How much does Medicare pay for CPT 64616?

Medicare allowed an average of $175.81 per service and paid $133.06 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $686.38, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64616?

Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box. It was billed 50,926 times to 19,592 Medicare beneficiaries by 843 providers in 2024.

Does 64616 pay differently in an office than a hospital?

Yes. The allowed amount averaged $183.73 in an office setting and $140.54 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 64616 most?

Neurology, with 41,341 services from 645 clinicians. Next are Physical Medicine and Rehabilitation, Pain Management, Nurse Practitioner.

CPT 64616

Injection of chemical for paralysis of nerve muscles on side of neck excluding voice box

$175.81Medicare-allowed amount per service, averaged across 50,926 services

Providers submitted

$686.38

Asking price, not received

Medicare allowed

$175.81

The fee schedule figure

Medicare paid

$133.06

Balance is patient coinsurance

Providers submitted an average of $686.38 for this code and Medicare allowed $175.81 — 3.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $133.06 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $183.73
Hospital / facility: $140.54

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 41,591 services were billed in an office setting and 9,335 in a facility.

Services: 50,926
Beneficiaries: 19,592
Providers billing it: 843
Total allowed: $8,953,300

What Medicare pays for CPT 64616

Across 50,926 services billed by 843 providers to 19,592 beneficiaries, Medicare allowed an average of $175.81 per service. That is 2.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 64616

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	41,341	15,499	$178.28	645
Physical Medicine and Rehabilitation	5,396	2,306	$168.57	107
Pain Management	813	327	$151.49	15
Nurse Practitioner	642	313	$151.98	18
Physician Assistant	520	234	$136.87	13
Interventional Pain Management	462	209	$186.05	9
Anesthesiology	447	202	$185.41	11
Otolaryngology	284	120	$111.51	7
Neuropsychiatry	221	76	$173.46	4
Internal Medicine	218	83	$168.55	4
Nephrology	155	51	$239.83	1
Psychiatry	106	47	$186.87	2
Ophthalmology	97	39	$155.09	2
Family Practice	83	29	$137.86	1
Neurosurgery	80	27	$138.93	2

64616 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	5,849	$174.54	$126.26	79
Florida	4,769	$199.45	$142.72	64
Texas	3,492	$183.96	$143.27	59
New York	3,344	$211.01	$140.57	58
Pennsylvania	2,774	$172.82	$130.43	55
Ohio	2,082	$172.50	$136.59	41
Massachusetts	1,818	$178.78	$126.38	26
Arizona	1,749	$168.36	$133.98	28
Colorado	1,571	$174.59	$135.00	28
Illinois	1,542	$197.39	$138.23	31
Washington	1,495	$170.78	$122.16	20
Virginia	1,406	$168.54	$124.29	22
Minnesota	1,229	$168.46	$136.51	22
North Carolina	1,219	$153.54	$124.42	21
Maryland	1,182	$184.22	$133.60	21
Missouri	1,144	$172.93	$130.79	23
Georgia	909	$172.93	$137.74	19
Tennessee	887	$147.43	$124.21	18
Alabama	833	$144.77	$131.10	12
Wisconsin	832	$134.30	$114.92	16
South Carolina	800	$163.35	$133.88	15
Michigan	775	$190.77	$135.94	14
Mississippi	652	$158.40	$132.88	7
Iowa	649	$130.49	$107.17	11
New Jersey	635	$190.07	$134.16	13
Oklahoma	635	$177.39	$140.06	4
Connecticut	577	$206.63	$141.45	11
Kentucky	560	$156.45	$120.99	8
Kansas	506	$149.05	$116.72	5
Delaware	495	$164.95	$134.62	4
Indiana	440	$159.19	$135.70	8
Montana	421	$149.41	$111.35	9
Oregon	419	$158.36	$124.65	9
Arkansas	404	$133.84	$117.00	5
District of Columbia	379	$232.74	$154.68	6
South Dakota	357	$155.11	$123.30	5
Nebraska	330	$133.81	$110.81	7
Louisiana	302	$173.38	$142.83	6
Maine	279	$156.52	$120.19	5
Nevada	245	$171.17	$133.14	6
Idaho	172	$141.46	$120.94	3
North Dakota	156	$146.13	$115.89	3
New Mexico	135	$140.79	$101.63	3
Utah	118	$134.24	$99.53	3
West Virginia	112	$160.87	$118.33	3
New Hampshire	78	$148.12	$110.30	2
Rhode Island	53	$104.71	$78.52	2
Hawaii	45	$141.84	$109.05	1
Vermont	42	$118.09	$91.14	1
Wyoming	29	$109.44	$84.87	1

Related codes

64635Destruction of lower or sacral spinal facet joint nerves$498.61
64636Destruction of lower or sacral spinal facet joint nerves$170.99
64615Injection of chemical for paralysis of facial and neck nerve muscles o$139.05
64633Destruction of upper or middle spinal facet joint nerves$505.48
64640Destruction of peripheral nerve or branch$128.51
64634Destruction of upper or middle spinal facet joint nerves$174.09
64612Injection of chemical for paralysis of nerve muscles on side of face$170.37
64642Injection of chemical for paralysis of nerve muscles on arm or leg$120.67
64643Injection of chemical for paralysis of nerve muscles on arm or leg$81.52
64644Injection of chemical for paralysis of nerve muscles on arm or leg$147.30
64624Destruction of nerve branches of knee$425.22
64617Injection of chemical for paralysis of nerve muscles on side of voice$193.92

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.