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See a sample rate comparisonCPT 64616 Fee Schedule
Medicare rates as of October 2026
CPT 64616 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 RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $143.62 national non-facility rate (2026) · View Medicare rates for 64616 |
| Medicaid Fee Schedule | $108.83 median of the 8 states in the free preview · View Medicaid rates for 64616 |
National average reimbursement for CPT 64616 by major payers:
$181.13
BCBS / Anthem
$179.35
UnitedHealthcare
$189.33
Aetna
$190.24
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 64616.
CPT 64616
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Port Charlotte Ltd
$2,965.00Published rateHolston Valley Ambulatory Surgery Center, LLC
$566.00Published rateCapital City Surgery Center, LLC
Capital City Surgery Center LLC
$253.00Published rateJoon Y. Kim, Md, PC, Clayton Cataract & Laser Surgery Center
$120.00Published ratePresence Lakeshore Gastroenterology, LLC
Presence Lakeshore Gastroenterology LLC Dba Des Plaines Endoscopy Cent
$52.00Published rate
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See a sample payer proposalCPT 64616 vs. Other Surgical Procedures on the Nervous System Codes
The table lists codes related to 64616. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| 64617-CPT | Moderate | 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. |
| 64620-CPT | Moderate | Inject Nerve For Pain Control, An Injection Into A Nerve To Deaden The Sensation Of Pain At A Location. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64616. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64616 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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Frequently Asked Questions
For general estimates, you can often contact your insurance provider or the healthcare facility directly. However, for a detailed lookup of fee schedules based on CPT codes and your specific location, you should use tools like Payerprice. Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and specific location to get relevant pricing information for their specific situation.
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare professionals to describe medical, surgical, and diagnostic services. They are crucial because they help ensure consistent communication and billing practices across the healthcare system. Understanding the CPT code for a service helps you research its cost and verify billing.
To find specific pricing information for a CPT code based on your location and for your specific situation, it is recommended to use a specialized tool. Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and specific location to get detailed pricing information.