Cost analysis for CPT 64490 — Injection of upper or middle spine facet joint using imaging guidance, single level
Average Medicare Payment
$173.51
2023 data
Total Payments (2023)
$33.0M
Services (2023)
169.7K
Price Change (2014–2023)
+9.0%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $159.23 | $28.7M | 165.0K | — |
| 2015 | $157.31 | $31.0M | 180.5K | -1.2% |
| 2016 | $169.08 | $36.9M | 193.8K | +7.5% |
| 2017 | $152.29 | $33.2M | 200.3K | -9.9% |
| 2018 | $153.38 | $35.2M | 211.7K | +0.7% |
| 2019 | $160.31 | $38.8M | 219.4K | +4.5% |
| 2020 | $166.76 | $30.7M | 167.0K | +4.0% |
| 2021 | $169.25 | $32.3M | 172.7K | +1.5% |
| 2022 | $169.10 | $31.3M | 167.2K | -0.1% |
| 2023 | $173.51 | $33.0M | 169.7K | +2.6% |
The most expensive state pays 2.1x more than the cheapest for this procedure. CA averages $237.44 vs VT at $110.51.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| CA | $237.44 | $4.0M | 16.6K | 339 |
| NJ | $228.40 | $791.6K | 3.5K | 97 |
| NV | $219.25 | $505.4K | 2.3K | 48 |
| OR | $217.88 | $551.0K | 2.5K | 49 |
| CT | $214.83 | $233.9K | 1.1K | 29 |
| MD | $213.60 | $1.3M | 5.9K | 120 |
| DE | $212.35 | $174.1K | 820 | 18 |
| AK | $207.40 | $27.8K | 134 | 5 |
| NY | $205.80 | $1.3M | 6.1K | 161 |
| GA | $201.63 | $1.8M | 8.9K | 180 |
| MN | $198.67 | $557.1K | 2.8K | 67 |
| AZ | $197.94 | $1.6M | 8.3K | 163 |
| WA | $197.18 | $524.1K | 2.7K | 60 |
| CO | $195.24 | $819.8K | 4.2K | 90 |
| RI | $193.90 | $37.2K | 192 | 7 |
| FL | $193.76 | $4.5M | 23.4K | 430 |
| TX | $192.89 | $2.8M | 14.7K | 342 |
| IA | $189.08 | $114.4K | 605 | 17 |
| IN | $188.47 | $592.6K | 3.1K | 89 |
| PA | $186.41 | $791.5K | 4.2K | 121 |
| IL | $186.20 | $688.0K | 3.7K | 93 |
| AR | $182.86 | $478.0K | 2.6K | 55 |
| NM | $182.77 | $189.7K | 1.0K | 24 |
| SC | $181.29 | $853.3K | 4.7K | 77 |
| MI | $181.14 | $443.1K | 2.4K | 79 |
| TN | $180.97 | $811.6K | 4.5K | 85 |
| LA | $180.66 | $593.3K | 3.3K | 61 |
| WY | $179.39 | $48.3K | 269 | 7 |
| KS | $178.57 | $239.1K | 1.3K | 29 |
| WI | $176.49 | $332.0K | 1.9K | 54 |
| ID | $175.38 | $128.4K | 732 | 19 |
| UT | $174.28 | $234.6K | 1.3K | 42 |
| KY | $174.24 | $355.5K | 2.0K | 46 |
| NE | $173.93 | $120.0K | 690 | 20 |
| MS | $173.88 | $543.2K | 3.1K | 45 |
| MT | $171.83 | $79.4K | 462 | 12 |
| VA | $171.58 | $698.0K | 4.1K | 84 |
| MA | $171.24 | $521.8K | 3.0K | 80 |
| NH | $168.75 | $96.7K | 573 | 18 |
| OK | $168.73 | $476.8K | 2.8K | 54 |
| ND | $168.44 | $31.0K | 184 | 7 |
| NC | $168.13 | $522.2K | 3.1K | 87 |
| OH | $165.82 | $697.1K | 4.2K | 101 |
| AL | $161.32 | $364.3K | 2.3K | 55 |
| MO | $142.73 | $276.3K | 1.9K | 51 |
| ME | $125.23 | $20.9K | 167 | 8 |
| SD | $124.13 | $41.5K | 334 | 10 |
| WV | $121.94 | $54.0K | 443 | 14 |
| VT | $110.51 | $15.6K | 141 | 4 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| The Southeastern Spine Institute Ambulatory Surgery Center, Llc | Ambulatory Surgical Center | SC | $164.6K | 622 | $264.58 |
| Interventional Therapeutics Institute, Llc | Ambulatory Surgical Center | FL | $135.1K | 570 | $237.01 |
| West Florida Medical Center Clinic Pa | Ambulatory Surgical Center | FL | $105.4K | 444 | $237.35 |
| Pisa Asc Holdco Llc | Ambulatory Surgical Center | AZ | $91.5K | 305 | $299.92 |
| Oasis Surgery Center, Lp | Ambulatory Surgical Center | CA | $89.0K | 293 | $303.68 |
| Harmony Surgery Center, Llc | Ambulatory Surgical Center | CO | $86.0K | 319 | $269.54 |
| Northridge Outpatient Surgery Center Inc | Ambulatory Surgical Center | CA | $84.2K | 279 | $301.77 |
| Round Rock Surgery Center Llc | Ambulatory Surgical Center | TX | $83.9K | 330 | $254.38 |
| Embassy Surgery Center, Llc | Ambulatory Surgical Center | CA | $79.2K | 268 | $295.46 |
| Lone Tree Surgery Center, Llc | Ambulatory Surgical Center | CO | $75.6K | 274 | $276.01 |
| Chattanooga Pain Management Center Llc | Ambulatory Surgical Center | TN | $74.3K | 313 | $237.37 |
| Monterey Peninsula Surgery Center Capitola | Ambulatory Surgical Center | CA | $73.0K | 199 | $367.03 |
| Norcal Anesthesia And Pain Affiliates, Inc. | Ambulatory Surgical Center | CA | $72.9K | 257 | $283.69 |
| Murrells Inlet Asc Llc | Ambulatory Surgical Center | SC | $69.9K | 261 | $267.63 |
| North Naples Surgery Center Llc | Ambulatory Surgical Center | FL | $69.4K | 276 | $251.60 |
| Central Texas Day Surgery Center Limited Partnership | Ambulatory Surgical Center | TX | $68.4K | 202 | $338.55 |
| National Surgical Centers Of America Llc | Ambulatory Surgical Center | FL | $68.3K | 254 | $268.74 |
| Ku Medwest Ambulatory Surgery Center, Llc | Ambulatory Surgical Center | KS | $68.0K | 270 | $251.99 |
| Congress Medical Surgery Center Llc | Ambulatory Surgical Center | CA | $67.7K | 216 | $313.43 |
| Madison Surgery Center, Inc. | Ambulatory Surgical Center | WI | $67.0K | 247 | $271.41 |
The data suggests significant pricing inconsistencies for CPT 64490. With a 2.1x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.