CPT 64616
Global 010 ActiveChemodenerv musc neck dyston
CPT 64616 Billing & Documentation Guide
CPT code 64616 (Chemodenerv musc neck dyston) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.49, a non-facility practice expense RVU of 2.31, and a malpractice RVU of 0.5, a total non-facility RVU of 4.3 and facility RVU of 2.98. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $145.6, though rates vary from $124.65 to $175.7 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64616, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 64616 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 64616 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 64616
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.49 | 1.49 |
| Practice Expense RVU | 2.31 | 0.99 |
| Malpractice RVU | 0.5 | 0.5 |
| Total RVU | 4.3 | 2.98 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64616
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $151.91 | $99.74 | $144.13 - $175.45 | 29 |
| Florida | $159.69 | $115.46 | $148.63 - $172.32 | 3 |
| Georgia | $143.43 | $101.37 | $138.5 - $148.36 | 2 |
| Illinois | $156.41 | $113.81 | $146.31 - $165.99 | 4 |
| Michigan | $145.73 | $104.32 | $139.07 - $152.38 | 2 |
| North Carolina | $132.43 | $91.29 | $132.43 - $132.43 | 1 |
| New York | $160.91 | $111.72 | $134.81 - $175.7 | 5 |
| Ohio | $137.04 | $96.79 | $137.04 - $137.04 | 1 |
| Pennsylvania | $143.64 | $100.46 | $136.38 - $150.91 | 2 |
| Texas | $141.51 | $98.11 | $135.49 - $149.76 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 64616
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64616 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0333T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0464T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 64616
What does CPT code 64616 mean? +
CPT code 64616 represents: Chemodenerv musc neck dyston. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 010.
What is the Medicare reimbursement for CPT 64616? +
The 2026 Medicare national average non-facility payment for CPT 64616 is $145.6. Rates range from $124.65 to $175.7 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64616? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 64616? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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