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CPT code 64611: Salivary gland injection, bilateral parotid and submandibular glands2026 Medicare rate & RVUs in Washington, DC area

Reports bilateral botulinum toxin treatment of the parotid and submandibular glands for excessive saliva, including chronic drooling related to neurologic disease.

CMS RVU26DEffective Oct 1, 2026One payment locality14.2K Medicare services in 2024

In Washington, DC area, Medicare pays $158.30 for 64611 in the office and $122.49 when it’s performed in a hospital or facility.

$158.30Office (non-facility)
$122.49Hospital or facility
+14.2%vs the national office rate ($138.61)

Check a contract rate as a % of Medicare · 64611 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 64611 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 64611 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 64611 covers

This service uses injected medication to reduce saliva production by treating the parotid and submandibular glands on both sides. It is commonly performed for persistent drooling, including in patients with neurologic conditions such as cerebral palsy, Parkinson disease, or stroke. Neurologists, otolaryngologists, and other clinicians who manage sialorrhea may provide the injections in office or facility settings.

Report the code for the bilateral gland treatment, not for injections into facial or other muscles. Document the indication, glands treated, laterality, medication and dose, and the procedure performed. The code is priced as bilateral; modifier 50 does not increase payment. Related postoperative visits are included in its 10-day global period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 64611

Across 109 of 109 payment localities, the office rate for 64611 runs from $119.30 in Arkansas to $176.99 in San Benito County, CA. Washington, DC area pays $158.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

64611 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$158.30
  2. Los Angeles, CA · California$152.48−$5.82
  3. Miami, FL · Florida$162.31+$4.01
  4. Chicago, IL · Illinois$156.18−$2.12
  5. Manhattan, NY · New York$163.32+$5.02
  6. Alaska · Alaska$155.46−$2.84
  7. Alabama · Alabama$121.44−$36.86

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

64611 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$119.30$93.19
ArizonaArizona$133.88$104.43
Bakersfield, CACalifornia$143.00$109.69
Chico, CACalifornia$141.99$108.67
El Centro, CACalifornia$142.05$108.74
Fresno, CACalifornia$141.99$108.67
Hanford, CACalifornia$141.99$108.67
Madera, CACalifornia$141.99$108.67

64611 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$119.30

$159.49

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
64611 office rate range by state
State / territoryOffice rate rangeLocalities
AK$155.461
AL$121.441
AR$119.301
AZ$133.881
CA$141.99–$176.9929
CO$142.061
CT$149.121
DC$158.301
DE$136.361
FL$141.11–$162.313
GA$131.16–$142.812
GU$145.761
HI$145.761
IA$122.921
ID$124.371
IL$137.93–$156.184
IN$125.191
KS$123.301
KY$127.271
LA$127.47–$134.952
MA$141.39–$156.432
MD$138.99–$158.303
ME$126.31–$132.982
MI$132.27–$144.322
MN$132.121
MO$125.55–$134.213
MS$122.401
MT$138.591
NC$127.731
ND$130.881
NE$123.411
NH$140.771
NJ$149.69–$156.352
NM$133.581
NV$136.531
NY$130.14–$169.345
OH$130.701
OK$125.841
OR$134.38–$146.052
PA$130.34–$145.512
PR$139.431
RI$140.881
SC$129.651
SD$129.961
TN$124.191
TX$129.39–$143.138
UT$131.751
VA$133.22–$158.302
VI$139.431
VT$131.261
WA$140.82–$158.832
WI$125.731
WV$132.151
WY$135.231

See 64611 in every payment locality

How the 64611 rate is calculated

Each of 64611’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 64611

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.00

1.00 RVUs× 1.000 GPCI

Practice expense2.76

2.76 RVUs× 1.000 GPCI

Malpractice0.39

0.39 RVUs× 1.000 GPCI

Adjusted RVUs

4.1500

Conversion factor

$33.4009

Medicare rate

$138.61

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,168

Code
64611
Physician work
1.00
Practice expense
2.76
Malpractice
0.39

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 64611 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.00× 1.0541.0540
Practice expense2.76× 1.1783.2513
Malpractice0.39× 1.1130.4341
Total RVUs4.7393
Conversion factor× 33.4009

Office rate, Washington, DC area$158.30

Office: (1 × 1.054 + 2.76 × 1.178 + 0.39 × 1.113) × $33.4009 = $158.30

Facility: (1 × 1.054 + 1.85 × 1.178 + 0.39 × 1.113) × $33.4009 = $122.49

Open 64611 in the RVU calculator

Payment rules and modifiers for 64611

64611 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64611

Salivary gland injection, bilateral parotid and submandibular glands

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 64611

Salivary gland injection, bilateral parotid and submandibular glands

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

64611 without 51 · national office

$138.61

Salivary gland injection, bilateral parotid and submandibular glands

64611-51 · Second procedure: 50%

$69.31

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 64611

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 64611
CodeHow it relatesOffice range, Washington, DC area
Same family
64612Facial chemodenervation, facial nerve muscles, unilateralChemodenervation targets facial muscles rather than salivary glands.$160.52
64615Migraine chemodenervation, bilateral head and neckChemodenervation code for chronic migraine treatment.$176.13
64616Neck chemodenervation, neck muscles, excluding larynxChemodenervation code for neck muscles, commonly used for cervical dystonia.$161.93
64617Laryngeal chemodenervation, unilateral, EMG guidance when performedChemodenervation code for laryngeal muscles, with electromyographic guidance.$179.06

How 64611 has changed in Washington, DC area

64611 · Office / nonfacility

$158.30

Effective 2026-10-01

The base rate is $8.87 higher than on 2025-10-01, moving from $149.43 to $158.30 (5.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $149.43changed to$158.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.03 changed to 1.00
    • Practice expense RVU 2.58 changed to 2.76
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $154.16changed to$149.43

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $151.65changed to$154.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $154.74changed to$151.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.48 changed to 2.58
    • Malpractice RVU 0.38 changed to 0.40
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $158.50changed to$154.74

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.44 changed to 2.48
    • Malpractice RVU 0.37 changed to 0.38
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $154.62changed to$158.50

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.33 changed to 2.44
    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $147.22changed to$154.62

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.09 changed to 2.33
    • Malpractice RVU 0.35 changed to 0.36
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $144.69changed to$147.22

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.02 changed to 2.09
    • Malpractice RVU 0.40 changed to 0.35
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $144.51changed to$144.69

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.03 changed to 2.02
    • Malpractice RVU 0.39 changed to 0.40

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $140.88changed to$144.51

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.94 changed to 2.03
    • Malpractice RVU 0.40 changed to 0.39
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $139.90changed to$140.88

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.93 changed to 1.94
    • Malpractice RVU 0.39 changed to 0.40
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $140.43changed to$139.90

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.92 changed to 1.93
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $139.73changed to$140.43

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $131.78changed to$139.73

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.88 changed to 1.92
    • Malpractice RVU 0.28 changed to 0.40
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $131.47changed to$131.78

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.05 changed to 1.88
    • Malpractice RVU 0.29 changed to 0.28
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $131.47

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$158.30$122.49RVU26D
2026-07-01$158.30$122.49RVU26C
2026-04-01$158.30$122.49RVU26B
2026-01-01$158.30$122.49RVU26A
2025-10-01$149.43$127.45RVU25D
2025-07-01$149.43$127.45RVU25C
2025-04-01$149.43$127.45RVU25B
2025-01-01$149.43$127.45RVU25A
2024-10-01$154.16$131.15RVU24D
2024-07-01$154.16$131.15RVU24C
2024-04-01$154.16$131.15RVU24B
2024-03-09$154.16$131.15RVU24AR
2024-01-01$151.65$129.01RVU24A
2023-10-01$154.74$131.70RVU23D
2023-07-01$154.74$131.70RVU23C
2023-04-01$154.74$131.70RVU23B
2023-01-01$154.74$131.70RVU23A
2022-10-01$158.50$134.98RVU22D
2022-07-01$158.50$134.98RVU22C
2022-04-01$158.50$134.98RVU22B
2022-01-01$158.50$134.98RVU22A
2021-10-01$154.62$131.77RVU21D
2021-07-01$154.62$131.77RVU21C
2021-04-01$154.62$131.77RVU21B
2021-01-01$154.62$131.77RVU21A
2020-10-01$147.22$127.39RVU20D
2020-07-01$147.22$127.39RVU20C
2020-04-01$147.22$127.39RVU20B
2020-01-01$147.22$127.39RVU20A
2019-10-01$144.69$126.45RVU19D
2019-07-01$144.69$126.45RVU19C
2019-04-01$144.69$126.45RVU19B
2019-01-01$144.69$126.45RVU19A
2018-10-01$144.51$123.69RVU18D
2018-07-01$144.51$123.69RVU18C
2018-04-01$144.51$123.69RVU18B
2018-01-01$144.51$123.69RVU18AR1
2017-10-01$140.88$123.58RVU17D
2017-07-01$140.88$123.58RVU17C
2017-04-01$140.88$123.58RVU17B
2017-01-01$140.88$123.58RVU17A
2016-10-01$139.90$122.21RVU16D
2016-07-01$139.90$122.21RVU16C
2016-04-01$139.90$122.21RVU16B
2016-01-01$139.90$122.21RVU16A
2015-10-01$140.43$122.68RVU15D
2015-07-01$140.43$122.68RVU15C
2015-04-01$139.73$122.07RVU15B
2015-01-01$139.73$122.07RVU15A
2014-10-01$131.78$114.99RVU14D
2014-07-01$131.78$114.99RVU14C
2014-04-01$131.78$114.99RVU14B
2014-01-01$131.78$114.99RVU14A
2013-10-01$131.47$113.53RVU13D
2013-07-01$131.47$113.53RVU13C
2013-04-01$131.47$113.53RVU13B
2013-01-01$131.47$113.53RVU13AR

Price 64611 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

64611 billing questions

When should 64611 be chosen over 64612?

Use 64611 for bilateral parotid and submandibular gland chemodenervation to reduce saliva. Code 64612 describes chemodenervation of facial muscles, not salivary glands.

Is modifier 50 needed for the bilateral treatment?

The code is already priced as bilateral, and modifier 50 does not increase payment. Document that the bilateral gland treatment was performed.

How many units should be reported for treatment of both sides?

Report the bilateral service as one code rather than a separate unit for each gland or side. The code's bilateral pricing does not support an increased payment from modifier 50.

Is the medication included in the procedure code?

The code reports the gland chemodenervation procedure. Any separately reportable drug supply depends on how the medication was furnished and applicable drug-billing requirements.

What documentation supports 64611?

Record the clinical reason for treating excessive saliva, the parotid and submandibular glands treated on both sides, and the medication and dose administered.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 64611PPRRVU2026_Oct_nonQPP.csv, line 7,168 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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