Medicare Epidural Injection Cost 2026 | Out-of-Pocket Estimator
Lumbar transforaminal epidural steroid injection (CPT 64483) is covered by Medicare Part B for chronic back pain. It is performed in a hospital outpatient department or ASC and does not typically require general anesthesia.
2026 Medicare Cost Summary — Epidural Injection (CPT 64483)
Source: CMS 2026 MPFS, OPPS Final Rule, ASC Final Rule, IPPS. All amounts are national averages.
| Cost Component | Medicare-Approved Amount | Your Share (20%) |
|---|---|---|
| Surgeon Fee — Epidural Injection (CPT 64483) | $99 | $20 |
| Hospital Outpatient (HOPD) Facility Fee | $903 | $181 |
| Ambulatory Surgery Center (ASC) Facility Fee | $485 | $97 |
| Anesthesia (estimated) | included | 20% of approved |
What Medicare Pays
Medicare pays 80% of the approved amount for Part B services after your $283 annual deductible. With no supplemental insurance, you owe the remaining 20% with no annual out-of-pocket cap. With Medigap Plan G, you pay only the $283 Part B deductible — everything else is covered. With Medigap Plan N, you pay the $283 deductible plus a $20 copay per visit.
About This Calculator
MediCostCalc uses 2026 CMS official fee schedules — the Medicare Physician Fee Schedule (MPFS), Outpatient Prospective Payment System (OPPS), Ambulatory Surgical Center (ASC) Final Rule, and Inpatient Prospective Payment System (IPPS) — to give you a personalized, line-item cost estimate. No sign-up required. All data is from official CMS sources.
How Much Does an Epidural Injection Cost with Medicare?
Medicare Part B covers lumbar epidural steroid injections (CPT 62323) for chronic back pain and radiculopathy when conservative treatments have been tried first. The national average Medicare-approved physician fee is $151; your 20% share is approximately $30. The facility fee is billed separately and depends on where the injection is performed.
Epidural Cost: ASC vs. Hospital Outpatient
Epidural steroid injections are almost always performed as outpatient procedures — either in an ambulatory surgery center or a hospital pain management clinic. Setting matters significantly for your bill:
| Setting | Facility Fee | Your 20% |
|---|---|---|
| Ambulatory Surgery Center (ASC) | $401 | $80 |
| Hospital Outpatient Dept (HOPD) | $621 | $124 |
Total estimated out-of-pocket at an ASC (facility + physician): approximately $110. At a hospital outpatient department: approximately $154. Choosing an ASC saves about $44 per injection — significant if you receive multiple injections per year. With Medigap Plan G, you pay only the $283 annual Part B deductible, then $0 for subsequent injections that year.
How Many Epidural Injections Does Medicare Cover Per Year?
Medicare does not set a hard annual limit on epidural steroid injections, but coverage requires medical necessity documentation for each injection. In practice, most pain management physicians follow clinical guidelines of 3–4 injections per year per spinal region. If Medicare denies an injection as not medically necessary, you have the right to appeal.
Fluoroscopy guidance (CPT 77003) is almost always used during the injection to confirm needle placement — this is billed as a separate add-on code and adds approximately $20–$40 to your cost share. It is appropriate and should appear on your Medicare Summary Notice (MSN).