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CPT code 64612: Facial chemodenervation, facial nerve muscles, unilateral2026 Medicare rate & RVUs in Nevada

Report 64612 for botulinum toxin treatment of facial nerve–innervated muscles, such as in blepharospasm or hemifacial spasm, on one side.

CMS RVU26DEffective Oct 1, 2026One payment locality79.5K Medicare services in 2024

In Nevada, Medicare pays $140.09 for 64612 in the office and $106.65 when it’s performed in a hospital or facility.

$140.09Office (non-facility)
$106.65Hospital or facility
−1.1%vs the national office rate ($141.62)

Check a contract rate as a % of Medicare · 64612 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 64612 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 64612 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 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.

How Nevada compares for 64612

Across 109 of 109 payment localities, the office rate for 64612 runs from $124.77 in Arkansas to $180.25 in San Benito County, CA. Nevada pays $140.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

64612 in Nevada vs other payment areas
  1. Nevada · this page$140.09
  2. Los Angeles, CA · California$156.01+$15.92
  3. Washington, DC area · District of Columbia$160.52+$20.43
  4. Miami, FL · Florida$159.96+$19.87
  5. Chicago, IL · Illinois$154.91+$14.82
  6. Manhattan, NY · New York$164.18+$24.09
  7. Alaska · Alaska$165.75+$25.66

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

Every other payment area

64612 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$126.64$97.42
ArkansasArkansas$124.77$96.08
ArizonaArizona$137.55$105.19
Bakersfield, CACalifornia$146.97$110.37
Chico, CACalifornia$146.18$109.57
El Centro, CACalifornia$146.22$109.62
Fresno, CACalifornia$146.18$109.57
Hanford, CACalifornia$146.18$109.57

64612 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.

$124.77

$165.75

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

View every state and territory as a table
64612 office rate range by state
State / territoryOffice rate rangeLocalities
AK$165.751
AL$126.641
AR$124.771
AZ$137.551
CA$146.18–$180.2529
CO$145.561
CT$151.201
DC$160.521
DE$139.841
FL$142.70–$159.963
GA$134.17–$145.082
GU$149.351
HI$149.351
IA$128.451
ID$129.621
IL$139.58–$154.914
IN$130.351
KS$128.541
KY$131.231
LA$131.30–$137.852
MA$144.95–$159.152
MD$142.32–$160.523
ME$131.06–$137.272
MI$135.37–$145.252
MN$137.301
MO$129.48–$137.503
MS$127.111
MT$141.601
NC$132.351
ND$135.871
NE$128.961
NH$143.941
NJ$152.32–$158.952
NM$136.411
NV$140.091
NY$134.43–$169.145
OH$134.201
OK$130.241
OR$138.40–$149.442
PA$134.02–$147.852
PR$142.421
RI$144.291
SC$133.621
SD$135.191
TN$129.291
TX$133.18–$145.618
UT$135.461
VA$137.31–$160.522
VI$142.421
VT$135.971
WA$144.47–$161.702
WI$131.301
WV$134.511
WY$139.101

See 64612 in every payment locality

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

Office or facility?

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.

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,169

Code
64612
Physician work
1.37
Practice expense
2.58
Malpractice
0.29

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 64612 in Nevada
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0001.3700
Practice expense2.58× 1.0012.5826
Malpractice0.29× 0.8330.2416
Total RVUs4.1941
Conversion factor× 33.4009

Office rate, Nevada$140.09

Office: (1.37 × 1 + 2.58 × 1.001 + 0.29 × 0.833) × $33.4009 = $140.09

Facility: (1.37 × 1 + 1.58 × 1.001 + 0.29 × 0.833) × $33.4009 = $106.65

Open 64612 in the RVU calculator

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

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
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 · 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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).

When to use modifier 50

Codes related to 64612

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

Codes related to 64612
CodeHow it relatesOffice range, Nevada
Same family
64615Migraine chemodenervation, bilateral head and neckChemodenervation code for chronic migraine involving specified head and neck muscle groups.$153.60
64616Neck chemodenervation, neck muscles, excluding larynxChemodenervation for neck muscles, including treatment such as cervical dystonia.$140.91
64642Chemodenervation, one extremity, 1–4 musclesChemodenervation code for one extremity with one to four muscles treated.$161.25
64611Salivary gland injection, bilateral parotid and submandibular glandsRelated chemodenervation service directed to salivary glands rather than facial muscles.$136.53
Often billed with
J0585OnabotulinumtoxinA, per 1 unitDrug code for onabotulinumtoxinA when that product is supplied and separately reportable.No office rate

How 64612 has changed in Nevada

64612 · Office / nonfacility

$140.09

Effective 2026-10-01

The base rate is $7.32 higher than on 2025-10-01, moving from $132.77 to $140.09 (5.5%).

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

    $132.77changed to$140.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.41 changed to 1.37
    • Practice expense RVU 2.45 changed to 2.58
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $136.92changed to$132.77

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $134.68changed to$136.92

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $139.56changed to$134.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.39 changed to 2.45
    • Malpractice RVU 0.29 changed to 0.30
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $143.11changed to$139.56

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.34 changed to 2.39
    • Malpractice RVU 0.28 changed to 0.29
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $142.08changed to$143.11

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.29 changed to 2.34
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $139.33changed to$142.08

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.14 changed to 2.29
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $138.45changed to$139.33

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.12 changed to 2.14
    • Malpractice RVU 0.30 changed to 0.27
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $137.60changed to$138.45

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.11 changed to 2.12
    • Malpractice RVU 0.29 changed to 0.30

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $135.98changed to$137.60

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.03 changed to 2.11
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $138.78changed to$135.98

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.05 changed to 2.03
    • Malpractice RVU 0.31 changed to 0.29
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $138.17changed to$138.78

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.03 changed to 2.05
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $137.48changed to$138.17

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $145.48changed to$137.48

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.05 changed to 2.03
    • Malpractice RVU 0.44 changed to 0.30
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $147.89changed to$145.48

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.24 changed to 2.05
    • Malpractice RVU 0.46 changed to 0.44
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$147.89

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$140.09$106.65RVU26D
2026-07-01$140.09$106.65RVU26C
2026-04-01$140.09$106.65RVU26B
2026-01-01$140.09$106.65RVU26A
2025-10-01$132.77$114.98RVU25D
2025-07-01$132.77$114.98RVU25C
2025-04-01$132.77$114.98RVU25B
2025-01-01$132.77$114.98RVU25A
2024-10-01$136.92$118.28RVU24D
2024-07-01$136.92$118.28RVU24C
2024-04-01$136.92$118.28RVU24B
2024-03-09$136.92$118.28RVU24AR
2024-01-01$134.68$116.35RVU24A
2023-10-01$139.56$120.92RVU23D
2023-07-01$139.56$120.92RVU23C
2023-04-01$139.56$120.92RVU23B
2023-01-01$139.56$120.92RVU23A
2022-10-01$143.11$124.07RVU22D
2022-07-01$143.11$124.07RVU22C
2022-04-01$143.11$124.07RVU22B
2022-01-01$143.11$124.07RVU22A
2021-10-01$142.08$123.59RVU21D
2021-07-01$142.08$123.59RVU21C
2021-04-01$142.08$123.59RVU21B
2021-01-01$142.08$123.59RVU21A
2020-10-01$139.33$122.37RVU20D
2020-07-01$139.33$122.37RVU20C
2020-04-01$139.33$122.37RVU20B
2020-01-01$139.33$122.37RVU20A
2019-10-01$138.45$122.32RVU19D
2019-07-01$138.45$122.32RVU19C
2019-04-01$138.45$122.32RVU19B
2019-01-01$138.45$122.32RVU19A
2018-10-01$137.60$121.49RVU18D
2018-07-01$137.60$121.49RVU18C
2018-04-01$137.60$121.49RVU18B
2018-01-01$137.60$121.49RVU18AR1
2017-10-01$135.98$121.88RVU17D
2017-07-01$135.98$121.88RVU17C
2017-04-01$135.98$121.88RVU17B
2017-01-01$135.98$121.88RVU17A
2016-10-01$138.78$123.73RVU16D
2016-07-01$138.78$123.73RVU16C
2016-04-01$138.78$123.73RVU16B
2016-01-01$138.78$123.73RVU16A
2015-10-01$138.17$123.82RVU15D
2015-07-01$138.17$123.82RVU15C
2015-04-01$137.48$123.20RVU15B
2015-01-01$137.48$123.20RVU15A
2014-10-01$145.48$130.75RVU14D
2014-07-01$145.48$130.75RVU14C
2014-04-01$145.48$130.75RVU14B
2014-01-01$145.48$130.75RVU14A
2013-10-01$147.89$132.05RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 64612 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

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
RVUs for 64612PPRRVU2026_Oct_nonQPP.csv, line 7,169 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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