Single interlaminar epidural or subarachnoid injection at a lumbar or sacral level, performed under fluoroscopic or CT guidance, delivering a steroid, anesthetic, or other non-neurolytic drug.
- Medicare
- $273.22
- 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 ↓
- Level injected, interlaminar or caudal approach, and imaging modality used
- Saved fluoroscopic or CT image showing needle position or contrast spread
- Drug name, dose, and volume
- Radicular symptoms, duration of at least four weeks, and failed conservative care
- Pre-procedure pain and function scores
- For repeat injections, response to the prior injection with percent relief and duration
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 ↓
For interlaminar lumbar epidural steroid injections, 62323 is the code you will bill most. It covers the needle placement through the interlaminar space at a lumbar or sacral level, the injection, and the fluoroscopy or CT used to guide it. Caudal epidurals through the sacral hiatus also report here.
The imaging is part of the code. Do not add 77003 or 77012. If the physician injects contrast to confirm spread, that is also included. One unit per session, even if the needle is repositioned.
Medicare covers these under the epidural steroid injection LCDs, which set the rules that cause most denials: radicular pain for at least four weeks, failed conservative care, documented pain and function scores, and a cap of four ESI sessions per spinal region in a rolling 12 months. Repeat injections need documented relief from the prior one (at least 50 percent for a sustained period is the usual threshold). Many commercial payers also require prior authorization. A same-day E/M needs modifier 25 and a separately identifiable reason, such as working up a new knee complaint.
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 (8.18) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.76 |
| Practice expense RVU | 6.25 |
| Malpractice RVU | 0.17 |
| Total RVU | 8.18 |
| Medicare national rate | $273.22 |
| 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 | $273.22 |
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 62323 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- More than four ESI sessions in the lumbar region in a rolling 12 months
- Repeat injection without documented relief from the prior one
- Fluoroscopy billed separately with 77003
- No prior authorization on file with the commercial payer
- Diagnosis limited to axial low back pain without radiculopathy or stenosis
- Same-day E/M billed without modifier 25 or a separate problem
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can you bill 77003 with CPT 62323?
02Is a caudal epidural billed as 62323?
03How many lumbar epidural injections does Medicare allow per year?
04Does 62323 need modifier 50 for a bilateral injection?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe's notes capture the radicular history, conservative care timeline, and pain scores the ESI LCD asks for, along with the percent relief from any prior injection. That gives the coder everything needed for a clean repeat-injection claim.
See how Mira captures CPT 62323 documentation