$136.20–$192.97
64612 treats facial nerve–innervated muscles, commonly for blepharospasm or hemifacial spasm. 64615 is for chronic migraine treatment involving specified head and neck muscle groups.
On this page
CMS RVU26D · Effective 2026-10-01
64612 Facial chemodenervation Medicare reimbursement rates
Report 64612 for botulinum toxin treatment of facial nerve–innervated muscles, such as in blepharospasm or hemifacial spasm, on one side. Compare 64612 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 64612?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$124.77–$180.25
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $55.48 per service.
Facility setting
$96.08–$132.08
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $36.00 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 64612 pays more and less
109 payment localities
$124.77 to $180.25
Chemodenervation
About 64612: Facial muscle chemodenervation
Report 64612 for botulinum toxin treatment of facial nerve–innervated muscles, such as in blepharospasm or hemifacial spasm, on one side.
This service uses targeted injections to reduce activity in facial muscles supplied by the facial nerve. Typical indications include blepharospasm and hemifacial spasm. Neurologists and ophthalmologists commonly perform it; other physicians with relevant expertise may provide treatment in office or facility settings. The injected muscles may include muscles around the eye or elsewhere in the face, depending on the documented disorder and treatment plan.
Select 64612 for unilateral treatment of facial nerve–innervated muscles, not by counting injection sites. For treatment on both sides, report modifier 50; CMS pays the bilateral procedure at 150%. Document the treated side, muscles, indication, and procedure performed. 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%. Assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 64612
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.37 · 32%
- Practice expense (office) RVU2.58 · 61%
- Malpractice RVU0.29 · 7%
79.5K
Medicare services in 2024 · #633 by national volume
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.
64612 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$124.65–$175.70
Use 64616 for chemodenervation of neck muscles, such as in cervical dystonia; use 64612 for facial nerve–innervated muscles.
$143.40–$205.87
64642 applies to treatment of one extremity with one to four muscles. 64612 applies to unilateral facial nerve muscle treatment.
See how rates vary across the country
64612 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$124.77
$165.75
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $165.75 | 1 |
| AL | $126.64 | 1 |
| AR | $124.77 | 1 |
| AZ | $137.55 | 1 |
| CA | $146.18–$180.25 | 29 |
| CO | $145.56 | 1 |
| CT | $151.20 | 1 |
| DC | $160.52 | 1 |
| DE | $139.84 | 1 |
| FL | $142.70–$159.96 | 3 |
| GA | $134.17–$145.08 | 2 |
| GU | $149.35 | 1 |
| HI | $149.35 | 1 |
| IA | $128.45 | 1 |
| ID | $129.62 | 1 |
| IL | $139.58–$154.91 | 4 |
| IN | $130.35 | 1 |
| KS | $128.54 | 1 |
| KY | $131.23 | 1 |
| LA | $131.30–$137.85 | 2 |
| MA | $144.95–$159.15 | 2 |
| MD | $142.32–$160.52 | 3 |
| ME | $131.06–$137.27 | 2 |
| MI | $135.37–$145.25 | 2 |
| MN | $137.30 | 1 |
| MO | $129.48–$137.50 | 3 |
| MS | $127.11 | 1 |
| MT | $141.60 | 1 |
| NC | $132.35 | 1 |
| ND | $135.87 | 1 |
| NE | $128.96 | 1 |
| NH | $143.94 | 1 |
| NJ | $152.32–$158.95 | 2 |
| NM | $136.41 | 1 |
| NV | $140.09 | 1 |
| NY | $134.43–$169.14 | 5 |
| OH | $134.20 | 1 |
| OK | $130.24 | 1 |
| OR | $138.40–$149.44 | 2 |
| PA | $134.02–$147.85 | 2 |
| PR | $142.42 | 1 |
| RI | $144.29 | 1 |
| SC | $133.62 | 1 |
| SD | $135.19 | 1 |
| TN | $129.29 | 1 |
| TX | $133.18–$145.61 | 8 |
| UT | $135.46 | 1 |
| VA | $137.31–$160.52 | 2 |
| VI | $142.42 | 1 |
| VT | $135.97 | 1 |
| WA | $144.47–$161.70 | 2 |
| WI | $131.30 | 1 |
| WV | $134.51 | 1 |
| WY | $139.10 | 1 |
Compare 64612 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $126.64 | Facility $97.42 |
| Alaska* | Office $165.75 | Facility $130.18 |
| Arizona | Office $137.55 | Facility $105.19 |
| Arkansas | Office $124.77 | Facility $96.08 |
| Atlanta | Office $145.08 | Facility $111.15 |
| Austin | Office $145.61 | Facility $110.27 |
| Bakersfield | Office $146.97 | Facility $110.37 |
| Baltimore/Surr. Cntys | Office $150.94 | Facility $115.10 |
| Beaumont | Office $133.18 | Facility $102.78 |
| Brazoria | Office $139.08 | Facility $105.98 |
| Chicago | Office $154.91 | Facility $121.35 |
| Chico | Office $146.18 | Facility $109.57 |
| Colorado | Office $145.56 | Facility $110.02 |
| Connecticut | Office $151.20 | Facility $115.23 |
| Dallas | Office $140.31 | Facility $107.04 |
| Dc + Md/Va Suburbs | Office $160.52 | Facility $121.18 |
| Delaware | Office $139.84 | Facility $106.84 |
| Detroit | Office $145.25 | Facility $113.02 |
| East St. Louis | Office $144.55 | Facility $113.82 |
| El Centro | Office $146.22 | Facility $109.62 |
| Fort Lauderdale | Office $150.57 | Facility $116.73 |
| Fort Worth | Office $139.58 | Facility $106.64 |
| Fresno | Office $146.18 | Facility $109.57 |
| Galveston | Office $139.72 | Facility $106.55 |
| Hanford-Corcoran | Office $146.18 | Facility $109.57 |
| Hawaii, Guam | Office $149.35 | Facility $111.37 |
| Houston | Office $145.02 | Facility $111.86 |
| Idaho | Office $129.62 | Facility $98.89 |
| Indiana | Office $130.35 | Facility $99.39 |
| Iowa | Office $128.45 | Facility $97.89 |
| Kansas | Office $128.54 | Facility $98.35 |
| Kentucky | Office $131.23 | Facility $101.54 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $156.01 | Facility $116.50 |
| Madera | Office $146.18 | Facility $109.57 |
| Manhattan | Office $164.18 | Facility $125.37 |
| Merced | Office $146.18 | Facility $109.57 |
| Metropolitan Boston | Office $159.15 | Facility $119.27 |
| Metropolitan Kansas City | Office $136.14 | Facility $104.78 |
| Metropolitan Philadelphia | Office $147.85 | Facility $113.08 |
| Metropolitan St. Louis | Office $137.50 | Facility $105.71 |
| Miami | Office $159.96 | Facility $125.19 |
| Minnesota | Office $137.30 | Facility $102.93 |
| Mississippi | Office $127.11 | Facility $98.36 |
| Modesto | Office $146.18 | Facility $109.57 |
| Montana** | Office $141.60 | Facility $108.20 |
| Napa | Office $167.14 | Facility $123.12 |
| Nebraska | Office $128.96 | Facility $98.13 |
| Nevada** | Office $140.09 | Facility $106.65 |
| New Hampshire | Office $143.94 | Facility $109.17 |
| New Mexico | Office $136.41 | Facility $105.79 |
| New Orleans | Office $137.85 | Facility $106.42 |
| North Carolina | Office $132.35 | Facility $101.19 |
| North Dakota** | Office $135.87 | Facility $102.47 |
| Northern Nj | Office $158.95 | Facility $120.20 |
| Nyc Suburbs/Long Island | Office $169.14 | Facility $129.42 |
| Ohio | Office $134.20 | Facility $103.71 |
| Oklahoma | Office $130.24 | Facility $100.41 |
| Oxnard-Thousand Oaks-Ventura | Office $154.93 | Facility $115.45 |
| Portland | Office $149.44 | Facility $112.33 |
| Poughkpsie/N Nyc Suburbs | Office $153.90 | Facility $117.33 |
| Puerto Rico | Office $142.42 | Facility $108.65 |
| Queens | Office $164.51 | Facility $125.03 |
| Redding | Office $146.18 | Facility $109.57 |
| Rest Of California | Office $146.18 | Facility $109.57 |
| Rest Of Florida | Office $142.70 | Facility $110.77 |
| Rest Of Georgia | Office $134.17 | Facility $104.38 |
| Rest Of Illinois | Office $139.58 | Facility $109.08 |
| Rest Of Louisiana | Office $131.30 | Facility $101.74 |
| Rest Of Maine | Office $131.06 | Facility $100.34 |
| Rest Of Maryland | Office $142.32 | Facility $108.52 |
| Rest Of Massachusetts | Office $144.95 | Facility $109.78 |
| Rest Of Michigan | Office $135.37 | Facility $104.88 |
| Rest Of Missouri | Office $129.48 | Facility $100.68 |
| Rest Of New Jersey | Office $152.32 | Facility $115.84 |
| Rest Of New York | Office $134.43 | Facility $102.70 |
| Rest Of Oregon | Office $138.40 | Facility $105.13 |
| Rest Of Pennsylvania | Office $134.02 | Facility $103.36 |
| Rest Of Texas | Office $136.29 | Facility $104.59 |
| Rest Of Washington | Office $144.47 | Facility $109.30 |
| Rhode Island | Office $144.29 | Facility $109.78 |
| Riverside-San Bernardino-Ontario | Office $149.29 | Facility $112.68 |
| Sacramento-Roseville-Folsom | Office $152.82 | Facility $113.97 |
| Salinas | Office $152.25 | Facility $113.53 |
| San Diego-Chula Vista-Carlsbad | Office $155.45 | Facility $115.50 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $176.06 | Facility $128.96 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $175.73 | Facility $128.63 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $180.25 | Facility $132.08 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $178.90 | Facility $130.74 |
| San Luis Obispo-Paso Robles | Office $149.88 | Facility $111.84 |
| Santa Cruz-Watsonville | Office $156.61 | Facility $116.03 |
| Santa Maria-Santa Barbara | Office $152.71 | Facility $113.77 |
| Santa Rosa-Petaluma | Office $158.15 | Facility $117.13 |
| Seattle (King Cnty) | Office $161.70 | Facility $120.71 |
| South Carolina | Office $133.62 | Facility $102.76 |
| South Dakota** | Office $135.19 | Facility $101.79 |
| Southern Maine | Office $137.27 | Facility $104.17 |
| Stockton | Office $146.18 | Facility $109.57 |
| Suburban Chicago | Office $151.74 | Facility $117.44 |
| Tennessee | Office $129.29 | Facility $98.93 |
| Utah | Office $135.46 | Facility $104.06 |
| Vallejo | Office $166.67 | Facility $122.64 |
| Vermont | Office $135.97 | Facility $102.91 |
| Virgin Islands | Office $142.42 | Facility $108.65 |
| Virginia | Office $137.31 | Facility $104.47 |
| Visalia | Office $146.18 | Facility $109.57 |
| West Virginia | Office $134.51 | Facility $105.48 |
| Wisconsin | Office $131.30 | Facility $99.30 |
| Wyoming** | Office $139.10 | Facility $105.70 |
| Yuba City | Office $146.18 | Facility $109.57 |
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64612 billing questions
When should 64612 be used instead of 64615?
Use 64612 for treatment of facial nerve–innervated muscles, such as for blepharospasm or hemifacial spasm. Code 64615 describes chemodenervation for chronic migraine involving specified head and neck muscle groups.
Is 64612 reported per muscle or injection site?
No. Select the code for the unilateral facial nerve muscle treatment, rather than billing a unit for each muscle or injection site.
How is treatment on both sides reported?
Report modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.
Are postoperative visits separately payable?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can the botulinum toxin product be reported separately?
When a separately reportable toxin product is supplied, report the applicable drug code as supported by the product and documentation. For example, J0585 describes onabotulinumtoxinA.
How does CMS apply multiple-procedure payment?
When multiple procedures are performed 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,16664605,,Injection treatment of nerve,A,,5.51,25.12,,4.85,,2.33,32.96,12.69,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16764610,,Injection treatment of nerve,A,,7.02,16.52,,4.23,,2.20,25.74,13.45,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16864611,,Chemodenerv saliv glands,A,,1.00,2.76,,1.85,,0.39,4.15,3.24,0,010,0.10,0.80,0.10,2,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16964612,,Destroy nerve face muscle,A,,1.37,2.58,,1.58,,0.29,4.24,3.24,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17064615,,Chemodenerv musc migraine,A,,1.80,2.28,,0.85,,0.62,4.70,3.27,0,010,0.10,0.80,0.10,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17164616,,Chemodenerv musc neck dyston,A,,1.49,2.31,,0.99,,0.50,4.30,2.98,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17264617,,Chemodener muscle larynx emg,A,,1.85,2.65,,0.64,,0.26,4.76,2.75,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00