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CMS RVU26D · Effective 2026-10-01

64644 in Chico

Office / nonfacility

$196.88

Base rate per service

Facility setting

$101.33

Base rate per service

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.

Neurology procedure

About 64644: Extremity chemodenervation, five or more muscles

Reports chemodenervation injections into five or more muscles in one arm or leg, commonly to reduce focal spasticity or other involuntary muscle activity.

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.

CMS billing rules for 64644

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
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 RVU1.77 · 31%
  • Practice expense (office) RVU3.54 · 62%
  • Malpractice RVU0.40 · 7%

38.6K

Medicare services in 2024 · #886 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.

64644 compared with similar codes

Office rates for Chico, from the same CMS release.

64642

Chemodenervation

One extremity, 1–4 muscles

$167.47

Both apply to one extremity; 64642 is selected for one to four treated muscles, while 64644 is for five or more.

64645

Muscle chemodenervation

Additional extremity, five-plus muscles

$132.09

64645 describes treatment of five or more muscles in an additional extremity. This code describes the first extremity treated.

64646

Muscle chemodenervation

Trunk, one to five muscles

$173.08

64646 applies to chemodenervation of trunk muscles. Use 64644 for five or more muscles in one extremity.

The same code, a different location

How does Chico compare?

In Bakersfield, the office rate for 64644 is $197.97—$1.09 higher than the $196.88 rate in Chico. Both use the same code, release and participation basis.

64644 across payment areas

Same release and payment basis · bars start at $0

  1. Chico · This locality

    $196.88

  2. Bakersfield

    $197.97

    $1.09 higher than Chico

  3. El Centro

    $196.94

    $0.06 higher than Chico

  4. Fresno

    $196.88

    The same base rate than Chico

  5. Hanford-Corcoran

    $196.88

    The same base rate than Chico

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $210.29

    $13.41 higher than Chico

  7. Madera

    $196.88

    The same base rate than Chico

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 64644 ranges from $167.57 in Arkansas to $243.28 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Merced

    California · 64644

    Office

    $196.88

    Facility

    $101.33

    The same base rate than Chico for the office setting.

  • Modesto

    California · 64644

    Office

    $196.88

    Facility

    $101.33

    The same base rate than Chico for the office setting.

  • Napa

    California · 64644

    Office

    $225.47

    Facility

    $110.57

    $28.59 higher than Chico for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 64644

    Office

    $208.86

    Facility

    $105.81

    $11.98 higher than Chico for the office setting.

  • Redding

    California · 64644

    Office

    $196.88

    Facility

    $101.33

    The same base rate than Chico for the office setting.

  • Rest Of California

    California · 64644

    Office

    $196.88

    Facility

    $101.33

    The same base rate than Chico for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 64644

    Office

    $201.17

    Facility

    $105.63

    $4.29 higher than Chico for the office setting.

  • Sacramento-Roseville-Folsom

    California · 64644

    Office

    $205.92

    Facility

    $104.54

    $9.04 higher than Chico for the office setting.

  • Salinas

    California · 64644

    Office

    $205.15

    Facility

    $104.12

    $8.27 higher than Chico for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 64644

    Office

    $209.55

    Facility

    $105.29

    $12.67 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 64644

    Office

    $237.59

    Facility

    $114.67

    $40.71 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 64644

    Office

    $237.13

    Facility

    $114.21

    $40.25 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 64644

    Office

    $243.28

    Facility

    $117.58

    $46.40 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 64644

    Office

    $241.43

    Facility

    $115.72

    $44.55 higher than Chico for the office setting.

  • San Luis Obispo-Paso Robles

    California · 64644

    Office

    $201.96

    Facility

    $102.67

    $5.08 higher than Chico for the office setting.

  • Santa Cruz-Watsonville

    California · 64644

    Office

    $211.18

    Facility

    $105.26

    $14.30 higher than Chico for the office setting.

  • Santa Maria-Santa Barbara

    California · 64644

    Office

    $205.80

    Facility

    $104.16

    $8.92 higher than Chico for the office setting.

  • Santa Rosa-Petaluma

    California · 64644

    Office

    $213.25

    Facility

    $106.20

    $16.37 higher than Chico for the office setting.

  • Stockton

    California · 64644

    Office

    $196.88

    Facility

    $101.33

    The same base rate than Chico for the office setting.

  • Vallejo

    California · 64644

    Office

    $224.82

    Facility

    $109.92

    $27.94 higher than Chico for the office setting.

  • Visalia

    California · 64644

    Office

    $196.88

    Facility

    $101.33

    The same base rate than Chico for the office setting.

  • Yuba City

    California · 64644

    Office

    $196.88

    Facility

    $101.33

    The same base rate than Chico for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 64644

    Office

    $216.47

    Facility

    $113.77

    $19.59 higher than Chico for the office setting.

  • Miami

    Florida · 64644

    Office

    $215.99

    Facility

    $125.24

    $19.11 higher than Chico for the office setting.

  • Chicago

    Illinois · 64644

    Office

    $209.03

    Facility

    $121.41

    $12.15 higher than Chico for the office setting.

  • Manhattan

    New York · 64644

    Office

    $221.49

    Facility

    $120.19

    $24.61 higher than Chico for the office setting.

  • Alaska*

    Alaska · 64644

    Office

    $221.97

    Facility

    $129.12

    $25.09 higher than Chico for the office setting.

  • Alabama

    Alabama · 64644

    Office

    $170.14

    Facility

    $93.86

    $26.74 lower than Chico for the office setting.

  • Arkansas

    Arkansas · 64644

    Office

    $167.57

    Facility

    $92.68

    $29.31 lower than Chico for the office setting.

  • Arizona

    Arizona · 64644

    Office

    $185.13

    Facility

    $100.66

    $11.75 lower than Chico for the office setting.

  • Colorado

    Colorado · 64644

    Office

    $196.07

    Facility

    $103.31

    $0.81 lower than Chico for the office setting.

  • Connecticut

    Connecticut · 64644

    Office

    $203.81

    Facility

    $109.92

    $6.93 higher than Chico for the office setting.

  • Delaware

    Delaware · 64644

    Office

    $188.25

    Facility

    $102.12

    $8.63 lower than Chico for the office setting.

  • Fort Lauderdale

    Florida · 64644

    Office

    $203.05

    Facility

    $114.74

    $6.17 higher than Chico for the office setting.

  • Rest Of Florida

    Florida · 64644

    Office

    $192.24

    Facility

    $108.90

    $4.64 lower than Chico for the office setting.

  • Atlanta

    Georgia · 64644

    Office

    $195.47

    Facility

    $106.90

    $1.41 lower than Chico for the office setting.

  • Rest Of Georgia

    Georgia · 64644

    Office

    $180.51

    Facility

    $102.75

    $16.37 lower than Chico for the office setting.

  • Hawaii, Guam

    Hawaii · 64644

    Office

    $201.29

    Facility

    $102.17

    $4.41 higher than Chico for the office setting.

  • Iowa

    Iowa · 64644

    Office

    $172.61

    Facility

    $92.85

    $24.27 lower than Chico for the office setting.

  • Idaho

    Idaho · 64644

    Office

    $174.22

    Facility

    $94.02

    $22.66 lower than Chico for the office setting.

  • East St. Louis

    Illinois · 64644

    Office

    $194.81

    Facility

    $114.61

    $2.07 lower than Chico for the office setting.

  • Rest Of Illinois

    Illinois · 64644

    Office

    $187.95

    Facility

    $108.36

    $8.93 lower than Chico for the office setting.

  • Suburban Chicago

    Illinois · 64644

    Office

    $204.64

    Facility

    $115.11

    $7.76 higher than Chico for the office setting.

  • Indiana

    Indiana · 64644

    Office

    $175.22

    Facility

    $94.41

    $21.66 lower than Chico for the office setting.

  • Kansas

    Kansas · 64644

    Office

    $172.74

    Facility

    $93.93

    $24.14 lower than Chico for the office setting.

  • Kentucky

    Kentucky · 64644

    Office

    $176.46

    Facility

    $98.96

    $20.42 lower than Chico for the office setting.

  • New Orleans

    Louisiana · 64644

    Office

    $185.56

    Facility

    $103.53

    $11.32 lower than Chico for the office setting.

  • Rest Of Louisiana

    Louisiana · 64644

    Office

    $176.56

    Facility

    $99.41

    $20.32 lower than Chico for the office setting.

  • Metropolitan Boston

    Massachusetts · 64644

    Office

    $214.61

    Facility

    $110.52

    $17.73 higher than Chico for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 64644

    Office

    $195.22

    Facility

    $103.42

    $1.66 lower than Chico for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 64644

    Office

    $203.46

    Facility

    $109.92

    $6.58 higher than Chico for the office setting.

  • Rest Of Maryland

    Maryland · 64644

    Office

    $191.63

    Facility

    $103.41

    $5.25 lower than Chico for the office setting.

  • Rest Of Maine

    Maine · 64644

    Office

    $176.21

    Facility

    $96.01

    $20.67 lower than Chico for the office setting.

  • Southern Maine

    Maine · 64644

    Office

    $184.73

    Facility

    $98.33

    $12.15 lower than Chico for the office setting.

  • Detroit

    Michigan · 64644

    Office

    $195.75

    Facility

    $111.62

    $1.13 lower than Chico for the office setting.

  • Rest Of Michigan

    Michigan · 64644

    Office

    $182.16

    Facility

    $102.56

    $14.72 lower than Chico for the office setting.

  • Minnesota

    Minnesota · 64644

    Office

    $184.74

    Facility

    $95.04

    $12.14 lower than Chico for the office setting.

  • Metropolitan Kansas City

    Missouri · 64644

    Office

    $183.20

    Facility

    $101.34

    $13.68 lower than Chico for the office setting.

  • Metropolitan St. Louis

    Missouri · 64644

    Office

    $185.07

    Facility

    $102.08

    $11.81 lower than Chico for the office setting.

  • Rest Of Missouri

    Missouri · 64644

    Office

    $174.05

    Facility

    $98.91

    $22.83 lower than Chico for the office setting.

  • Mississippi

    Mississippi · 64644

    Office

    $170.80

    Facility

    $95.74

    $26.08 lower than Chico for the office setting.

  • Montana**

    Montana · 64644

    Office

    $190.69

    Facility

    $103.52

    $6.19 lower than Chico for the office setting.

  • North Carolina

    North Carolina · 64644

    Office

    $177.97

    Facility

    $96.64

    $18.91 lower than Chico for the office setting.

  • North Dakota**

    North Dakota · 64644

    Office

    $182.78

    Facility

    $95.61

    $14.10 lower than Chico for the office setting.

  • Nebraska

    Nebraska · 64644

    Office

    $173.30

    Facility

    $92.84

    $23.58 lower than Chico for the office setting.

  • New Hampshire

    New Hampshire · 64644

    Office

    $193.90

    Facility

    $103.15

    $2.98 lower than Chico for the office setting.

  • Northern Nj

    New Jersey · 64644

    Office

    $214.27

    Facility

    $113.15

    $17.39 higher than Chico for the office setting.

  • Rest Of New Jersey

    New Jersey · 64644

    Office

    $205.26

    Facility

    $110.06

    $8.38 higher than Chico for the office setting.

  • New Mexico

    New Mexico · 64644

    Office

    $183.59

    Facility

    $103.65

    $13.29 lower than Chico for the office setting.

  • Nevada**

    Nevada · 64644

    Office

    $188.61

    Facility

    $101.34

    $8.27 lower than Chico for the office setting.

  • Nyc Suburbs/Long Island

    New York · 64644

    Office

    $228.30

    Facility

    $124.65

    $31.42 higher than Chico for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 64644

    Office

    $207.42

    Facility

    $111.96

    $10.54 higher than Chico for the office setting.

  • Queens

    New York · 64644

    Office

    $221.93

    Facility

    $118.89

    $25.05 higher than Chico for the office setting.

  • Rest Of New York

    New York · 64644

    Office

    $180.84

    Facility

    $98.02

    $16.04 lower than Chico for the office setting.

  • Ohio

    Ohio · 64644

    Office

    $180.54

    Facility

    $100.95

    $16.34 lower than Chico for the office setting.

  • Oklahoma

    Oklahoma · 64644

    Office

    $175.09

    Facility

    $97.24

    $21.79 lower than Chico for the office setting.

  • Portland

    Oregon · 64644

    Office

    $201.37

    Facility

    $104.52

    $4.49 higher than Chico for the office setting.

  • Rest Of Oregon

    Oregon · 64644

    Office

    $186.28

    Facility

    $99.45

    $10.60 lower than Chico for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 64644

    Office

    $199.21

    Facility

    $108.46

    $2.33 higher than Chico for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 64644

    Office

    $180.29

    Facility

    $100.26

    $16.59 lower than Chico for the office setting.

  • Puerto Rico

    Puerto Rico · 64644

    Office

    $191.82

    Facility

    $103.68

    $5.06 lower than Chico for the office setting.

  • Rhode Island

    Rhode Island · 64644

    Office

    $194.30

    Facility

    $104.25

    $2.58 lower than Chico for the office setting.

  • South Carolina

    South Carolina · 64644

    Office

    $179.73

    Facility

    $99.18

    $17.15 lower than Chico for the office setting.

  • South Dakota**

    South Dakota · 64644

    Office

    $181.85

    Facility

    $94.67

    $15.03 lower than Chico for the office setting.

  • Tennessee

    Tennessee · 64644

    Office

    $173.77

    Facility

    $94.53

    $23.11 lower than Chico for the office setting.

  • Austin

    Texas · 64644

    Office

    $196.17

    Facility

    $103.94

    $0.71 lower than Chico for the office setting.

  • Beaumont

    Texas · 64644

    Office

    $179.13

    Facility

    $99.80

    $17.75 lower than Chico for the office setting.

  • Brazoria

    Texas · 64644

    Office

    $187.19

    Facility

    $100.80

    $9.69 lower than Chico for the office setting.

  • Dallas

    Texas · 64644

    Office

    $188.88

    Facility

    $102.05

    $8.00 lower than Chico for the office setting.

  • Fort Worth

    Texas · 64644

    Office

    $187.87

    Facility

    $101.92

    $9.01 lower than Chico for the office setting.

  • Galveston

    Texas · 64644

    Office

    $188.07

    Facility

    $101.50

    $8.81 lower than Chico for the office setting.

  • Houston

    Texas · 64644

    Office

    $195.39

    Facility

    $108.82

    $1.49 lower than Chico for the office setting.

  • Rest Of Texas

    Texas · 64644

    Office

    $183.39

    Facility

    $100.66

    $13.49 lower than Chico for the office setting.

  • Utah

    Utah · 64644

    Office

    $182.26

    Facility

    $100.32

    $14.62 lower than Chico for the office setting.

  • Virginia

    Virginia · 64644

    Office

    $184.78

    Facility

    $99.09

    $12.10 lower than Chico for the office setting.

  • Virgin Islands

    United States Virgin Islands · 64644

    Office

    $191.82

    Facility

    $103.68

    $5.06 lower than Chico for the office setting.

  • Vermont

    Vermont · 64644

    Office

    $182.94

    Facility

    $96.63

    $13.94 lower than Chico for the office setting.

  • Rest Of Washington

    Washington · 64644

    Office

    $194.56

    Facility

    $102.76

    $2.32 lower than Chico for the office setting.

  • Seattle (King Cnty)

    Washington · 64644

    Office

    $218.07

    Facility

    $111.11

    $21.19 higher than Chico for the office setting.

  • Wisconsin

    Wisconsin · 64644

    Office

    $176.51

    Facility

    $92.99

    $20.37 lower than Chico for the office setting.

  • West Virginia

    West Virginia · 64644

    Office

    $180.99

    Facility

    $105.23

    $15.89 lower than Chico for the office setting.

  • Wyoming**

    Wyoming · 64644

    Office

    $187.25

    Facility

    $100.07

    $9.63 lower than Chico for the office setting.

See how rates vary across the country

64644 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$167.57

$221.97

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$221.971
AL$170.141
AR$167.571
AZ$185.131
CA$196.88–$243.2829
CO$196.071
CT$203.811
DC$216.471
DE$188.251
FL$192.24–$215.993
GA$180.51–$195.472
GU$201.291
HI$201.291
IA$172.611
ID$174.221
IL$187.95–$209.034
IN$175.221
KS$172.741
KY$176.461
LA$176.56–$185.562
MA$195.22–$214.612
MD$191.63–$216.473
ME$176.21–$184.732
MI$182.16–$195.752
MN$184.741
MO$174.05–$185.073
MS$170.801
MT$190.691
NC$177.971
ND$182.781
NE$173.301
NH$193.901
NJ$205.26–$214.272
NM$183.591
NV$188.611
NY$180.84–$228.305
OH$180.541
OK$175.091
OR$186.28–$201.372
PA$180.29–$199.212
PR$191.821
RI$194.301
SC$179.731
SD$181.851
TN$173.771
TX$179.13–$196.178
UT$182.261
VA$184.78–$216.472
VI$191.821
VT$182.941
WA$194.56–$218.072
WI$176.511
WV$180.991
WY$187.251

Explore 64644 on the national rate map →

Where does this rate apply?

Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 64644 in Chico, the physician’s office rate is $196.88 and the facility-setting rate is $101.33: a difference of $95.55.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 64644 in Chico. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$216.57

$196.88 × 110% = $216.57

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64644 in Chico.

PPRRVU2026_Oct_nonQPP.csv

7,187

Code
64644
Physician work
1.77
Practice expense
3.54
Malpractice
0.40

GPCI2026.csv

9

Locality
Chico
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 64644 in Chico
ComponentRVULocality factorAdjusted
Physician work1.77× 1.0171.8001
Practice expense3.54× 1.0963.8798
Malpractice0.40× 0.5360.2144
Total RVUs5.8943
Conversion factor× 33.4009

Office / nonfacility rate, Chico$196.88

Open 64644 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.771.017
Practice expense3.541.096
Malpractice0.40.536

(1.77 × 1.017 + 3.54 × 1.096 + 0.4 × 0.536) × $33.4009 = $196.88

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.771.017
Practice expense0.931.096
Malpractice0.40.536

(1.77 × 1.017 + 0.93 × 1.096 + 0.4 × 0.536) × $33.4009 = $101.33

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

64644 · Office / nonfacility

$196.88

Effective 2026-10-01

The base rate is $18.57 higher than on 2025-10-01, moving from $178.31 to $196.88 (10.4%).

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

    $178.31changed to$196.88

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.82 changed to 1.77
    • Practice expense RVU 3.15 changed to 3.54
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $178.31

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$196.88$101.33RVU26D
2026-07-01$196.88$101.33RVU26C
2026-04-01$196.88$101.33RVU26B
2026-01-01$196.88$101.33RVU26A
2025-10-01$178.31$112.19RVU25D
2025-07-01$178.31$112.19RVU25C
2025-04-01$178.31$112.19RVU25B
2025-01-01$178.31$112.19RVU25A

64644 billing questions

How is this distinguished from 64642?

Both describe treatment in one extremity. Use 64644 when five or more muscles in that extremity are treated; 64642 is for one to four.

Does the muscle count refer to injections or muscles?

Count the muscles treated, not injection sites, needle passes, or units of medication. The record should identify the muscles injected.

Can another extremity be reported separately?

Yes, when treatment is performed in an additional extremity, the applicable additional-extremity code may be reported. Match that code to the number of muscles treated in the additional extremity.

Should modifier 50 be used for both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service. Report qualifying treatment by extremity using the applicable code structure.

Is the chemodenervating drug included?

This code represents the injection service. When the practice supplies the drug, the drug may be reported separately under the applicable drug code, supported by documentation of the product and dose.

What happens when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures subject to the standard multiple-procedure rule are paid at 50% when performed in the same session.

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.

RVUs for 64644PPRRVU2026_Oct_nonQPP.csv, line 7,187 (RVU26D)
Geographic factors for ChicoGPCI2026.csv, line 9 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet