CPT code 64644: Muscle chemodenervation, one extremity, five or more muscles2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $191.82 for 64644 in the office and $103.68 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 64644 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 64644 covers

This service covers injection of a chemodenervating agent into five or more muscles in a single extremity to reduce unwanted muscle activity. Neurologists, physiatrists, and other clinicians who manage movement disorders or spasticity commonly perform it in outpatient clinics and hospital settings. Treatment may address focal upper- or lower-extremity muscle overactivity, including patterns that interfere with positioning, movement, or daily function.

Select the code by counting the muscles treated in that extremity, not the number of injection sites or the drug units. Documentation should identify the treated extremity and muscles, the treatment plan, and the administered product and dose. A separately treated additional extremity may support an additional-extremity code. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and 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 Puerto Rico compares for 64644

Across 109 of 109 payment localities, the office rate for 64644 runs from $167.57 in Arkansas to $243.28 in San Benito County, CA. Puerto Rico pays $191.82. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

64644 rates by state

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

See 64644 in every payment locality

How the 64644 rate is calculated

Each of 64644’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 64644

The CMS indicators that decide how 64644 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 64644

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

How 64644 has changed in Puerto Rico

Price 64644 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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