$144.29
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.
On this page
CMS RVU26D · Effective 2026-10-01
64615 Migraine chemodenervation Medicare reimbursement rates in Rhode Island
Reports bilateral medication injections into head and neck muscles for chronic migraine treatment, commonly performed by a neurologist or headache specialist. Compare 64615 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 64615 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
$158.40
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$109.06
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 64615: Bilateral head and neck chemodenervation for migraine
Reports bilateral medication injections into head and neck muscles for chronic migraine treatment, commonly performed by a neurologist or headache specialist.
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.
CMS billing rules for 64615
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- 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 RVU1.80 · 38%
- Practice expense (office) RVU2.28 · 49%
- Malpractice RVU0.62 · 13%
191.4K
Medicare services in 2024 · #397 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.
64615 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$145.31
Code 64616 is for neck-muscle chemodenervation, typically for cervical dystonia. Code 64615 represents the bilateral head and neck treatment for migraine.
$166.13
Code 64642 applies to chemodenervation of a limited number of muscles in one extremity; 64615 is for bilateral head and neck treatment.
Compare 64615 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
$158.40
Facility
$109.06
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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 64615 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,170
- Code
- 64615
- Physician work
- 1.80
- Practice expense
- 2.28
- Malpractice
- 0.62
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.80 | × 1.019 | 1.8342 |
| Practice expense | 2.28 | × 1.033 | 2.3552 |
| Malpractice | 0.62 | × 0.892 | 0.5530 |
| Total RVUs | 4.7425 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$158.40
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.8 | 1.019 |
| Practice expense | 2.28 | 1.033 |
| Malpractice | 0.62 | 0.892 |
(1.8 × 1.019 + 2.28 × 1.033 + 0.62 × 0.892) × $33.4009 = $158.40
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.8 | 1.019 |
| Practice expense | 0.85 | 1.033 |
| Malpractice | 0.62 | 0.892 |
(1.8 × 1.019 + 0.85 × 1.033 + 0.62 × 0.892) × $33.4009 = $109.06
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.
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 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.
7,16764610,,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
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
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