$162.98
Both codes cover trunk muscle chemodenervation. Choose 64646 for one to five muscles and 64647 for six or more.
On this page
CMS RVU26D · Effective 2026-10-01
64647 Trunk chemodenervation Medicare reimbursement rates in Utah
Reports botulinum toxin chemodenervation of six or more trunk muscles, such as paraspinal or abdominal muscles, for a documented movement or tone disorder. Compare 64647 office and facility rates across CMS payment localities in Utah.
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 64647 in Utah?
Utah 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
$181.45
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$112.69
1 of 1 localities have a supported rate.
Payment area: Utah
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 64647: Trunk muscle chemodenervation, six or more muscles
Reports botulinum toxin chemodenervation of six or more trunk muscles, such as paraspinal or abdominal muscles, for a documented movement or tone disorder.
This service involves injecting a chemodenervating agent, commonly botulinum toxin, into six or more distinct trunk muscles to reduce unwanted muscle activity. Neurologists, physiatrists, and other qualified clinicians may perform it in an office or outpatient facility for conditions such as trunk spasticity or dystonia. Paraspinal and abdominal muscles are examples of trunk targets; the treated muscles should be identified in the record.
Select this code based on the number of distinct trunk muscles treated, not the number of needle passes or injection points. Documentation should support the indication and identify the muscles injected; report the toxin product separately when applicable. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 64647
- 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 RVU2.06 · 36%
- Practice expense (office) RVU3.11 · 55%
- Malpractice RVU0.50 · 9%
1.7K
Medicare services in 2024 · #2583 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.
64647 compared with similar codes
Office rates for Utah, from the same CMS release.
$156.21
64642 is for one extremity treated in one to four muscles. Use 64647 for six or more trunk muscles.
$182.26
64644 covers five or more muscles in one extremity; 64647 applies to six or more muscles in the trunk.
Compare 64647 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
Utah →
Office / nonfacility
$181.45
Facility
$112.69
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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 64647 in Utah.
PPRRVU2026_Oct_nonQPP.csv
7,190
- Code
- 64647
- Physician work
- 2.06
- Practice expense
- 3.11
- Malpractice
- 0.50
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.06 | × 1.000 | 2.0600 |
| Practice expense | 3.11 | × 0.940 | 2.9234 |
| Malpractice | 0.50 | × 0.898 | 0.4490 |
| Total RVUs | 5.4324 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$181.45
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.06 | 1 |
| Practice expense | 3.11 | 0.94 |
| Malpractice | 0.5 | 0.898 |
(2.06 × 1 + 3.11 × 0.94 + 0.5 × 0.898) × $33.4009 = $181.45
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.06 | 1 |
| Practice expense | 0.92 | 0.94 |
| Malpractice | 0.5 | 0.898 |
(2.06 × 1 + 0.92 × 0.94 + 0.5 × 0.898) × $33.4009 = $112.69
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.
64647 billing questions
When should this code be selected instead of 64646?
Use 64647 when six or more trunk muscles are treated. Code 64646 is for one to five trunk muscles.
Do injection points determine the muscle count?
No. Select the code by the number of distinct muscles treated, not the number of needle passes or injection points. Document the muscles injected.
Can modifier 50 be used for injections on both sides of the trunk?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Is the botulinum toxin product included in this service?
The code represents the chemodenervation procedure. Report the toxin product separately under its applicable drug code when separately reportable.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's payment.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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.
7,18764644,,Chemodenerv 1 extrem 5/> mus,A,,1.77,3.54,,0.93,,0.40,5.71,3.10,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,18864645,,Chemodenerv 1 extrem 5/> ea,A,,1.36,2.18,,0.41,,0.34,3.88,2.11,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,18964646,,Chemodenerv trunk musc 1-5,A,,1.76,2.86,,0.87,,0.48,5.10,3.11,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19064647,,Chemodenerv trunk musc 6/>,A,,2.06,3.11,,0.92,,0.50,5.67,3.48,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19164650,,Chemodenerv eccrine glands,A,,0.68,1.80,,0.21,,0.11,2.59,1.00,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19264653,,Chemodenerv eccrine glands,A,,0.86,2.03,,0.26,,0.17,3.06,1.29,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19364654,,1st opn implt bat modulj sys,A,,11.00,2.96,NA,2.96,,2.79,16.75,16.75,0,090,0.11,0.76,0.13,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985