How much does Medicare pay for CPT 64644?

Medicare allowed an average of $147.30 per service and paid $110.68 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $610.02, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64644?

Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity. It was billed 19,479 times to 8,251 Medicare beneficiaries by 388 providers in 2024.

Does 64644 pay differently in an office than a hospital?

Yes. The allowed amount averaged $161.38 in an office setting and $109.24 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 64644 most?

Physical Medicine and Rehabilitation, with 13,259 services from 250 clinicians. Next are Neurology, Nurse Practitioner, Family Practice.

CPT 64644

Injection of chemical for paralysis of nerve muscles on arm or leg, 5 or more muscles, first extremity

$147.30Medicare-allowed amount per service, averaged across 19,479 services

Providers submitted

$610.02

Asking price, not received

Medicare allowed

$147.30

The fee schedule figure

Medicare paid

$110.68

Balance is patient coinsurance

Providers submitted an average of $610.02 for this code and Medicare allowed $147.30 — 4.1× 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 $110.68 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $161.38
Hospital / facility: $109.24

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. 14,218 services were billed in an office setting and 5,261 in a facility.

Services: 19,479
Beneficiaries: 8,251
Providers billing it: 388
Total allowed: $2,869,257

What Medicare pays for CPT 64644

Across 19,479 services billed by 388 providers to 8,251 beneficiaries, Medicare allowed an average of $147.30 per service. That is 2.4 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 64644

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Medicine and Rehabilitation	13,259	5,697	$146.21	250
Neurology	5,612	2,306	$152.47	125
Nurse Practitioner	143	57	$89.16	3
Family Practice	122	37	$118.09	2
Physician Assistant	113	48	$149.04	2
Pain Management	70	31	$148.33	2
Psychiatry	70	39	$136.81	1
Neurosurgery	36	11	$130.64	1
Neuropsychiatry	33	14	$124.24	1
Hand Surgery	21	11	$106.71	1

64644 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	1,664	$167.16	$117.26	27
New York	1,247	$174.92	$117.95	29
Texas	1,170	$133.25	$100.08	23
Illinois	1,067	$153.58	$107.58	20
Massachusetts	1,000	$154.25	$105.92	17
Pennsylvania	995	$147.50	$109.75	18
Missouri	963	$142.14	$105.90	13
Connecticut	843	$178.57	$128.19	12
Wisconsin	839	$114.10	$93.36	13
Minnesota	823	$140.04	$108.44	19
Florida	815	$160.27	$117.49	25
New Jersey	758	$151.92	$107.48	11
Ohio	702	$144.60	$114.41	16
Kansas	607	$138.55	$107.97	8
North Carolina	522	$141.54	$110.95	12
Iowa	452	$125.89	$103.93	7
Nebraska	429	$124.47	$101.63	6
Mississippi	423	$117.34	$92.93	6
Virginia	351	$144.62	$103.13	9
Washington	296	$148.98	$102.01	7
Indiana	291	$142.96	$121.74	6
South Carolina	284	$156.85	$127.06	7
Kentucky	237	$112.77	$93.42	6
Colorado	228	$151.94	$109.57	5
District of Columbia	214	$163.76	$107.84	5
Alabama	205	$148.49	$131.61	5
Maryland	195	$143.35	$102.95	7
Delaware	169	$139.56	$119.23	3
New Hampshire	166	$110.59	$79.93	4
Tennessee	166	$161.75	$132.71	3
Georgia	157	$118.88	$91.50	5
Louisiana	132	$161.90	$135.18	3
Idaho	114	$99.73	$86.55	2
North Dakota	105	$97.49	$79.01	3
Arizona	98	$163.86	$135.65	3
Rhode Island	94	$171.30	$136.89	3
Michigan	93	$149.85	$116.97	4
Montana	90	$154.12	$113.88	2
Utah	89	$128.76	$105.07	2
Arkansas	78	$97.07	$83.37	2
South Dakota	67	$162.71	$128.62	2
Nevada	52	$178.57	$130.51	2
New Mexico	51	$113.23	$79.10	1
Maine	47	$105.34	$85.01	2
West Virginia	35	$103.86	$68.83	1
Oregon	28	$170.13	$141.23	1
Oklahoma	28	$144.31	$111.37	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
64616Injection of chemical for paralysis of nerve muscles on side of neck e$175.81
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
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.