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CPT code 64617: Laryngeal chemodenervation, unilateral, EMG guidance when performed2026 Medicare rate & RVUs in Virginia

Reports percutaneous chemodenervation of a laryngeal muscle, commonly for spasmodic dysphonia, with EMG guidance included when performed.

CMS RVU26DEffective Oct 1, 2026One payment locality10.4K Medicare services in 2024

In Virginia, Medicare pays $154.93 for 64617 in the office and $88.94 when it’s performed in a hospital or facility.

$154.93Office (non-facility)
$88.94Hospital or facility
−2.6%vs the national office rate ($158.99)

Check a contract rate as a % of Medicare · 64617 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 64617 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 64617 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 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.

How Virginia compares for 64617

Across 109 of 109 payment localities, the office rate for 64617 runs from $142.30 in Arkansas to $200.88 in San Benito County, CA. Virginia pays $154.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

64617 in Virginia vs other payment areas
  1. Virginia · this page$154.93
  2. Los Angeles, CA · California$174.80+$19.87
  3. Washington, DC area · District of Columbia$179.06+$24.13
  4. Miami, FL · Florida$175.90+$20.97
  5. Chicago, IL · Illinois$171.11+$16.18
  6. Manhattan, NY · New York$182.37+$27.44
  7. Alaska · Alaska$191.74+$36.81

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

Every other payment area

64617 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$144.16$85.41
ArkansasArkansas$142.30$84.63
ArizonaArizona$154.99$89.94
Bakersfield, CACalifornia$165.26$91.68
Chico, CACalifornia$164.51$90.93
El Centro, CACalifornia$164.55$90.97
Fresno, CACalifornia$164.51$90.93
Hanford, CACalifornia$164.51$90.93

64617 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.

$142.30

$191.74

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

View every state and territory as a table
64617 office rate range by state
State / territoryOffice rate rangeLocalities
AK$191.741
AL$144.161
AR$142.301
AZ$154.991
CA$164.51–$200.8829
CO$163.491
CT$168.861
DC$179.061
DE$157.361
FL$159.46–$175.903
GA$151.10–$162.342
GU$167.461
HI$167.461
IA$146.231
ID$147.331
IL$156.18–$171.114
IN$148.061
KS$146.181
KY$148.431
LA$148.44–$154.952
MA$162.91–$177.742
MD$159.96–$179.063
ME$148.62–$154.992
MI$152.41–$161.852
MN$155.441
MO$146.55–$154.763
MS$144.421
MT$158.971
NC$149.921
ND$153.831
NE$146.771
NH$161.531
NJ$170.45–$177.632
NM$153.391
NV$157.631
NY$151.98–$187.115
OH$151.361
OK$147.581
OR$156.06–$167.582
PA$151.25–$165.412
PR$159.831
RI$162.151
SC$150.961
SD$153.221
TN$146.911
TX$150.41–$163.268
UT$152.791
VA$154.93–$179.062
VI$159.831
VT$153.811
WA$162.41–$180.582
WI$149.261
WV$151.141
WY$156.731

See 64617 in every payment locality

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

Office or facility?

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.

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,172

Code
64617
Physician work
1.85
Practice expense
2.65
Malpractice
0.26

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 64617 in Virginia
ComponentRVULocality factorAdjusted
Physician work1.85× 1.0001.8500
Practice expense2.65× 0.9832.6049
Malpractice0.26× 0.7060.1836
Total RVUs4.6385
Conversion factor× 33.4009

Office rate, Virginia$154.93

Office: (1.85 × 1 + 2.65 × 0.983 + 0.26 × 0.706) × $33.4009 = $154.93

Facility: (1.85 × 1 + 0.64 × 0.983 + 0.26 × 0.706) × $33.4009 = $88.94

Open 64617 in the RVU calculator

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

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 · 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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).

When to use modifier 50

Codes related to 64617

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

Codes related to 64617
CodeHow it relatesOffice range, Virginia
Same family
64616Neck chemodenervation, neck muscles, excluding larynxChemodenervation of neck muscles; differs from 64617 by the treated anatomy.$137.40
64612Facial chemodenervation, facial nerve muscles, unilateralChemodenervation of facial muscles rather than laryngeal muscles.$137.31
64611Salivary gland injection, bilateral parotid and submandibular glandsChemodenervation targets salivary glands rather than laryngeal muscles.$133.22
Often billed with
J0585OnabotulinumtoxinA, per 1 unitOnabotulinumtoxinA drug supply may be reported separately when used and separately reportable.No office rate

How 64617 has changed in Virginia

64617 · Office / nonfacility

$154.93

Effective 2026-10-01

The base rate is $1.85 higher than on 2025-10-01, moving from $153.08 to $154.93 (1.2%).

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

    $153.08changed to$154.93

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.90 changed to 1.85
    • Practice expense RVU 2.66 changed to 2.65
    • Malpractice RVU 0.28 changed to 0.26
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $158.60changed to$153.08

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.70 changed to 2.66
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $156.01changed to$158.60

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $163.19changed to$156.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.72 changed to 2.70
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $166.14changed to$163.19

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.69 changed to 2.72
    • Malpractice RVU 0.25 changed to 0.27
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $166.09changed to$166.14

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.64 changed to 2.69
    • Malpractice RVU 0.26 changed to 0.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $165.35changed to$166.09

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.46 changed to 2.64
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $164.34changed to$165.35

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.44 changed to 2.46
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $162.71changed to$164.34

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.39 changed to 2.44
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $180.05changed to$162.71

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.76 changed to 2.39
    • Malpractice RVU 0.46 changed to 0.29
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $195.25changed to$180.05

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.12 changed to 2.76
    • Malpractice RVU 0.59 changed to 0.46
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $190.95changed to$195.25

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.23 changed to 3.12
    • Malpractice RVU 0.29 changed to 0.59

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $190.00changed to$190.95

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $189.27changed to$190.00

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.27 changed to 3.23
    • Malpractice RVU 0.23 changed to 0.29
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$189.27

    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$154.93$88.94RVU26D
2026-07-01$154.93$88.94RVU26C
2026-04-01$154.93$88.94RVU26B
2026-01-01$154.93$88.94RVU26A
2025-10-01$153.08$102.79RVU25D
2025-07-01$153.08$102.79RVU25C
2025-04-01$153.08$102.79RVU25B
2025-01-01$153.08$102.79RVU25A
2024-10-01$158.60$105.21RVU24D
2024-07-01$158.60$105.21RVU24C
2024-04-01$158.60$105.21RVU24B
2024-03-09$158.60$105.21RVU24AR
2024-01-01$156.01$103.49RVU24A
2023-10-01$163.19$107.50RVU23D
2023-07-01$163.19$107.50RVU23C
2023-04-01$163.19$107.50RVU23B
2023-01-01$163.19$107.50RVU23A
2022-10-01$166.14$108.63RVU22D
2022-07-01$166.14$108.63RVU22C
2022-04-01$166.14$108.63RVU22B
2022-01-01$166.14$108.63RVU22A
2021-10-01$166.09$108.81RVU21D
2021-07-01$166.09$108.81RVU21C
2021-04-01$166.09$108.81RVU21B
2021-01-01$166.09$108.81RVU21A
2020-10-01$165.35$111.70RVU20D
2020-07-01$165.35$111.70RVU20C
2020-04-01$165.35$111.70RVU20B
2020-01-01$165.35$111.70RVU20A
2019-10-01$164.34$111.75RVU19D
2019-07-01$164.34$111.75RVU19C
2019-04-01$164.34$111.75RVU19B
2019-01-01$164.34$111.75RVU19A
2018-10-01$162.71$111.60RVU18D
2018-07-01$162.71$111.60RVU18C
2018-04-01$162.71$111.60RVU18B
2018-01-01$162.71$111.60RVU18AR1
2017-10-01$180.05$119.60RVU17D
2017-07-01$180.05$119.60RVU17C
2017-04-01$180.05$119.60RVU17B
2017-01-01$180.05$119.60RVU17A
2016-10-01$195.25$124.15RVU16D
2016-07-01$195.25$124.15RVU16C
2016-04-01$195.25$124.15RVU16B
2016-01-01$195.25$124.15RVU16A
2015-10-01$190.95$116.42RVU15D
2015-07-01$190.95$116.42RVU15C
2015-04-01$190.00$115.84RVU15B
2015-01-01$190.00$115.84RVU15A
2014-10-01$189.27$114.14RVU14D
2014-07-01$189.27$114.14RVU14C
2014-04-01$189.27$114.14RVU14B
2014-01-01$189.27$114.14RVU14A
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 64617 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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
RVUs for 64617PPRRVU2026_Oct_nonQPP.csv, line 7,172 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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