CPT code 64615: Migraine chemodenervation, bilateral head and neck2026 Medicare rate & RVUs

Medicare pays $156.98 for 64615 nationally in the office and $109.22 in a hospital or facility. Local office rates run $136.20–$192.97.

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

What 64615 covers

This service covers medication injections into muscles on both sides of the head and neck, commonly using onabotulinumtoxinA for chronic migraine. A neurologist or headache specialist may inject muscles such as the frontalis, temporalis, occipital, cervical paraspinal, and trapezius muscles in an office or outpatient facility. The service represents the overall bilateral treatment, rather than a separate charge for each injection site.

Select the code for bilateral chemodenervation of the covered head and neck muscles, and document the indication, treated sites, laterality, and dose. Report the bilateral code once for the session; modifier 50 does not increase its payment. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Related postoperative visits during the 10-day global period are included. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted. The toxin may be reported separately under its applicable drug code when supplied by the practice.

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 64615 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

64615 rates by state

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

How the 64615 rate is calculated

Each of 64615’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.

Payment rules and modifiers for 64615

64615 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

64615 compared with similar codes

How to choose

64612Facial chemodenervationFacial nerve muscles, unilateral

Use 64615 for the bilateral head and neck muscle treatment associated with chronic migraine. Code 64612 addresses facial-muscle chemodenervation for a different indication and is not the migraine service.

64616Neck chemodenervationNeck muscles, excluding larynx

Code 64616 is for neck-muscle chemodenervation, typically for cervical dystonia. Code 64615 represents the bilateral head and neck treatment for migraine.

64642ChemodenervationOne extremity, 1–4 muscles

Code 64642 applies to chemodenervation of a limited number of muscles in one extremity; 64615 is for bilateral head and neck treatment.

Codes related to 64615

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

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

Open CMS sourceHow we calculate rates