CPT 64494: Lumbar/Sacral Facet Joint Injection, Second Level
Medicare pays $99 and commercial payers pay $312 on average nationally for this procedure.
CPT code 64494 describes an add-on image-guided diagnostic or therapeutic injection into a second lumbar or sacral paravertebral facet (zygapophyseal) joint or the nerves supplying that joint; service type is an image-guided facet joint injection and the typical site of service is an outpatient procedure room, ambulatory surgical center, or hospital imaging suite using fluoroscopy or CT guidance.
For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.
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National Reimbursement Benchmarks
Medicare’s mean of $99.20 sits well below BUCA’s average commercial mean of $311.60, indicating a substantial gap between federal reimbursement and this commercial benchmark—BUCA’s mean is roughly three times higher than Medicare’s. This gap highlights the difference in payment levels that providers can expect between Medicare and certain commercial arrangements.
Dispersion varies notably across payers. Blue Cross Blue Shield shows the widest interquartile spread (P75–P25 = $125.00), followed by BUCA with a spread of $129.00; UnitedHealth Group has a moderate spread of $82.10. Aetna and Cigna are among the tightest, with spreads of $108.50 and $76.20 respectively, indicating relatively less variability in negotiated rates for those carriers.