Billing code 64615: Migraine chemodenervationMedicare rate & RVUs in Ohio
Reports bilateral medication injections into head and neck muscles for chronic migraine treatment, commonly performed by a neurologist or headache specialist.
Medicare pays $150.52 for 64615 in the office in Ohio (Ohio). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 64615 covers
This service covers medication injections into muscles on both sides of the head and neck, commonly using onabotulinumtoxinA for chronic migraine. A neurologist or headache specialist may inject muscles such as the frontalis, temporalis, occipital, cervical paraspinal, and trapezius muscles in an office or outpatient facility. The service represents the overall bilateral treatment, rather than a separate charge for each injection site.
Select the code for bilateral chemodenervation of the covered head and neck muscles, and document the indication, treated sites, laterality, and dose. Report the bilateral code once for the session; modifier 50 does not increase its payment. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Related postoperative visits during the 10-day global period are included. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted. The toxin may be reported separately under its applicable drug code when supplied by the practice.
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.
64615 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $150.52 | $106.92 |
How the 64615 rate is calculated
Each of 64615’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 · 64615
RVUs × geographic indexes × conversion factor
Work1.80
1.80 RVUs× 1.000 GPCI
Practice expense2.28
2.28 RVUs× 1.000 GPCI
Malpractice0.62
0.62 RVUs× 1.000 GPCI
Adjusted RVUs
4.7000
Conversion factor
$33.4009
Medicare rate
$156.98
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64615
64615 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64615
Migraine chemodenervation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 64615
Migraine chemodenervation
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
64615 without 51 · national office
$156.98
Migraine chemodenervation
64615-51 · Second procedure: 50%
$78.49
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%).
64615 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64612Facial chemodenervation
- Use 64615 for the bilateral head and neck muscle treatment associated with chronic migraine. Code 64612 addresses facial-muscle chemodenervation for a different indication and is not the migraine service.
- 64616Neck chemodenervation
- Code 64616 is for neck-muscle chemodenervation, typically for cervical dystonia. Code 64615 represents the bilateral head and neck treatment for migraine.
- 64642Chemodenervation
- Code 64642 applies to chemodenervation of a limited number of muscles in one extremity; 64615 is for bilateral head and neck treatment.
64615 billing questions
Should modifier 50 be appended?
No. The code is already priced as bilateral, and modifier 50 does not increase payment.
Is the service reported per injection site or muscle?
Report the bilateral service once for the session, not once for each injection or treated muscle. Document the sites and dose.
Can the botulinum toxin drug be billed separately?
The practice may report the applicable drug code separately when it supplies the toxin. Keep documentation of the product and dose administered.
How does the 10-day global period affect follow-up visits?
Related postoperative visits during the 10 days after the procedure are included in the service.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard 50% multiple-procedure reduction.
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
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