CPT code 64617: Laryngeal chemodenervation, unilateral, EMG guidance when performed2026 Medicare rate & RVUs in California
Reports percutaneous chemodenervation of a laryngeal muscle, commonly for spasmodic dysphonia, with EMG guidance included when performed.
Medicare pays $164.51–$200.88 for 64617 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 64617 covers
This service delivers a chemodenervating agent through the skin into a targeted laryngeal muscle. Otolaryngologists and laryngologists commonly use it for adductor laryngeal dystonia, also called spasmodic dysphonia; a typical target is the thyroarytenoid muscle. Treatment may be performed in an office or facility. EMG guidance used to localize the muscle is included in the procedure when performed.
Report the code for unilateral treatment and document the indication, targeted muscle, injection, and laterality. For bilateral treatment, modifier 50 applies; CMS pays the bilateral procedure at 150%. 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%. Medicare does not pay an assistant at surgery for this service; 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 64617 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
$164.51 to $200.88
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $165.26 | $91.68 |
| Chico, CA | $164.51 | $90.93 |
| El Centro, CA | $164.55 | $90.97 |
| Fresno, CA | $164.51 | $90.93 |
| Hanford, CA | $164.51 | $90.93 |
| Los Angeles, CA | $174.80 | $95.38 |
| Madera, CA | $164.51 | $90.93 |
| Marin County, CA | $196.45 | $101.79 |
| Merced, CA | $164.51 | $90.93 |
| Modesto, CA | $164.51 | $90.93 |
| Napa, CA | $186.76 | $98.27 |
| Oxnard, CA | $173.55 | $94.20 |
| Redding, CA | $164.51 | $90.93 |
| Rest of California | $164.51 | $90.93 |
| Riverside, CA | $167.32 | $93.74 |
| Sacramento, CA | $171.61 | $93.53 |
| Salinas, CA | $170.95 | $93.14 |
| San Benito County, CA | $200.88 | $104.07 |
| San Diego, CA | $174.21 | $93.92 |
| San Francisco, CA | $196.16 | $101.49 |
| San Luis Obispo, CA | $168.31 | $91.84 |
| Santa Clara County, CA | $199.67 | $102.86 |
| Santa Cruz, CA | $175.29 | $93.72 |
| Santa Maria, CA | $171.38 | $93.10 |
| Santa Rosa, CA | $176.99 | $94.55 |
| Stockton, CA | $164.51 | $90.93 |
| Vallejo, CA | $186.33 | $97.84 |
| Visalia, CA | $164.51 | $90.93 |
| Yuba City, CA | $164.51 | $90.93 |
How the 64617 rate is calculated
Each of 64617’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 · 64617
RVUs × geographic indexes × conversion factor
Work1.85
1.85 RVUs× 1.000 GPCI
Practice expense2.65
2.65 RVUs× 1.000 GPCI
Malpractice0.26
0.26 RVUs× 1.000 GPCI
Adjusted RVUs
4.7600
Conversion factor
$33.4009
Medicare rate
$158.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64617
64617 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64617
Laryngeal chemodenervation, unilateral, EMG guidance when performed
| 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 · 64617
Laryngeal chemodenervation, unilateral, EMG guidance when performed
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
64617 without 50 · national office
$158.99
Laryngeal chemodenervation, unilateral, EMG guidance when performed
64617-50 · Bilateral: 150%
$238.49
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).
64617 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64616Neck chemodenervationNeck muscles, excluding larynx
- Choose 64617 for percutaneous laryngeal muscle chemodenervation, such as treatment of spasmodic dysphonia. Choose 64616 when the treated muscles are in the neck.
- 31570Vocal fold injectionDirect, without optical magnification
- 31570 describes therapeutic injection into vocal cord(s) by direct laryngoscopy. 64617 describes percutaneous laryngeal chemodenervation, with EMG guidance included when performed.
- 31571Vocal fold injectionMicroscope or telescope
- 31571 is therapeutic vocal-cord injection by direct laryngoscopy with an operating microscope or telescope. 64617 is percutaneous chemodenervation of laryngeal muscle.
64617 billing questions
When should 64617 be used instead of 64616?
Use 64617 for percutaneous chemodenervation of laryngeal muscle or muscles. Code 64616 addresses chemodenervation of neck muscles, not the laryngeal target.
Can both sides be treated with 64617?
Yes. Report bilateral treatment with modifier 50; CMS pays it at 150%.
Can EMG guidance be billed separately?
EMG guidance is included when performed as part of 64617. Document the guidance and the muscle targeted.
Is the injected drug included in 64617?
The procedure code describes the chemodenervation service, not the drug supply. Report the applicable drug code separately when the drug is supplied and separately reportable.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in 64617.
How does the multiple-procedure rule affect payment?
For multiple procedures 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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