Cervical or thoracic interlaminar epidural or subarachnoid injection of a drug such as a steroid, done with fluoroscopic or CT imaging guidance.
- Medicare
- $276.56
- Work RVU
- 1.9
- 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 symptoms with matching exam and imaging
- At least four weeks of conservative care with dates
- Level, approach, and imaging used with saved images
- Medication and dose
- Percent relief and duration from prior injection, if repeat
- Function measures before and after
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 ↓
62321 reports a cervical or thoracic interlaminar epidural with imaging guidance, fluoroscopy or CT. The guidance and contrast are part of the code. Billing 77003 or 77012 on top of it is a straight NCCI denial.
This is the code most spine and pain physicians in orthopedic groups use for neck and upper back radicular pain. Medicare's epidural injection LCDs set the rules: a radicular pain diagnosis with matching exam findings, at least four weeks of conservative care, and no more than four sessions per region in a rolling 12 months. A repeat injection needs at least 50 percent relief or functional improvement documented from the one before. Read your own MAC's LCD, since the details are set there.
One unit per session, no matter how many levels the medication spreads to. Interlaminar epidurals are not billed bilaterally. If the patient also gets a facet or transforaminal injection the same day in a different region, check the LCD and NCCI edits, and use modifier 59 or an X modifier only when the procedures are truly separate. A same-day E/M needs modifier 25 and a decision beyond the planned injection.
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 (1.9) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (8.28) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.9 |
| Practice expense RVU | 6.2 |
| Malpractice RVU | 0.18 |
| Total RVU | 8.28 |
| Medicare national rate | $276.56 |
| 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 | $276.56 |
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 62321 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Imaging guidance billed separately
- Frequency limit exceeded for the region
- Repeat without documented 50 percent relief
- Bilateral modifier added to an interlaminar injection
- Same-day E/M without separate decision
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can 77003 be billed with 62321?
02Is 62321 billed per level?
03How much relief is needed to repeat a cervical epidural for Medicare?
04Can I bill an E/M with an epidural on the same day?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records conservative care dates, radicular exam findings, and the percent relief from the last injection, so a repeat epidural meets the LCD before the claim goes out.
See how Mira captures CPT 62321 documentation