CPT code 64616: Neck chemodenervation, neck muscles, excluding larynx2026 Medicare rate & RVUs in South Dakota

Reports medication-induced weakening of neck muscles, commonly for cervical dystonia, when treatment targets neck muscles rather than laryngeal or other muscle groups.

CMS RVU26DEffective Oct 1, 2026One payment locality80.7K Medicare services in 2024

In South Dakota, Medicare pays $132.53 for 64616 in the office and $88.45 when it’s performed in a hospital or facility.

$132.53Office (non-facility)
$88.45Hospital or facility
−7.7%vs the national office rate ($143.62)

Check a contract rate as a % of Medicare · 64616 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 64616 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 64616 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 64616 covers

This service involves injecting a medication such as botulinum toxin into neck muscles to reduce involuntary muscle activity. Neurologists, physiatrists, and other clinicians who treat movement disorders commonly perform it in an office or facility setting. Cervical dystonia, with involuntary neck contractions or abnormal head posture, is a typical indication. The code is for neck muscles and excludes laryngeal muscle treatment.

Select the code based on the treated anatomy and clinical service, not simply the injection location or number of injection sites. Document the indication, muscles treated, medication, and treatment details. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 South Dakota compares for 64616

Across 109 of 109 payment localities, the office rate for 64616 runs from $124.65 in Arkansas to $175.70 in NYC suburbs and Long Island, NY. South Dakota pays $132.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

64616 in South Dakota vs other payment areas
  1. South Dakota · this page$132.53
  2. Los Angeles, CA · California$154.17+$21.64
  3. Washington, DC area · District of Columbia$161.93+$29.40
  4. Miami, FL · Florida$172.32+$39.79
  5. Chicago, IL · Illinois$165.99+$33.46
  6. Manhattan, NY · New York$169.09+$36.56
  7. Alaska · Alaska$166.02+$33.49

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

Every other payment area

64616 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$126.73$88.15
ArkansasArkansas$124.65$86.77
ArizonaArizona$138.83$96.10
Bakersfield, CACalifornia$145.45$97.12
Chico, CACalifornia$144.13$95.81
El Centro, CACalifornia$144.21$95.89
Fresno, CACalifornia$144.13$95.81
Hanford, CACalifornia$144.13$95.81

64616 rates by state

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

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.

$124.65

$166.02

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

View every state and territory as a table
64616 office rate range by state
State / territoryOffice rate rangeLocalities
AK$166.021
AL$126.731
AR$124.651
AZ$138.831
CA$144.13–$175.4529
CO$145.501
CT$154.071
DC$161.931
DE$141.261
FL$148.63–$172.323
GA$138.50–$148.362
GU$147.161
HI$147.161
IA$127.001
ID$128.651
IL$146.31–$165.994
IN$129.411
KS$127.931
KY$133.641
LA$134.05–$141.342
MA$145.12–$158.802
MD$143.68–$161.933
ME$131.14–$136.772
MI$139.07–$152.382
MN$134.101
MO$132.54–$139.953
MS$128.541
MT$143.591
NC$132.431
ND$133.701
NE$127.301
NH$144.701
NJ$154.33–$160.242
NM$140.581
NV$140.911
NY$134.81–$175.705
OH$137.041
OK$131.641
OR$138.36–$148.712
PA$136.38–$150.912
PR$144.221
RI$145.311
SC$135.251
SD$132.531
TN$128.871
TX$135.49–$149.768
UT$137.291
VA$137.40–$161.932
VI$144.221
VT$134.601
WA$144.37–$160.572
WI$128.831
WV$140.711
WY$139.281

See 64616 in every payment locality

How the 64616 rate is calculated

Each of 64616’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 · 64616

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.49

1.49 RVUs× 1.000 GPCI

Practice expense2.31

2.31 RVUs× 1.000 GPCI

Malpractice0.50

0.50 RVUs× 1.000 GPCI

Adjusted RVUs

4.3000

Conversion factor

$33.4009

Medicare rate

$143.62

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

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,171

Code
64616
Physician work
1.49
Practice expense
2.31
Malpractice
0.50

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 64616 in South Dakota
ComponentRVULocality factorAdjusted
Physician work1.49× 1.0001.4900
Practice expense2.31× 1.0002.3100
Malpractice0.50× 0.3360.1680
Total RVUs3.9680
Conversion factor× 33.4009

Office rate, South Dakota$132.53

Office: (1.49 × 1 + 2.31 × 1 + 0.5 × 0.336) × $33.4009 = $132.53

Facility: (1.49 × 1 + 0.99 × 1 + 0.5 × 0.336) × $33.4009 = $88.45

Open 64616 in the RVU calculator

Payment rules and modifiers for 64616

64616 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64616

Neck chemodenervation, neck muscles, excluding larynx

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 · 64616

Neck chemodenervation, neck muscles, excluding larynx

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

64616 without 50 · national office

$143.62

Neck chemodenervation, neck muscles, excluding larynx

64616-50 · Bilateral: 150%

$215.43

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

How 64616 has changed in South Dakota

64616 · Office / nonfacility

$132.53

Effective 2026-10-01

The base rate is $7.39 higher than on 2025-10-01, moving from $125.14 to $132.53 (5.9%).

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

    $125.14changed to$132.53

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.53 changed to 1.49
    • Practice expense RVU 2.14 changed to 2.31
    • Malpractice RVU 0.52 changed to 0.50
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $128.78changed to$125.14

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $126.68changed to$128.78

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $128.28changed to$126.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.07 changed to 2.14
    • Malpractice RVU 0.51 changed to 0.52
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $130.59changed to$128.28

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.50 changed to 0.51
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $128.86changed to$130.59

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.00 changed to 2.07
    • Malpractice RVU 0.47 changed to 0.50

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $126.91changed to$128.86

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.81 changed to 2.00
    • Malpractice RVU 0.48 changed to 0.47
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $125.50changed to$126.91

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.75 changed to 1.81
    • Malpractice RVU 0.52 changed to 0.48
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $123.20changed to$125.50

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.69 changed to 1.75

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $119.70changed to$123.20

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.60 changed to 1.69
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $118.66changed to$119.70

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.58 changed to 1.60
    • Malpractice RVU 0.51 changed to 0.52
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $117.50changed to$118.66

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.54 changed to 1.58
    • Malpractice RVU 0.50 changed to 0.51

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $116.92changed to$117.50

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $115.67changed to$116.92

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.52 changed to 1.54
    • Malpractice RVU 0.43 changed to 0.50
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$115.67

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$132.53$88.45RVU26D
2026-07-01$132.53$88.45RVU26C
2026-04-01$132.53$88.45RVU26B
2026-01-01$132.53$88.45RVU26A
2025-10-01$125.14$97.32RVU25D
2025-07-01$125.14$97.32RVU25C
2025-04-01$125.14$97.32RVU25B
2025-01-01$125.14$97.32RVU25A
2024-10-01$128.78$99.48RVU24D
2024-07-01$128.78$99.48RVU24C
2024-04-01$128.78$99.48RVU24B
2024-03-09$128.78$99.48RVU24AR
2024-01-01$126.68$97.86RVU24A
2023-10-01$128.28$99.14RVU23D
2023-07-01$128.28$99.14RVU23C
2023-04-01$128.28$99.14RVU23B
2023-01-01$128.28$99.14RVU23A
2022-10-01$130.59$100.48RVU22D
2022-07-01$130.59$100.48RVU22C
2022-04-01$130.59$100.48RVU22B
2022-01-01$130.59$100.48RVU22A
2021-10-01$128.86$100.60RVU21D
2021-07-01$128.86$100.60RVU21C
2021-04-01$128.86$100.60RVU21B
2021-01-01$128.86$100.60RVU21A
2020-10-01$126.91$102.37RVU20D
2020-07-01$126.91$102.37RVU20C
2020-04-01$126.91$102.37RVU20B
2020-01-01$126.91$102.37RVU20A
2019-10-01$125.50$103.15RVU19D
2019-07-01$125.50$103.15RVU19C
2019-04-01$125.50$103.15RVU19B
2019-01-01$125.50$103.15RVU19A
2018-10-01$123.20$103.40RVU18D
2018-07-01$123.20$103.40RVU18C
2018-04-01$123.20$103.40RVU18B
2018-01-01$123.20$103.40RVU18AR1
2017-10-01$119.70$102.84RVU17D
2017-07-01$119.70$102.84RVU17C
2017-04-01$119.70$102.84RVU17B
2017-01-01$119.70$102.84RVU17A
2016-10-01$118.66$101.83RVU16D
2016-07-01$118.66$101.83RVU16C
2016-04-01$118.66$101.83RVU16B
2016-01-01$118.66$101.83RVU16A
2015-10-01$117.50$101.33RVU15D
2015-07-01$117.50$101.33RVU15C
2015-04-01$116.92$100.83RVU15B
2015-01-01$116.92$100.83RVU15A
2014-10-01$115.67$100.98RVU14D
2014-07-01$115.67$100.98RVU14C
2014-04-01$115.67$100.98RVU14B
2014-01-01$115.67$100.98RVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 64616 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

64616 billing questions

When should this code be chosen instead of 64615?

Use 64616 for treatment directed at neck muscles, commonly for cervical dystonia. Code 64615 is for chemodenervation directed at muscles for chronic migraine treatment.

Can this code be used for injections into laryngeal muscles?

No. Laryngeal muscle treatment is reported with 64617, which identifies laryngeal chemodenervation with EMG guidance.

How is bilateral treatment reported?

Report modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.

Are follow-up visits included?

Related postoperative visits during the 10-day global period are included in the procedure.

What documentation supports reporting this code?

Document the clinical indication, the neck muscles treated, the medication administered, and the treatment performed. The record should distinguish neck treatment from laryngeal, facial, or extremity muscle treatment.

How does CMS handle this code when other procedures are performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid 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 64616PPRRVU2026_Oct_nonQPP.csv, line 7,171 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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