$155.71–$187.65
Choose 64616 for treatment directed at neck muscles, such as for cervical dystonia. Choose 64615 when the chemodenervation is directed at muscles for chronic migraine treatment.
On this page
CMS RVU26D · Effective 2026-10-01
64616 Neck chemodenervation Medicare reimbursement rates in California
Reports medication-induced weakening of neck muscles, commonly for cervical dystonia, when treatment targets neck muscles rather than laryngeal or other muscle groups. Compare 64616 office and facility rates across CMS payment localities in California.
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 64616 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$144.13–$175.45
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $31.32 per service.
Facility setting
$95.81–$111.88
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $16.07 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 64616 pays more and less in California
29 payment localities
$144.13 to $175.45
Chemodenervation
About 64616: Neck muscle chemodenervation for dystonia
Reports medication-induced weakening of neck muscles, commonly for cervical dystonia, when treatment targets neck muscles rather than laryngeal or other muscle groups.
This service involves injecting a medication such as botulinum toxin into neck muscles to reduce involuntary muscle activity. Neurologists, physiatrists, and other clinicians who treat movement disorders commonly perform it in an office or facility setting. Cervical dystonia, with involuntary neck contractions or abnormal head posture, is a typical indication. The code is for neck muscles and excludes laryngeal muscle treatment.
Select the code based on the treated anatomy and clinical service, not simply the injection location or number of injection sites. Document the indication, muscles treated, medication, and treatment details. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 64616
- 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 RVU1.49 · 35%
- Practice expense (office) RVU2.31 · 54%
- Malpractice RVU0.50 · 12%
80.7K
Medicare services in 2024 · #629 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.
64616 compared with similar codes
Office rates for California, from the same CMS release.
$164.51–$200.88
64617 is for laryngeal muscle treatment with EMG guidance. 64616 covers neck muscles outside the larynx.
$167.47–$205.87
64642 applies to chemodenervation of one extremity involving 1–4 muscles. Use 64616 when the treated muscles are in the neck.
Compare 64616 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $145.45 | Facility $97.12 |
| Chico | Office $144.13 | Facility $95.81 |
| El Centro | Office $144.21 | Facility $95.89 |
| Fresno | Office $144.13 | Facility $95.81 |
| Hanford-Corcoran | Office $144.13 | Facility $95.81 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $154.17 | Facility $102.02 |
| Madera | Office $144.13 | Facility $95.81 |
| Merced | Office $144.13 | Facility $95.81 |
| Modesto | Office $144.13 | Facility $95.81 |
| Napa | Office $163.08 | Facility $104.97 |
| Oxnard-Thousand Oaks-Ventura | Office $152.76 | Facility $100.65 |
| Redding | Office $144.13 | Facility $95.81 |
| Rest Of California | Office $144.13 | Facility $95.81 |
| Riverside-San Bernardino-Ontario | Office $149.47 | Facility $101.15 |
| Sacramento-Roseville-Folsom | Office $150.24 | Facility $98.97 |
| Salinas | Office $149.69 | Facility $98.59 |
| San Diego-Chula Vista-Carlsbad | Office $152.59 | Facility $99.86 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $170.95 | Facility $108.79 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $170.38 | Facility $108.22 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $175.45 | Facility $111.88 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $173.13 | Facility $109.55 |
| San Luis Obispo-Paso Robles | Office $147.45 | Facility $97.23 |
| Santa Cruz-Watsonville | Office $153.51 | Facility $99.94 |
| Santa Maria-Santa Barbara | Office $150.08 | Facility $98.67 |
| Santa Rosa-Petaluma | Office $154.96 | Facility $100.82 |
| Stockton | Office $144.13 | Facility $95.81 |
| Vallejo | Office $162.26 | Facility $104.15 |
| Visalia | Office $144.13 | Facility $95.81 |
| Yuba City | Office $144.13 | Facility $95.81 |
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64616 billing questions
When should this code be chosen instead of 64615?
Use 64616 for treatment directed at neck muscles, commonly for cervical dystonia. Code 64615 is for chemodenervation directed at muscles for chronic migraine treatment.
Can this code be used for injections into laryngeal muscles?
No. Laryngeal muscle treatment is reported with 64617, which identifies laryngeal chemodenervation with EMG guidance.
How is bilateral treatment reported?
Report modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.
Are follow-up visits included?
Related postoperative visits during the 10-day global period are included in the procedure.
What documentation supports reporting this code?
Document the clinical indication, the neck muscles treated, the medication administered, and the treatment performed. The record should distinguish neck treatment from laryngeal, facial, or extremity muscle treatment.
How does CMS handle this code when other procedures are performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid 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.
7,16864611,,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
7,17364620,,Injection treatment of nerve,A,,2.82,3.58,,1.83,,0.36,6.76,5.01,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,17464624,,Dstrj nulyt agt gnclr nrv,A,,2.44,9.65,,1.33,,0.22,12.31,3.99,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00