CPT
60500 — Parathyroidectomy or exploration of parathyroid gland
Verify the code matches the actual service and dose.
Surgery & procedures
64493 — Paravertebral facet joint/nerve, lumbar or sacral; single level
This code covers a facet joint injection at a single level of the lumbar or sacral spine, in which a physician injects a local anesthetic and/or steroid medication into the small joints along the back of the spine.
- Typical setting: Doctor's office, hospital outpatient
- National avg charge (illustrative): $125-$290 Medicare allowed for single level (approx. $140-$240 national Medicare average; commercial payers $200-$450)
- Most-disputed reason: Incorrect level count: billing for multiple spinal levels using 64494 (second level) and 64495 (third and beyond add-on) without documentation of each level treated separately
What it means
What 64493 actually means
This code covers a facet joint injection at a single level of the lumbar or sacral spine, in which a physician injects a local anesthetic and/or steroid medication into the small joints along the back of the spine. These injections are used to diagnose and treat facet joint-mediated low back pain. Imaging guidance is typically included in current practice.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Incorrect level count: billing for multiple spinal levels using 64494 (second level) and 64495 (third and beyond add-on) without documentation of each level treated separately
- Bilateral billing without modifier: injecting both sides of the same spinal level requires modifier -50 (bilateral) — billing two units of 64493 without this modifier may be incorrect depending on payer
- Frequency violation: billing facet injections more frequently than payer policy allows (Medicare typically limits facet injections per region per year) without supporting documentation of medical necessity
If you see 64493 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 64493 often also see these adjacent codes on the same bill.
CPT
62323 — Lumbar/sacral epidural; diagnostic or therapeutic, imaging guidance
Verify the code matches the actual service and dose.
CPT
64483 — Epidural injection, lumbar/sacral, single level
Common procedure with frequent coding errors around bilateral and fluoroscopy.
CPT
66984 — Extracapsular cataract removal with intraocular lens prosthesis, one stage
Verify the code matches the actual service and dose.
CPT
69210 — Removal of impacted cerumen requiring instrumentation, one or both ears
Verify the code matches the actual service and dose.
Related BillBusted guides
Plain-English reads if you see 64493 on a bill.
64493 FAQ
Plain-English answers.
What does 64493 usually cost?
$125-$290 Medicare allowed for single level (approx. $140-$240 national Medicare average; commercial payers $200-$450). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 64493?
Incorrect level count: billing for multiple spinal levels using 64494 (second level) and 64495 (third and beyond add-on) without documentation of each level treated separately
What should I do if I see 64493 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 64493 before paying.
Don't pay 64493 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.