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CPT code 63650: Neurostimulator lead, percutaneous epidural array2026 Medicare rate & RVUs in Hawaii, Guam, HI

Percutaneous epidural neurostimulator lead placement is reported when a clinician advances an electrode array through a needle, commonly for spinal cord stimulation.

CMS RVU26DEffective Oct 1, 2026One payment locality125.8K Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $2,669.10 for 63650 in the office and $380.24 when it’s performed in a hospital or facility.

$2,669.10Office (non-facility)
$380.24Hospital or facility
+11.7%vs the national office rate ($2,388.50)

Check a contract rate as a % of Medicare · 63650 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 63650 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 63650 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 63650 covers

The clinician advances a neurostimulator electrode array through a percutaneous needle into the epidural space, positioning it to deliver spinal cord stimulation. Pain medicine physicians, anesthesiologists, and neurosurgeons commonly perform the procedure for patients with persistent pain, including during a temporary stimulation trial before a permanent system is considered. The lead may connect to an external stimulator during a trial or to an implanted pulse generator for ongoing therapy.

Report 63650 for percutaneous epidural array placement, rather than the open laminectomy approach in 63655. The operative or procedure note should support the percutaneous approach, epidural placement, and array work performed. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Hawaii, Guam, HI compares for 63650

Across 109 of 109 payment localities, the office rate for 63650 runs from $2,075.47 in Arkansas to $3,343.02 in San Benito County, CA. Hawaii, Guam, HI pays $2,669.10. The RVUs are the same everywhere; the geographic indexes change the dollars.

63650 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$2,669.10
  2. Los Angeles, CA · California$2,778.84+$109.74
  3. Washington, DC area · District of Columbia$2,783.07+$113.97
  4. Miami, FL · Florida$2,516.15−$152.95
  5. Chicago, IL · Illinois$2,434.95−$234.15
  6. Manhattan, NY · New York$2,763.81+$94.71
  7. Alaska · Alaska$2,631.46−$37.64

Other areas in Hawaii first, then benchmark localities. Bars start at $0.

Every other payment area

63650 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$2,110.88$349.44
ArkansasArkansas$2,075.47$346.24
ArizonaArizona$2,318.69$368.02
Bakersfield, CACalifornia$2,587.02$380.69
Chico, CACalifornia$2,584.63$378.30
El Centro, CACalifornia$2,584.76$378.43
Fresno, CACalifornia$2,584.63$378.30
Hanford, CACalifornia$2,584.63$378.30

63650 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$2,075.47

$2,963.83

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
63650 office rate range by state
State / territoryOffice rate rangeLocalities
AK$2,631.461
AL$2,110.881
AR$2,075.471
AZ$2,318.691
CA$2,584.63–$3,343.0229
CO$2,521.791
CT$2,562.651
DC$2,783.071
DE$2,361.451
FL$2,308.08–$2,516.153
GA$2,163.60–$2,428.572
GU$2,669.101
HI$2,669.101
IA$2,191.601
ID$2,204.251
IL$2,218.10–$2,467.994
IN$2,219.501
KS$2,171.001
KY$2,149.901
LA$2,142.52–$2,266.462
MA$2,499.72–$2,808.232
MD$2,414.21–$2,783.073
ME$2,208.18–$2,359.602
MI$2,206.65–$2,332.072
MN$2,431.671
MO$2,093.97–$2,286.343
MS$2,085.641
MT$2,388.451
NC$2,236.311
ND$2,372.821
NE$2,208.131
NH$2,472.501
NJ$2,596.27–$2,745.652
NM$2,217.071
NV$2,386.221
NY$2,274.20–$2,828.455
OH$2,203.461
OK$2,154.781
OR$2,372.14–$2,621.822
PA$2,212.44–$2,485.082
PR$2,411.521
RI$2,460.341
SC$2,222.711
SD$2,370.981
TN$2,182.511
TX$2,194.99–$2,509.468
UT$2,258.051
VA$2,344.54–$2,783.072
VI$2,411.521
VT$2,354.171
WA$2,498.07–$2,878.662
WI$2,280.811
WV$2,120.931
WY$2,381.641

See 63650 in every payment locality

How the 63650 rate is calculated

Each of 63650’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 63650

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.97

6.97 RVUs× 1.000 GPCI

Practice expense63.75

63.75 RVUs× 1.000 GPCI

Malpractice0.79

0.79 RVUs× 1.000 GPCI

Adjusted RVUs

71.5100

Conversion factor

$33.4009

Medicare rate

$2,388.50

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,077

Code
63650
Physician work
6.97
Practice expense
63.75
Malpractice
0.79

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 63650 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work6.97× 1.0006.9700
Practice expense63.75× 1.13772.4838
Malpractice0.79× 0.5790.4574
Total RVUs79.9112
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$2669.10

Office: (6.97 × 1 + 63.75 × 1.137 + 0.79 × 0.579) × $33.4009 = $2669.10

Facility: (6.97 × 1 + 3.48 × 1.137 + 0.79 × 0.579) × $33.4009 = $380.24

Open 63650 in the RVU calculator

Payment rules and modifiers for 63650

63650 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63650

Neurostimulator lead, percutaneous epidural array

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 63650

Neurostimulator lead, percutaneous epidural array

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

63650 without 51 · national office

$2,388.50

Neurostimulator lead, percutaneous epidural array

63650-51 · Second procedure: 50%

$1,194.25

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 63650

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 63650
CodeHow it relatesOffice range, Hawaii, Guam, HI
Used instead
63655Paddle lead implant, laminectomy approachUses a laminectomy approach to place epidural neurostimulator electrodes.No office rate
Often billed with
63685Neurostimulator generator, spinal pulse generator or receiverMay accompany permanent lead placement when an implanted pulse generator is inserted.No office rate
Same family
63663Lead revision, percutaneous electrode arrayCovers revision or replacement of existing percutaneous spinal electrode arrays.$1,029.14

How 63650 has changed in Hawaii, Guam, HI

63650 · Office / nonfacility

$2669.10

Effective 2026-10-01

The base rate is $275.11 higher than on 2025-10-01, moving from $2393.99 to $2669.10 (11.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $2393.99changed to$2669.10

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.15 changed to 6.97
    • Practice expense RVU 57.79 changed to 63.75
    • Malpractice RVU 0.82 changed to 0.79
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $2560.78changed to$2393.99

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 60.33 changed to 57.79

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $2518.98changed to$2560.78

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $2633.92changed to$2518.98

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 61.14 changed to 60.33
    • Malpractice RVU 0.79 changed to 0.82
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $2753.99changed to$2633.92

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 62.84 changed to 61.14
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $2605.42changed to$2753.99

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 58.56 changed to 62.84
    • Malpractice RVU 0.76 changed to 0.79

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $2187.40changed to$2605.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 46.26 changed to 58.56
    • Malpractice RVU 0.77 changed to 0.76
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1848.61changed to$2187.40

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 38.15 changed to 46.26
    • Malpractice RVU 0.68 changed to 0.77
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1500.45changed to$1848.61

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 29.76 changed to 38.15

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1490.18changed to$1500.45

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 29.41 changed to 29.76
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1522.23changed to$1490.18

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 30.06 changed to 29.41
    • Malpractice RVU 0.67 changed to 0.68
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1522.10changed to$1522.23

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 29.92 changed to 30.06
    • Malpractice RVU 0.68 changed to 0.67

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1514.52changed to$1522.10

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1511.80changed to$1514.52

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 29.91 changed to 29.92
    • Malpractice RVU 0.61 changed to 0.68
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$1511.80

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$2,669.10$380.24RVU26D
2026-07-01$2,669.10$380.24RVU26C
2026-04-01$2,669.10$380.24RVU26B
2026-01-01$2,669.10$380.24RVU26A
2025-10-01$2,393.99$413.78RVU25D
2025-07-01$2,393.99$413.78RVU25C
2025-04-01$2,393.99$413.78RVU25B
2025-01-01$2,393.99$413.78RVU25A
2024-10-01$2,560.78$423.52RVU24D
2024-07-01$2,560.78$423.52RVU24C
2024-04-01$2,560.78$423.52RVU24B
2024-03-09$2,560.78$423.52RVU24AR
2024-01-01$2,518.98$416.61RVU24A
2023-10-01$2,633.92$427.72RVU23D
2023-07-01$2,633.92$427.72RVU23C
2023-04-01$2,633.92$427.72RVU23B
2023-01-01$2,633.92$427.72RVU23A
2022-10-01$2,753.99$435.68RVU22D
2022-07-01$2,753.99$435.68RVU22C
2022-04-01$2,753.99$435.68RVU22B
2022-01-01$2,753.99$435.68RVU22A
2021-10-01$2,605.42$438.98RVU21D
2021-07-01$2,605.42$438.98RVU21C
2021-04-01$2,605.42$438.98RVU21B
2021-01-01$2,605.42$438.98RVU21A
2020-10-01$2,187.40$443.04RVU20D
2020-07-01$2,187.40$443.04RVU20C
2020-04-01$2,187.40$443.04RVU20B
2020-01-01$2,187.40$443.04RVU20A
2019-10-01$1,848.61$437.77RVU19D
2019-07-01$1,848.61$437.77RVU19C
2019-04-01$1,848.61$437.77RVU19B
2019-01-01$1,848.61$437.77RVU19A
2018-10-01$1,500.45$437.71RVU18D
2018-07-01$1,500.45$437.71RVU18C
2018-04-01$1,500.45$437.71RVU18B
2018-01-01$1,500.45$437.71RVU18AR1
2017-10-01$1,490.18$437.40RVU17D
2017-07-01$1,490.18$437.40RVU17C
2017-04-01$1,490.18$437.40RVU17B
2017-01-01$1,490.18$437.40RVU17A
2016-10-01$1,522.23$442.59RVU16D
2016-07-01$1,522.23$442.59RVU16C
2016-04-01$1,522.23$442.59RVU16B
2016-01-01$1,522.23$442.59RVU16A
2015-10-01$1,522.10$442.32RVU15D
2015-07-01$1,522.10$442.32RVU15C
2015-04-01$1,514.52$440.12RVU15B
2015-01-01$1,514.52$440.12RVU15A
2014-10-01$1,511.80$444.03RVU14D
2014-07-01$1,511.80$444.03RVU14C
2014-04-01$1,511.80$444.03RVU14B
2014-01-01$1,511.80$444.03RVU14A
2013-10-01Not available in this setting$459.14RVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 63650 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

63650 billing questions

How is 63650 different from 63655?

63650 describes percutaneous placement through a needle. Use 63655 for epidural electrode placement through a laminectomy approach.

Can 63650 be reported with an implanted pulse generator code?

It may be reported with 63685 when percutaneous lead placement and pulse generator insertion are performed as part of the same permanent system procedure. A temporary trial typically uses an external stimulator rather than an implanted generator.

Should modifier 50 be appended for bilateral placement?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.

Are postoperative visits included?

Related postoperative visits during the 10-day global period are included in the procedure's payment.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for 63650. Co-surgeons and team surgery are not permitted.

What documentation supports 63650?

Document the percutaneous approach, epidural electrode array placement, and the clinical purpose, such as a spinal cord stimulation trial or permanent lead placement.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 63650PPRRVU2026_Oct_nonQPP.csv, line 7,077 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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