CPT code 64612: Facial chemodenervation, facial nerve muscles, unilateral2026 Medicare rate & RVUs in California
Report 64612 for botulinum toxin treatment of facial nerve–innervated muscles, such as in blepharospasm or hemifacial spasm, on one side.
Medicare pays $146.18–$180.25 for 64612 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 64612 covers
This service uses targeted injections to reduce activity in facial muscles supplied by the facial nerve. Typical indications include blepharospasm and hemifacial spasm. Neurologists and ophthalmologists commonly perform it; other physicians with relevant expertise may provide treatment in office or facility settings. The injected muscles may include muscles around the eye or elsewhere in the face, depending on the documented disorder and treatment plan.
Select 64612 for unilateral treatment of facial nerve–innervated muscles, not by counting injection sites. For treatment on both sides, report modifier 50; CMS pays the bilateral procedure at 150%. Document the treated side, muscles, indication, and procedure performed. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment is statutorily restricted, and 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.
Where 64612 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$146.18 to $180.25
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $146.97 | $110.37 |
| Chico, CA | $146.18 | $109.57 |
| El Centro, CA | $146.22 | $109.62 |
| Fresno, CA | $146.18 | $109.57 |
| Hanford, CA | $146.18 | $109.57 |
| Los Angeles, CA | $156.01 | $116.50 |
| Madera, CA | $146.18 | $109.57 |
| Marin County, CA | $176.06 | $128.96 |
| Merced, CA | $146.18 | $109.57 |
| Modesto, CA | $146.18 | $109.57 |
| Napa, CA | $167.14 | $123.12 |
| Oxnard, CA | $154.93 | $115.45 |
| Redding, CA | $146.18 | $109.57 |
| Rest of California | $146.18 | $109.57 |
| Riverside, CA | $149.29 | $112.68 |
| Sacramento, CA | $152.82 | $113.97 |
| Salinas, CA | $152.25 | $113.53 |
| San Benito County, CA | $180.25 | $132.08 |
| San Diego, CA | $155.45 | $115.50 |
| San Francisco, CA | $175.73 | $128.63 |
| San Luis Obispo, CA | $149.88 | $111.84 |
| Santa Clara County, CA | $178.90 | $130.74 |
| Santa Cruz, CA | $156.61 | $116.03 |
| Santa Maria, CA | $152.71 | $113.77 |
| Santa Rosa, CA | $158.15 | $117.13 |
| Stockton, CA | $146.18 | $109.57 |
| Vallejo, CA | $166.67 | $122.64 |
| Visalia, CA | $146.18 | $109.57 |
| Yuba City, CA | $146.18 | $109.57 |
How the 64612 rate is calculated
Each of 64612’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 · 64612
RVUs × geographic indexes × conversion factor
Work1.37
1.37 RVUs× 1.000 GPCI
Practice expense2.58
2.58 RVUs× 1.000 GPCI
Malpractice0.29
0.29 RVUs× 1.000 GPCI
Adjusted RVUs
4.2400
Conversion factor
$33.4009
Medicare rate
$141.62
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64612
64612 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64612
Facial chemodenervation, facial nerve muscles, unilateral
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 64612
Facial chemodenervation, facial nerve muscles, unilateral
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.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
64612 without 50 · national office
$141.62
Facial chemodenervation, facial nerve muscles, unilateral
64612-50 · Bilateral: 150%
$212.43
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
64612 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64615Migraine chemodenervationBilateral head and neck
- 64612 treats facial nerve–innervated muscles, commonly for blepharospasm or hemifacial spasm. 64615 is for chronic migraine treatment involving specified head and neck muscle groups.
- 64616Neck chemodenervationNeck muscles, excluding larynx
- Use 64616 for chemodenervation of neck muscles, such as in cervical dystonia; use 64612 for facial nerve–innervated muscles.
- 64642ChemodenervationOne extremity, 1–4 muscles
- 64642 applies to treatment of one extremity with one to four muscles. 64612 applies to unilateral facial nerve muscle treatment.
64612 billing questions
When should 64612 be used instead of 64615?
Use 64612 for treatment of facial nerve–innervated muscles, such as for blepharospasm or hemifacial spasm. Code 64615 describes chemodenervation for chronic migraine involving specified head and neck muscle groups.
Is 64612 reported per muscle or injection site?
No. Select the code for the unilateral facial nerve muscle treatment, rather than billing a unit for each muscle or injection site.
How is treatment on both sides reported?
Report modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.
Are postoperative visits separately payable?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can the botulinum toxin product be reported separately?
When a separately reportable toxin product is supplied, report the applicable drug code as supported by the product and documentation. For example, J0585 describes onabotulinumtoxinA.
How does CMS apply multiple-procedure payment?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%.
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
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