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See a sample rate comparisonCPT 64642 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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 | None RT - Right side of body PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 64642 |
| Medicaid Fee Schedule | View Medicaid rates for 64642 |
National average reimbursement for CPT 64642 by major payers:
$199.45
$199.07
$212.14
$192.34
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CPT 64642
5 of 25 sample ratesHigher to lower in this preview
Greenville Surgery Center, LLC, Texas Health Surgery Center Dallas
Greenville Surgery Center LLC
$1,963.00Published rateSurgery Center Of Columbia Lp
$1,062.00Published rateBrown Urology, Inc., Collyer Street Operatory
Brown Urology Inc
$721.00Published rateThe Aesthetic Surgery Centre, PLLC, Cedar Laser And Surgery Center
Aesthetic Surgery Centre, PLLC
$400.00Published rateSkin Cancer Treatment Center, L.L.C.
Skin Cancer Treatment Center LLC
$147.00Published rate
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See a sample payer proposalCPT 64642 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64642 code is part of the Surgery services used for Surgical Procedures on the Nervous System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 64642 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 64642-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. |
| 64643-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. |
| 64644-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. |
| 64645-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 64642. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64642 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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