Summary & Overview
CPT 64650: Bilateral Axillary Eccrine Gland Injection for Hyperhidrosis
CPT code 64650 represents a minimally invasive, office- or outpatient-based injection of a chemical agent into the eccrine glands of both axillae to treat focal hyperhidrosis. Nationally, this code matters because it identifies a common specialty procedure for patients with bothersome axillary sweating and drives coverage, billing, and utilization discussions across payers. Payors commonly involved in coverage and reimbursement for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what CPT code 64650 denotes clinically, how it is typically delivered (office or outpatient procedural setting), and which major payers are relevant for coverage considerations. The publication provides benchmarks and policy context around procedure coding, typical sites of service, and common billing practices where available. It also outlines clinical context for when bilateral axillary eccrine gland injection is used as a treatment for hyperhidrosis.
Data not available in the input is noted where payer-specific rates, associated taxonomies, ICD-10 mappings, and related codes would normally appear. The focus is national in scope and intended to inform billing staff, practice managers, and policy analysts about the code’s clinical purpose and administrative implications.
Billing Code Overview
CPT code 64650 describes an in-office procedure in which a provider injects a chemical compound into the eccrine glands of both axillae (armpits) to treat hyperhidrosis, a condition of excessive sweating. This is a targeted, minimally invasive procedure intended to reduce focal sweat production in the bilateral axillary region.
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Service type: Office-based procedural treatment for focal hyperhidrosis
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Typical site of service: Ambulatory clinic or office setting; procedure may also occur in other outpatient procedural areas depending on facility capabilities and payer rules
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Clinical & Coding Specifications
Clinical Context
A 28-year-old patient presents to a dermatology clinic with focal, primary axillary hyperhidrosis causing social embarrassment and interference with daily activities despite antiperspirant use and topical agents. After clinical evaluation and documentation of failed conservative measures, the dermatologist discusses options including topical therapies, oral anticholinergics, botulinum toxin injections, and surgical interventions. The patient elects chemical ablation of the eccrine glands in both axillae. On the day of service the patient is consented, vital signs reviewed, and the treatment area is marked. The provider administers a local anesthetic field block, prepares the axillae with antiseptic, and injects the chemical compound into the dermal/epidermal region targeting the eccrine glands bilaterally. The patient is observed for immediate adverse effects, provided post-procedure care instructions, and scheduled for follow-up to assess efficacy and any delayed complications. Billing is submitted for 64650 with documentation including procedure note, informed consent, laterality, and any applicable modifiers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the procedure is performed on the left axilla only |