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See a sample rate comparisonCPT 64612 Fee Schedule
Medicare rates as of October 2026
CPT 64612 is classified under Surgery, in the Surgical Procedures on the Nervous System subgroup.
Muscle Injection For Spasm, An Injection Into A Muscle In Order To Weaken Or Temporarily Paralyze It. The Treatment Typically Is Given To Relieve Muscle Spasms Associated With Various Conditions.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 50 - Bilateral Procedure LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $141.62 national non-facility rate (2026) · View Medicare rates for 64612 |
| Medicaid Fee Schedule | $114.375 median of the 8 states in the free preview · View Medicaid rates for 64612 |
National average reimbursement for CPT 64612 by major payers:
$178.21
BCBS / Anthem
$194.86
UnitedHealthcare
$206.15
Aetna
$206.87
Cigna
Compare published rates across providers.
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CPT 64612
5 of 25 sample ratesHigher to lower in this preview
Lone Star Endoscopy Center LLC
$1,446.00Published rateCold Springs Medical Surgical Group LLC, De La Vina Surgicenter
Cold Springs Medical Surgical Group
$245.00Published rateBenjamin Chung Md Inc, Riverwalk Surgery Center
Benjamin Chung Md Inc
$162.00Published rateSurgery Center Of St. Joseph, LLC
Surgery Center Of St Joseph LLC
$102.00Published rateLakeforest Ambulatory Surgery Center, District Heights Ambulatory Surgery Center
Lakeforest Ambulatory Surgery Center
$60.00Published rate
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See a sample payer proposalCPT 64612 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 64612. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 64611-CPT | Low | Injection To Reduce Saliva, Specific Saliva Glands Are Injected With Botulinum Toxin. The Drug Paralyzes The Glands Temporarily Causing Saliva Flow To Be Reduced. |
| 64612-CPT | Low | Muscle Injection For Spasm, An Injection Into A Muscle In Order To Weaken Or Temporarily Paralyze It. The Treatment Typically Is Given To Relieve Muscle Spasms Associated With Various Conditions. |
| 64615-CPT | Low | Muscle Injection For Spasm, An Injection Into A Muscle In Order To Weaken Or Temporarily Paralyze It. The Treatment Typically Is Given To Relieve Muscle Spasms Associated With Various Conditions. |
| 64616-CPT | Low | Muscle Injection For Spasm, An Injection Into A Muscle In Order To Weaken Or Temporarily Paralyze It. The Treatment Typically Is Given To Relieve Muscle Spasms Associated With Various Conditions. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64612. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64612 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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