CPT 64650
Global 000 ActiveChemodenerv eccrine glands
CPT 64650 Billing & Documentation Guide
CPT code 64650 (Chemodenerv eccrine glands) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.68, a non-facility practice expense RVU of 1.8, and a malpractice RVU of 0.11, a total non-facility RVU of 2.59 and facility RVU of 1. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $89.07, though rates vary from $76.25 to $113.88 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64650, 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 64650 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 64650 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 64650
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.68 | 0.68 |
| Practice Expense RVU | 1.8 | 0.21 |
| Malpractice RVU | 0.11 | 0.11 |
| Total RVU | 2.59 | 1 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64650
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 | $96.66 | $33.82 | $90.96 - $113.88 | 29 |
| Florida | $90.19 | $36.9 | $85.71 - $94.59 | 3 |
| Georgia | $84.5 | $33.84 | $80.72 - $88.28 | 2 |
| Illinois | $87.91 | $36.59 | $83.35 - $91.73 | 4 |
| Michigan | $84.34 | $34.47 | $81.75 - $86.92 | 2 |
| North Carolina | $81.15 | $31.6 | $81.15 - $81.15 | 1 |
| New York | $95.85 | $36.61 | $82.41 - $102.47 | 5 |
| Ohio | $81.31 | $32.82 | $81.31 - $81.31 | 1 |
| Pennsylvania | $85.74 | $33.72 | $81.38 - $90.09 | 2 |
| Texas | $85.44 | $33.16 | $80.84 - $89.62 | 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 64650
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64650 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00400 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01610 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01710 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01991 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0216T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 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 |
Frequently Asked Questions, CPT 64650
What does CPT code 64650 mean? +
CPT code 64650 represents: Chemodenerv eccrine glands. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 64650? +
The 2026 Medicare national average non-facility payment for CPT 64650 is $89.07. Rates range from $76.25 to $113.88 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64650? +
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 64650? +
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 June 2, 2026.
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