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

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 Kentucky, Medicare pays $127.27 for 64611 in the office and $100.25 when it’s performed in a hospital or facility.

$127.27Office (non-facility)
$100.25Hospital or facility
−8.2%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 Kentucky
  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 Kentucky 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. Kentucky pays $127.27. The RVUs are the same everywhere; the geographic indexes change the dollars.

64611 in Kentucky vs other payment areas
  1. Kentucky · this page$127.27
  2. Los Angeles, CA · California$152.48+$25.21
  3. Washington, DC area · District of Columbia$158.30+$31.03
  4. Miami, FL · Florida$162.31+$35.04
  5. Chicago, IL · Illinois$156.18+$28.91
  6. Manhattan, NY · New York$163.32+$36.05
  7. Alaska · Alaska$155.46+$28.19

Other areas in Kentucky first, then benchmark localities. Bars start at $0.

Every other payment area

64611 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$121.44$94.84
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

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 Kentucky 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

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for 64611 in Kentucky
ComponentRVULocality factorAdjusted
Physician work1.00× 1.0001.0000
Practice expense2.76× 0.8892.4536
Malpractice0.39× 0.9150.3569
Total RVUs3.8105
Conversion factor× 33.4009

Office rate, Kentucky$127.27

Office: (1 × 1 + 2.76 × 0.889 + 0.39 × 0.915) × $33.4009 = $127.27

Facility: (1 × 1 + 1.85 × 0.889 + 0.39 × 0.915) × $33.4009 = $100.25

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, Kentucky
Same family
64612Facial chemodenervation, facial nerve muscles, unilateralChemodenervation targets facial muscles rather than salivary glands.$131.23
64615Migraine chemodenervation, bilateral head and neckChemodenervation code for chronic migraine treatment.$146.77
64616Neck chemodenervation, neck muscles, excluding larynxChemodenervation code for neck muscles, commonly used for cervical dystonia.$133.64
64617Laryngeal chemodenervation, unilateral, EMG guidance when performedChemodenervation code for laryngeal muscles, with electromyographic guidance.$148.43

How 64611 has changed in Kentucky

64611 · Office / nonfacility

$127.27

Effective 2026-10-01

The base rate is $9.25 higher than on 2025-10-01, moving from $118.02 to $127.27 (7.8%).

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

    $118.02changed to$127.27

    • 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
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $121.76changed to$118.02

    • 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

    $119.77changed to$121.76

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $119.47changed to$119.77

    • 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
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913

  5. January 1, 2023

    RVU23A

    $119.61changed to$119.47

    • 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
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $116.98changed to$119.61

    • 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

    $113.49changed to$116.98

    • 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
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $112.99changed to$113.49

    • 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
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $112.89changed to$112.99

    • 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

    $109.54changed to$112.89

    • 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
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $108.24changed to$109.54

    • 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
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $108.60changed to$108.24

    • 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

    $108.06changed to$108.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $103.39changed to$108.06

    • 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
    • Malpractice GPCI 0.774 changed to 0.795

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $103.21changed to$103.39

    • 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
    • Practice expense GPCI 0.871 changed to 0.872
    • Malpractice GPCI 0.752 changed to 0.774

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $103.21

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$127.27$100.25RVU26D
2026-07-01$127.27$100.25RVU26C
2026-04-01$127.27$100.25RVU26B
2026-01-01$127.27$100.25RVU26A
2025-10-01$118.02$101.85RVU25D
2025-07-01$118.02$101.85RVU25C
2025-04-01$118.02$101.85RVU25B
2025-01-01$118.02$101.85RVU25A
2024-10-01$121.76$104.83RVU24D
2024-07-01$121.76$104.83RVU24C
2024-04-01$121.76$104.83RVU24B
2024-03-09$121.76$104.83RVU24AR
2024-01-01$119.77$103.12RVU24A
2023-10-01$119.47$102.91RVU23D
2023-07-01$119.47$102.91RVU23C
2023-04-01$119.47$102.91RVU23B
2023-01-01$119.47$102.91RVU23A
2022-10-01$119.61$103.07RVU22D
2022-07-01$119.61$103.07RVU22C
2022-04-01$119.61$103.07RVU22B
2022-01-01$119.61$103.07RVU22A
2021-10-01$116.98$100.91RVU21D
2021-07-01$116.98$100.91RVU21C
2021-04-01$116.98$100.91RVU21B
2021-01-01$116.98$100.91RVU21A
2020-10-01$113.49$99.30RVU20D
2020-07-01$113.49$99.30RVU20C
2020-04-01$113.49$99.30RVU20B
2020-01-01$113.49$99.30RVU20A
2019-10-01$112.99$99.67RVU19D
2019-07-01$112.99$99.67RVU19C
2019-04-01$112.99$99.67RVU19B
2019-01-01$112.99$99.67RVU19A
2018-10-01$112.89$97.68RVU18D
2018-07-01$112.89$97.68RVU18C
2018-04-01$112.89$97.68RVU18B
2018-01-01$112.89$97.68RVU18AR1
2017-10-01$109.54$96.97RVU17D
2017-07-01$109.54$96.97RVU17C
2017-04-01$109.54$96.97RVU17B
2017-01-01$109.54$96.97RVU17A
2016-10-01$108.24$95.44RVU16D
2016-07-01$108.24$95.44RVU16C
2016-04-01$108.24$95.44RVU16B
2016-01-01$108.24$95.44RVU16A
2015-10-01$108.60$95.75RVU15D
2015-07-01$108.60$95.75RVU15C
2015-04-01$108.06$95.28RVU15B
2015-01-01$108.06$95.28RVU15A
2014-10-01$103.39$91.20RVU14D
2014-07-01$103.39$91.20RVU14C
2014-04-01$103.39$91.20RVU14B
2014-01-01$103.39$91.20RVU14A
2013-10-01$103.21$90.17RVU13D
2013-07-01$103.21$90.17RVU13C
2013-04-01$103.21$90.17RVU13B
2013-01-01$103.21$90.17RVU13AR

Price 64611 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

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 KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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