brachial Plexus Continuous Catheter Infusion

CPT-64417-AXILLARY-NERVE-INJECTION-NERVE-BLOCK

CPT 64417: Axillary Nerve Injection for Regional Anesthesia or Steroid Delivery

CPT-64418-SUPRASCAPULAR-NERVE-INJECTION-SHOULDER

CPT 64418: Suprascapular Nerve Injection, Shoulder

CPT-64420-INTERCOSTAL-NERVE-INJECTION

CPT 64420: Intercostal Nerve Injection, Single Level

CPT-64421-INTERCOSTAL-NERVE-INJECTION-ADDITIONAL-LEVEL

CPT 64421: Intercostal Nerve Injection (Additional Level)

CPT-64425-ILIOINGUINAL-ILIOHYPOGASTRIC-NERVE-INJECTION

CPT 64425: Ilioinguinal/Iliohypogastric Nerve Injection

Showing 1–10 of 37

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 64479: Transforaminal Epidural Injection, Cervical or Thoracic Single Level

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National Reimbursement Benchmarks

OpenPayer

CPT 64479: Transforaminal Epidural Injection, Cervical or Thoracic Single Level

Sign up for cpt 64479 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 64479: Transforaminal Epidural Injection, Cervical or Thoracic Single Level

Sign up for cpt 64479 policy alerts

National Reimbursement Benchmarks

CPT 64479: Transforaminal Epidural Injection, Cervical or Thoracic Single Level

Sign up for cpt 64479 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What procedure does CPT 64479 represent and where is it typically performed?

How are additional levels or lumbar/sacral injections coded in relation to 64479?

Which ICD-10 diagnoses in the provided content support medical necessity for CPT 64479?

What procedural steps and documentation are highlighted for a CPT 64479 service?

Which payers are identified as covering CPT 64479 and does the page provide reimbursement amounts?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What procedure does CPT 64479 represent and where is it typically performed?

How are additional levels or lumbar/sacral injections coded in relation to 64479?

Which ICD-10 diagnoses in the provided content support medical necessity for CPT 64479?

What procedural steps and documentation are highlighted for a CPT 64479 service?

Which payers are identified as covering CPT 64479 and does the page provide reimbursement amounts?

References