CPT code 64643: Chemodenervation, additional extremity, 1-4 muscles2026 Medicare rate & RVUs in Baltimore area, MD

In Baltimore area, MD, Medicare pays $106.15 for 64643 in the office and $63.15 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 64643 nationwide

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

What 64643 covers

This add-on code represents chemodenervation of an additional limb, treating one to four muscles in that extremity. It is commonly used when a clinician injects botulinum toxin to manage focal spasticity, such as after stroke, traumatic brain injury, or in cerebral palsy. Physicians and other qualified practitioners typically perform the injections in an office or facility setting, selecting target muscles based on the patient’s functional goals and examination findings.

Report 64643 with the primary extremity chemodenervation service, generally 64642, when another extremity is treated at the same session. The muscle count is assessed separately for each extremity; this code represents an additional extremity with one to four treated muscles, not each individual muscle or injection site. Documentation should identify the treated extremity, muscles, indication, and administered treatment. CMS classifies this as an add-on code: it is billed only with a primary procedure, and its payment falls within that procedure’s global period.

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 Baltimore area, MD compares for 64643

Across 109 of 109 payment localities, the office rate for 64643 runs from $88.75 in Arkansas to $123.85 in San Benito County, CA. Baltimore area, MD pays $106.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

64643 rates by state

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

See 64643 in every payment locality

How the 64643 rate is calculated

Each of 64643’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 64643

The CMS indicators that decide how 64643 is paid alongside other services.

Codes related to 64643

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

How 64643 has changed in Baltimore area, MD

Price 64643 for an earlier date of service

Where the Baltimore area, MD rate applies

Baltimore area, MD is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in Maryland. Some span more than one payment area; confirm with the service ZIP.

• Baltimore
• Aberdeen
• Aberdeen Proving Ground
• Abingdon
• Annapolis
• Annapolis Neck
• Arbutus
• Arden on the Severn

Browse all communities in Maryland

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