62264 Epidural lysis on single day
What 62264 is
CMS fee schedule short descriptor: Epidural lysis on single day.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 62264 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 4.31 | 8.64 | 0.42 | 13.37 | $446.57 |
| Facility (hospital, ASC) | 4.31 | 1.68 | 0.42 | 6.41 | $214.10 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: 10-day global period.
Medically Unlikely Edit (MUE)
Medicare caps 62264 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 62264? These codes are bundled into it
62264 is a Column 1 code in 259 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
00600 | Anes px crv spine&cord nos | 0 - no modifier bypass | Check pair |
00604 | Anes px crv spn&cord sitting | 0 - no modifier bypass | Check pair |
00620 | Anes px thrc spine&cord nos | 0 - no modifier bypass | Check pair |
00625 | Anes thrc spine wo 1lng vent | 0 - no modifier bypass | Check pair |
00626 | Anes thrc spine w/1 lng vent | 0 - no modifier bypass | Check pair |
00630 | Anes px lumbar region nos | 0 - no modifier bypass | Check pair |
00670 | Anes xtnsv sp&spi cord px | 0 - no modifier bypass | Check pair |
01937 | Anes drg/aspir crv/thrc | 0 - no modifier bypass | Check pair |
01938 | Anes drg/aspir lmbr/sac | 0 - no modifier bypass | Check pair |
01939 | Anes nulyt agt crv/thrc | 0 - no modifier bypass | Check pair |
01940 | Anes nulyt agt lmbr/sac | 0 - no modifier bypass | Check pair |
01941 | Anes neuromd/ntrvrt crv/thrc | 0 - no modifier bypass | Check pair |
01942 | Anes neuromd/ntrvrt lmbr/sac | 0 - no modifier bypass | Check pair |
0333T | Visual ep scr acuity auto | 0 - no modifier bypass | Check pair |
0464T | Visual ep test for glaucoma | 0 - no modifier bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
12013 | Rpr f/e/e/n/l/m 2.6-5.0 cm | 1 - modifier may bypass | Check pair |
Showing 30 of 259 column 2 codes. Use the pair checker for any specific combination.
62264 is bundled into these codes
62264 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 62264 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
62263 | Epidural lysis mult sessions | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.