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CPT 64479: Transforaminal Epidural Injection, Cervical or Thoracic Single Level
Headline: CPT code 64479: Targeted cervical or thoracic transforaminal epidural injection for radicular pain
Lead: CPT code 64479 denotes a transforaminal epidural injection of an anesthetic agent and/or steroid at a single cervical or thoracic spinal level. This targeted procedure is commonly used in pain management to address radicular symptoms and peri-procedural inflammatory pain.
What the code represents and national importance: CPT code 64479 captures a commonly performed, image-guided interventional pain procedure focused on a single cervical or thoracic nerve root. As spine-related pain remains a leading cause of disability and outpatient procedural volume, accurate coding for targeted epidural injections affects clinical documentation, payer adjudication, and national utilization metrics.
Key payers covered: Analysis typically includes national commercial payers such as Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare.
What readers will learn: The publication provides benchmarks and clinical context for CPT code 64479, compares it to related transforaminal epidural codes, and summarizes coding considerations and utilization drivers relevant to clinicians, billing teams, and policy analysts. It highlights where CPT code 64479 fits within interventional spine care and outlines the clinical scenarios that commonly lead to its use.
Policy and billing context: Coverage policies and prior authorization approaches among major payers influence access and reimbursement. The code's specification for a single cervical or thoracic level distinguishes it from additional-level or lumbar/sacral transforaminal injection codes.
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Billing Code Overview
CPT code 64479 describes the injection of an anesthetic agent and/or steroid delivered as a transforaminal epidural injection into a single level in the cervical or thoracic spine. This procedure is a targeted nerve-root injection administered to reduce radicular pain or inflammation originating from a specific spinal level.
Service Type: Transforaminal epidural steroid/anesthetic injection (single cervical or thoracic level)
Typical Site of Service: Outpatient procedural setting such as ambulatory surgery centers or hospital outpatient departments; may also be performed in specialized pain clinics with appropriate imaging support.
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).