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

Reports bilateral medication injections into head and neck muscles for chronic migraine treatment, commonly performed by a neurologist or headache specialist.

CMS RVU26DEffective Oct 1, 2026One payment locality191.4K Medicare services in 2024

In Iowa, Medicare pays $138.02 for 64615 in the office and $94.32 when it’s performed in a hospital or facility.

$138.02Office (non-facility)
$94.32Hospital or facility
−12.1%vs the national office rate ($156.98)

Check a contract rate as a % of Medicare · 64615 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 64615 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 64615 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 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.

How Iowa compares for 64615

Across 109 of 109 payment localities, the office rate for 64615 runs from $136.20 in Arkansas to $192.97 in NYC suburbs and Long Island, NY. Iowa pays $138.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

64615 in Iowa vs other payment areas
  1. Iowa · this page$138.02
  2. Los Angeles, CA · California$166.43+$28.41
  3. Washington, DC area · District of Columbia$176.13+$38.11
  4. Miami, FL · Florida$191.77+$53.75
  5. Chicago, IL · Illinois$184.60+$46.58
  6. Manhattan, NY · New York$185.30+$47.28
  7. Alaska · Alaska$182.70+$44.68

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

Every other payment area

64615 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$138.48$96.68
ArkansasArkansas$136.20$95.17
ArizonaArizona$151.64$105.36
Bakersfield, CACalifornia$157.34$104.99
Chico, CACalifornia$155.71$103.36
El Centro, CACalifornia$155.81$103.46
Fresno, CACalifornia$155.71$103.36
Hanford, CACalifornia$155.71$103.36

64615 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.

$136.20

$182.70

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

View every state and territory as a table
64615 office rate range by state
State / territoryOffice rate rangeLocalities
AK$182.701
AL$138.481
AR$136.201
AZ$151.641
CA$155.71–$187.6529
CO$158.041
CT$168.401
DC$176.131
DE$154.281
FL$164.05–$191.773
GA$152.74–$162.552
GU$158.701
HI$158.701
IA$138.021
ID$139.981
IL$162.02–$184.604
IN$140.781
KS$139.401
KY$146.771
LA$147.36–$155.312
MA$157.78–$171.952
MD$156.80–$176.133
ME$143.06–$148.662
MI$153.03–$168.522
MN$144.611
MO$145.94–$153.373
MS$140.991
MT$156.941
NC$144.411
ND$144.681
NE$138.241
NH$157.521
NJ$168.40–$174.362
NM$154.831
NV$153.601
NY$147.03–$192.975
OH$150.521
OK$144.221
OR$150.53–$161.102
PA$149.60–$165.192
PR$157.511
RI$158.401
SC$148.091
SD$143.231
TN$140.471
TX$148.66–$164.728
UT$150.301
VA$149.60–$176.132
VI$157.511
VT$145.991
WA$156.85–$173.492
WI$139.461
WV$155.931
WY$151.601

See 64615 in every payment locality

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.

How the rate is built · 64615

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.80

1.80 RVUs× 1.000 GPCI

Practice expense2.28

2.28 RVUs× 1.000 GPCI

Malpractice0.62

0.62 RVUs× 1.000 GPCI

Adjusted RVUs

4.7000

Conversion factor

$33.4009

Medicare rate

$156.98

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,170

Code
64615
Physician work
1.80
Practice expense
2.28
Malpractice
0.62

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 64615 in Iowa
ComponentRVULocality factorAdjusted
Physician work1.80× 1.0001.8000
Practice expense2.28× 0.9152.0862
Malpractice0.62× 0.3970.2461
Total RVUs4.1323
Conversion factor× 33.4009

Office rate, Iowa$138.02

Office: (1.8 × 1 + 2.28 × 0.915 + 0.62 × 0.397) × $33.4009 = $138.02

Facility: (1.8 × 1 + 0.85 × 0.915 + 0.62 × 0.397) × $33.4009 = $94.32

Open 64615 in the RVU calculator

Payment rules and modifiers for 64615

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

CMS payment indicators · 64615

Migraine chemodenervation, bilateral head and neck

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)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 · 64615

Migraine chemodenervation, bilateral head and neck

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

64615 without 51 · national office

$156.98

Migraine chemodenervation, bilateral head and neck

64615-51 · Second procedure: 50%

$78.49

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 64615

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

Codes related to 64615
CodeHow it relatesOffice range, Iowa
Often billed with
J0585OnabotulinumtoxinA, per 1 unitOnabotulinumtoxinA drug code commonly reported when the practice supplies the medication.No office rate
Used instead
64612Facial chemodenervation, facial nerve muscles, unilateralFor facial-muscle chemodenervation in a different clinical situation, rather than bilateral migraine treatment.$128.45
64616Neck chemodenervation, neck muscles, excluding larynxFor neck-muscle chemodenervation for cervical dystonia, rather than the bilateral migraine service.$127.00
64642Chemodenervation, one extremity, 1–4 musclesFor chemodenervation of a limited number of muscles in one extremity.$147.27

How 64615 has changed in Iowa

64615 · Office / nonfacility

$138.02

Effective 2026-10-01

The base rate is $6.26 higher than on 2025-10-01, moving from $131.76 to $138.02 (4.8%).

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

    $131.76changed to$138.02

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.85 changed to 1.80
    • Practice expense RVU 2.12 changed to 2.28
    • Malpractice RVU 0.63 changed to 0.62
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $136.81changed to$131.76

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.16 changed to 2.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $134.58changed to$136.81

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $138.09changed to$134.58

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.13 changed to 2.16
    • Malpractice RVU 0.65 changed to 0.63
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $140.02changed to$138.09

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.14 changed to 2.13
    • Malpractice RVU 0.60 changed to 0.65
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $139.13changed to$140.02

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.08 changed to 2.14
    • Malpractice RVU 0.59 changed to 0.60

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $137.51changed to$139.13

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.89 changed to 2.08
    • Malpractice RVU 0.58 changed to 0.59
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $135.14changed to$137.51

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.81 changed to 1.89
    • Malpractice RVU 0.61 changed to 0.58
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $132.85changed to$135.14

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.74 changed to 1.81
    • Malpractice RVU 0.62 changed to 0.61

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $130.97changed to$132.85

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.67 changed to 1.74
    • Malpractice RVU 0.64 changed to 0.62
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $130.76changed to$130.97

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.62 changed to 0.64
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $132.61changed to$130.76

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.68 changed to 1.67
    • Malpractice RVU 0.68 changed to 0.62

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $131.95changed to$132.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $128.70changed to$131.95

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.65 changed to 1.68
    • Malpractice RVU 0.57 changed to 0.68
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $125.97changed to$128.70

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.78 changed to 1.65
    • Malpractice RVU 0.60 changed to 0.57
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $125.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$138.02$94.32RVU26D
2026-07-01$138.02$94.32RVU26C
2026-04-01$138.02$94.32RVU26B
2026-01-01$138.02$94.32RVU26A
2025-10-01$131.76$105.48RVU25D
2025-07-01$131.76$105.48RVU25C
2025-04-01$131.76$105.48RVU25B
2025-01-01$131.76$105.48RVU25A
2024-10-01$136.81$108.24RVU24D
2024-07-01$136.81$108.24RVU24C
2024-04-01$136.81$108.24RVU24B
2024-03-09$136.81$108.24RVU24AR
2024-01-01$134.58$106.48RVU24A
2023-10-01$138.09$108.79RVU23D
2023-07-01$138.09$108.79RVU23C
2023-04-01$138.09$108.79RVU23B
2023-01-01$138.09$108.79RVU23A
2022-10-01$140.02$110.20RVU22D
2022-07-01$140.02$110.20RVU22C
2022-04-01$140.02$110.20RVU22B
2022-01-01$140.02$110.20RVU22A
2021-10-01$139.13$110.65RVU21D
2021-07-01$139.13$110.65RVU21C
2021-04-01$139.13$110.65RVU21B
2021-01-01$139.13$110.65RVU21A
2020-10-01$137.51$112.30RVU20D
2020-07-01$137.51$112.30RVU20C
2020-04-01$137.51$112.30RVU20B
2020-01-01$137.51$112.30RVU20A
2019-10-01$135.14$112.58RVU19D
2019-07-01$135.14$112.58RVU19C
2019-04-01$135.14$112.58RVU19B
2019-01-01$135.14$112.58RVU19A
2018-10-01$132.85$112.94RVU18D
2018-07-01$132.85$112.94RVU18C
2018-04-01$132.85$112.94RVU18B
2018-01-01$132.85$112.94RVU18AR1
2017-10-01$130.97$113.49RVU17D
2017-07-01$130.97$113.49RVU17C
2017-04-01$130.97$113.49RVU17B
2017-01-01$130.97$113.49RVU17A
2016-10-01$130.76$113.43RVU16D
2016-07-01$130.76$113.43RVU16C
2016-04-01$130.76$113.43RVU16B
2016-01-01$130.76$113.43RVU16A
2015-10-01$132.61$114.58RVU15D
2015-07-01$132.61$114.58RVU15C
2015-04-01$131.95$114.01RVU15B
2015-01-01$131.95$114.01RVU15A
2014-10-01$128.70$114.32RVU14D
2014-07-01$128.70$114.32RVU14C
2014-04-01$128.70$114.32RVU14B
2014-01-01$128.70$114.32RVU14A
2013-10-01$125.97$113.29RVU13D
2013-07-01$125.97$113.29RVU13C
2013-04-01$125.97$113.29RVU13B
2013-01-01$125.97$113.29RVU13AR

Price 64615 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

64615 billing questions

Should modifier 50 be appended?

No. The code is already priced as bilateral, and modifier 50 does not increase payment.

Is the service reported per injection site or muscle?

Report the bilateral service once for the session, not once for each injection or treated muscle. Document the sites and dose.

Can the botulinum toxin drug be billed separately?

The practice may report the applicable drug code separately when it supplies the toxin. Keep documentation of the product and dose administered.

How does the 10-day global period affect follow-up visits?

Related postoperative visits during the 10 days after the procedure are included in the service.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full; other procedures in that session are subject to the standard 50% multiple-procedure reduction.

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 64615PPRRVU2026_Oct_nonQPP.csv, line 7,170 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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