Interlaminar epidural or subarachnoid injection of a drug such as a steroid in the cervical or thoracic spine, done without imaging guidance.
- Medicare
- $163.66
- Work RVU
- 1.76
- Global, days
- 0
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Radicular pain diagnosis with exam findings
- Duration of symptoms and conservative care tried
- Level and approach
- Medication and dose
- Reason imaging guidance was not used
- Pain relief from prior injections, if repeat
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
Without imaging guidance, a cervical or thoracic interlaminar epidural is 62320. The code with imaging guidance is 62321. Contrast use is included in both.
For Medicare, this code is a problem. The epidural steroid injection LCDs require imaging guidance, so a blind cervical or thoracic epidural will usually deny as not reasonable and necessary. Most commercial payers have adopted the same rule. If a provider in your group still does them without guidance, use an ABN for Medicare patients and check commercial policies before scheduling.
In orthopedic and spine practices, epidurals are usually done by a pain or PM&R physician in the group, often after a surgeon's consult. Each region's injections count toward the LCD frequency limit (check your MAC), commonly four sessions per region in a rolling 12 months, with a follow-up visit showing at least 50 percent relief or functional improvement before repeating. Bill one unit per session, regardless of how much medication was given.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (1.76) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (4.9) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.76 |
| Practice expense RVU | 2.93 |
| Malpractice RVU | 0.21 |
| Total RVU | 4.9 |
| Medicare national rate | $163.66 |
| Global period | 0 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $163.66 |
HOPD (APC 5442) Hospital outpatient department | $721.17 |
ASC (PI G2) Ambulatory surgical center (freestanding) | $387.46 |
Common denial reasons
The recurring reasons claims for CPT 62320 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- No imaging guidance under the Medicare LCD
- Frequency limit exceeded for the region
- Repeat injection without documented relief from the last
- Same-day E/M without modifier 25
- Diagnosis does not support radicular pain
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Does Medicare cover 62320?
02What is the difference between 62320 and 62321?
03How many epidural injections does Medicare allow per year?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the radicular exam, conservative care, and percent relief from the last injection at each visit, which is what a repeat epidural needs under LCD rules.
See how Mira captures CPT 62320 documentation