$158.40
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 in Rhode Island
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 in Rhode Island.
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 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$144.29
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$109.78
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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.
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 rates for Rhode Island, from the same CMS release.
$145.31
Use 64616 for chemodenervation of neck muscles, such as in cervical dystonia; use 64612 for facial nerve–innervated muscles.
$166.13
64642 applies to treatment of one extremity with one to four muscles. 64612 applies to unilateral facial nerve muscle treatment.
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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
$144.29
Facility
$109.78
Need rates for a whole code list?
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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 64612 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,169
- Code
- 64612
- Physician work
- 1.37
- Practice expense
- 2.58
- Malpractice
- 0.29
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.37 | × 1.019 | 1.3960 |
| Practice expense | 2.58 | × 1.033 | 2.6651 |
| Malpractice | 0.29 | × 0.892 | 0.2587 |
| Total RVUs | 4.3198 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$144.29
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1.019 |
| Practice expense | 2.58 | 1.033 |
| Malpractice | 0.29 | 0.892 |
(1.37 × 1.019 + 2.58 × 1.033 + 0.29 × 0.892) × $33.4009 = $144.29
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1.019 |
| Practice expense | 1.58 | 1.033 |
| Malpractice | 0.29 | 0.892 |
(1.37 × 1.019 + 1.58 × 1.033 + 0.29 × 0.892) × $33.4009 = $109.78
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.
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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537