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64615 CPT Code: Chemodenervation (Botox) for Migraines

Last Updated: February 2, 2026

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When Botox (onabotulinumtoxinA) is used for the treatment of chronic migraines, the administration (the physician's work of doing the injections) is billed using CPT 64615.

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Billing 64615 vs J0585

A complete claim for migraine Botox treatment will have two distinct lines:

  1. 64615: The surgical administration code (Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral).
  2. J0585: The drug supply code (Botox), billed for the exact number of units administered.

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Bilateral is Inherent

The descriptor for 64615 explicitly states "bilateral." Therefore, you should NOT append Modifier 50 to 64615. The standard migraine protocol involves 31 injections across the head and neck, and the single unit of 64615 covers all of them.

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NCCI Edits

64615 bundles most local anesthesia and needle guidance. Do not bill E/M codes on the same day unless evaluating a completely separate, unrelated medical issue.

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