# CPT 64645: Chemodenervation 1 Extremity Ea Addl 5/> Muscles

Medicare CPT 64645 pays $129.60 in a non-facility setting and $70.48 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $113.82 in Arkansas to $151.94 in Alaska, a 33% spread.

Web page: https://www.med-reveal.com/rates/64645-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Neurology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $129.60 |
| National facility | $70.48 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $151.94 | $88.98 |
| District of Columbia | $146.29 | $76.65 |
| New York | $144.25 | $78.30 |
| New Jersey | $142.05 | $75.47 |
| Florida | $140.59 | $81.27 |
| California | $139.37 | $69.41 |
| Washington | $138.82 | $71.43 |
| Connecticut | $138.50 | $74.82 |
| Massachusetts | $138.11 | $71.69 |
| Illinois | $137.64 | $80.52 |
| Hawaii | $134.79 | $67.57 |
| Maryland | $134.16 | $72.53 |
| Colorado | $132.31 | $69.41 |
| Rhode Island | $131.63 | $70.56 |
| New Hampshire | $131.16 | $69.62 |
| Oregon | $130.72 | $68.44 |
| Puerto Rico | $130.23 | $70.46 |
| Virgin Islands | $130.23 | $70.46 |
| Michigan | $129.79 | $74.27 |
| Montana | $129.57 | $70.45 |
| Pennsylvania | $129.30 | $71.39 |
| Georgia | $128.55 | $72.15 |
| Texas | $127.91 | $69.71 |
| Delaware | $127.80 | $69.39 |
| Nevada | $127.77 | $68.59 |
| Wyoming | $126.64 | $67.52 |
| New Mexico | $125.83 | $71.62 |
| Arizona | $125.70 | $68.42 |
| Virginia | $125.02 | $66.90 |
| West Virginia | $124.95 | $73.58 |
| Utah | $124.07 | $68.50 |
| Louisiana | $123.79 | $69.82 |
| Minnesota | $123.71 | $62.88 |
| Missouri | $123.42 | $69.17 |
| Ohio | $123.35 | $69.38 |
| Vermont | $123.26 | $64.73 |
| North Dakota | $122.85 | $63.73 |
| South Carolina | $122.36 | $67.73 |
| Maine | $122.12 | $65.63 |
| South Dakota | $122.05 | $62.94 |
| North Carolina | $120.62 | $65.46 |
| Kentucky | $120.55 | $67.99 |
| Oklahoma | $119.27 | $66.48 |
| Wisconsin | $118.68 | $62.04 |
| Indiana | $118.44 | $63.64 |
| Idaho | $117.79 | $63.40 |
| Tennessee | $117.71 | $63.97 |
| Kansas | $116.97 | $63.53 |
| Nebraska | $116.93 | $62.36 |
| Iowa | $116.56 | $62.46 |
| Mississippi | $116.51 | $65.61 |
| Alabama | $115.57 | $63.84 |
| Arkansas | $113.82 | $63.04 |

## Related codes

- 10140: I&d Hematoma Seroma/fluid Collection — https://www.med-reveal.com/rates/10140-cpt-fee-schedule
- 11055: Paring/cutting Benign Hyperkeratotic Lesion 1 — https://www.med-reveal.com/rates/11055-cpt-fee-schedule
- 11056: Paring/cutting Benign Hyperkeratotic Lesion 2-4 — https://www.med-reveal.com/rates/11056-cpt-fee-schedule
- 11057: Paring/cutting Benign Hyperkeratotic Lesion >4 — https://www.med-reveal.com/rates/11057-cpt-fee-schedule
- 11403: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 2.1-3.0 Cm — https://www.med-reveal.com/rates/11403-cpt-fee-schedule
- 11404: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 3.1-4.0 Cm — https://www.med-reveal.com/rates/11404-cpt-fee-schedule
- 11406: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l >4.0 Cm — https://www.med-reveal.com/rates/11406-cpt-fee-schedule
- 11603: Excision Mal Lesion Trunk/arm/leg 2.1-3.0 Cm — https://www.med-reveal.com/rates/11603-cpt-fee-schedule

Commercial negotiated rates for 64645 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules