FeeBase
Log inGet started
Menu

CPT code 64647: Trunk chemodenervation, six or more muscles2026 Medicare rate & RVUs in Connecticut

Reports botulinum toxin chemodenervation of six or more trunk muscles, such as paraspinal or abdominal muscles, for a documented movement or tone disorder.

CMS RVU26DEffective Oct 1, 2026One payment locality1.7K Medicare services in 2024

In Connecticut, Medicare pays $202.26 for 64647 in the office and $123.48 when it’s performed in a hospital or facility.

$202.26Office (non-facility)
$123.48Hospital or facility
+6.8%vs the national office rate ($189.38)

Check a contract rate as a % of Medicare · 64647 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 64647 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 64647 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 64647 covers

This service involves injecting a chemodenervating agent, commonly botulinum toxin, into six or more distinct trunk muscles to reduce unwanted muscle activity. Neurologists, physiatrists, and other qualified clinicians may perform it in an office or outpatient facility for conditions such as trunk spasticity or dystonia. Paraspinal and abdominal muscles are examples of trunk targets; the treated muscles should be identified in the record.

Select this code based on the number of distinct trunk muscles treated, not the number of needle passes or injection points. Documentation should support the indication and identify the muscles injected; report the toxin product separately when applicable. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, 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 Connecticut compares for 64647

Across 109 of 109 payment localities, the office rate for 64647 runs from $166.64 in Arkansas to $235.12 in San Benito County, CA. Connecticut pays $202.26. The RVUs are the same everywhere; the geographic indexes change the dollars.

64647 in Connecticut vs other payment areas
  1. Connecticut · this page$202.26
  2. Los Angeles, CA · California$205.60+$3.34
  3. Washington, DC area · District of Columbia$213.48+$11.22
  4. Miami, FL · Florida$219.18+$16.92
  5. Chicago, IL · Illinois$212.01+$9.75
  6. Manhattan, NY · New York$220.40+$18.14
  7. Alaska · Alaska$223.04+$20.78

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

Every other payment area

64647 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$169.15$105.15
ArkansasArkansas$166.64$103.80
ArizonaArizona$183.76$112.88
Bakersfield, CACalifornia$194.13$113.96
Chico, CACalifornia$192.78$112.61
El Centro, CACalifornia$192.86$112.69
Fresno, CACalifornia$192.78$112.61
Hanford, CACalifornia$192.78$112.61

64647 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.

$166.64

$223.04

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

View every state and territory as a table
64647 office rate range by state
State / territoryOffice rate rangeLocalities
AK$223.041
AL$169.151
AR$166.641
AZ$183.761
CA$192.78–$235.1229
CO$193.201
CT$202.261
DC$213.481
DE$186.791
FL$193.21–$219.183
GA$181.37–$194.612
GU$196.581
HI$196.581
IA$170.481
ID$172.271
IL$189.75–$212.014
IN$173.221
KS$171.131
KY$176.431
LA$176.74–$185.532
MA$192.60–$210.522
MD$189.95–$213.483
ME$174.76–$182.292
MI$182.50–$197.202
MN$180.641
MO$174.61–$184.433
MS$170.591
MT$189.351
NC$176.391
ND$179.461
NE$171.001
NH$191.551
NJ$203.31–$211.472
NM$184.121
NV$186.701
NY$179.23–$227.735
OH$180.481
OK$174.541
OR$184.01–$197.742
PA$179.95–$198.102
PR$190.281
RI$192.311
SC$178.981
SD$178.291
TN$172.201
TX$178.85–$195.498
UT$181.451
VA$182.71–$213.482
VI$190.281
VT$180.091
WA$191.79–$213.352
WI$173.461
WV$182.971
WY$185.041

See 64647 in every payment locality

How the 64647 rate is calculated

Each of 64647’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 · 64647

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.06

2.06 RVUs× 1.000 GPCI

Practice expense3.11

3.11 RVUs× 1.000 GPCI

Malpractice0.50

0.50 RVUs× 1.000 GPCI

Adjusted RVUs

5.6700

Conversion factor

$33.4009

Medicare rate

$189.38

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,190

Code
64647
Physician work
2.06
Practice expense
3.11
Malpractice
0.50

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 64647 in Connecticut
ComponentRVULocality factorAdjusted
Physician work2.06× 1.0202.1012
Practice expense3.11× 1.0773.3495
Malpractice0.50× 1.2100.6050
Total RVUs6.0557
Conversion factor× 33.4009

Office rate, Connecticut$202.26

Office: (2.06 × 1.02 + 3.11 × 1.077 + 0.5 × 1.21) × $33.4009 = $202.26

Facility: (2.06 × 1.02 + 0.92 × 1.077 + 0.5 × 1.21) × $33.4009 = $123.48

Open 64647 in the RVU calculator

Payment rules and modifiers for 64647

The CMS indicators that decide how 64647 is paid alongside other services.

CMS payment indicators · 64647

Trunk chemodenervation, six or more muscles

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

64647 without 51 · national office

$189.38

Trunk chemodenervation, six or more muscles

64647-51 · Second procedure: 50%

$94.69

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 64647

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

Codes related to 64647
CodeHow it relatesOffice range, Connecticut
Same family
64646Muscle chemodenervation, trunk, one to five musclesTrunk chemodenervation for one to five muscles; 64647 covers six or more.$182.24
Used instead
64642Chemodenervation, one extremity, 1–4 musclesChemodenervation targets one extremity with one to four muscles rather than trunk muscles.$174.57
64644Muscle chemodenervation, one extremity, five or more musclesChemodenervation targets one extremity with five or more muscles rather than trunk muscles.$203.81
64643Chemodenervation, additional extremity, 1-4 musclesAddresses additional-extremity chemodenervation, not treatment of trunk muscles.$106.31

How 64647 has changed in Connecticut

64647 · Office / nonfacility

$202.26

Effective 2026-10-01

The base rate is $11.52 higher than on 2025-10-01, moving from $190.74 to $202.26 (6.0%).

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

    $190.74changed to$202.26

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.11 changed to 2.06
    • Practice expense RVU 2.82 changed to 3.11
    • Malpractice RVU 0.55 changed to 0.50
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $198.99changed to$190.74

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.85 changed to 2.82
    • Malpractice RVU 0.59 changed to 0.55

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $195.74changed to$198.99

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $198.11changed to$195.74

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.76 changed to 2.85
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $199.00changed to$198.11

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.72 changed to 2.76
    • Malpractice RVU 0.57 changed to 0.59
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $196.18changed to$199.00

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.63 changed to 2.72
    • Malpractice RVU 0.54 changed to 0.57

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $197.67changed to$196.18

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.42 changed to 2.63
    • Malpractice RVU 0.56 changed to 0.54
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $201.46changed to$197.67

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.39 changed to 2.42
    • Malpractice RVU 0.62 changed to 0.56
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $200.89changed to$201.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.37 changed to 2.39
    • Malpractice RVU 0.63 changed to 0.62

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $199.17changed to$200.89

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.39 changed to 2.37
    • Malpractice RVU 0.58 changed to 0.63
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $198.59changed to$199.17

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.46 changed to 2.39
    • Malpractice RVU 0.51 changed to 0.58
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $198.87changed to$198.59

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.50 changed to 0.51

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $197.88changed to$198.87

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $191.35changed to$197.88

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.43 changed to 2.46
    • Malpractice RVU 0.38 changed to 0.50
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$191.35

    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$202.26$123.48RVU26D
2026-07-01$202.26$123.48RVU26C
2026-04-01$202.26$123.48RVU26B
2026-01-01$202.26$123.48RVU26A
2025-10-01$190.74$138.16RVU25D
2025-07-01$190.74$138.16RVU25C
2025-04-01$190.74$138.16RVU25B
2025-01-01$190.74$138.16RVU25A
2024-10-01$198.99$143.42RVU24D
2024-07-01$198.99$143.42RVU24C
2024-04-01$198.99$143.42RVU24B
2024-03-09$198.99$143.42RVU24AR
2024-01-01$195.74$141.08RVU24A
2023-10-01$198.11$142.84RVU23D
2023-07-01$198.11$142.84RVU23C
2023-04-01$198.11$142.84RVU23B
2023-01-01$198.11$142.84RVU23A
2022-10-01$199.00$143.49RVU22D
2022-07-01$199.00$143.49RVU22C
2022-04-01$199.00$143.49RVU22B
2022-01-01$199.00$143.49RVU22A
2021-10-01$196.18$143.31RVU21D
2021-07-01$196.18$143.31RVU21C
2021-04-01$196.18$143.31RVU21B
2021-01-01$196.18$143.31RVU21A
2020-10-01$197.67$149.47RVU20D
2020-07-01$197.67$149.47RVU20C
2020-04-01$197.67$149.47RVU20B
2020-01-01$197.67$149.47RVU20A
2019-10-01$201.46$154.97RVU19D
2019-07-01$201.46$154.97RVU19C
2019-04-01$201.46$154.97RVU19B
2019-01-01$201.46$154.97RVU19A
2018-10-01$200.89$156.46RVU18D
2018-07-01$200.89$156.46RVU18C
2018-04-01$200.89$156.46RVU18B
2018-01-01$200.89$156.46RVU18AR1
2017-10-01$199.17$155.48RVU17D
2017-07-01$199.17$155.48RVU17C
2017-04-01$199.17$155.48RVU17B
2017-01-01$199.17$155.48RVU17A
2016-10-01$198.59$153.24RVU16D
2016-07-01$198.59$153.24RVU16C
2016-04-01$198.59$153.24RVU16B
2016-01-01$198.59$153.24RVU16A
2015-10-01$198.87$153.35RVU15D
2015-07-01$198.87$153.35RVU15C
2015-04-01$197.88$152.59RVU15B
2015-01-01$197.88$152.59RVU15A
2014-10-01$191.35$147.37RVU14D
2014-07-01$191.35$147.37RVU14C
2014-04-01$191.35$147.37RVU14B
2014-01-01$191.35$147.37RVU14A
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 64647 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

64647 billing questions

When should this code be selected instead of 64646?

Use 64647 when six or more trunk muscles are treated. Code 64646 is for one to five trunk muscles.

Do injection points determine the muscle count?

No. Select the code by the number of distinct muscles treated, not the number of needle passes or injection points. Document the muscles injected.

Can modifier 50 be used for injections on both sides of the trunk?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Is the botulinum toxin product included in this service?

The code represents the chemodenervation procedure. Report the toxin product separately under its applicable drug code when separately reportable.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure's payment.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

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 64647PPRRVU2026_Oct_nonQPP.csv, line 7,190 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 64647 pays in Connecticut?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 64647 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist