CPT code 63655: Paddle lead implant, laminectomy approach2026 Medicare rate & RVUs in Missouri
Reports surgical placement of an epidural paddle electrode for spinal cord stimulation, typically for a patient receiving a permanent implant after a successful trial.
CMS doesn’t publish an office rate for 63655 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 63655 covers
A surgeon places an epidural paddle electrode along the spinal cord through a laminotomy or laminectomy. Neurosurgeons and other surgeons experienced in spinal cord stimulation perform this procedure in an operating room, commonly for chronic pain when a patient is proceeding to permanent stimulation after a temporary trial. This code distinguishes surgical paddle-lead placement from percutaneous electrode placement.
Report the service when the operative record supports surgical exposure and epidural placement of a paddle electrode; document the approach, lead placement, and indication. Report pulse-generator placement separately when performed, using 63685. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.
Where 63655 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $814.10 |
| Metropolitan St. Louis, MO | Unavailable | $821.91 |
| Rest of Missouri | Unavailable | $786.37 |
How the 63655 rate is calculated
Each of 63655’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 · 63655
RVUs × geographic indexes × conversion factor
Work10.65
10.65 RVUs× 1.000 GPCI
Practice expense10.63
10.63 RVUs× 1.000 GPCI
Malpractice3.83
3.83 RVUs× 1.000 GPCI
Adjusted RVUs
25.1100
Conversion factor
$33.4009
Medicare rate
$838.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 63655
63655 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63655
Paddle lead implant, laminectomy approach
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 63655
Paddle lead implant, laminectomy approach
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
63655 without 51 · national facility
$838.70
Paddle lead implant, laminectomy approach
63655-51 · Second procedure: 50%
$419.35
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%).
63655 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 63650Neurostimulator leadPercutaneous epidural array
- Use 63655 for paddle placement through surgical spinal exposure; use 63650 for percutaneous epidural electrode-array placement.
- 63685Neurostimulator generatorSpinal pulse generator or receiver
- 63655 covers placement of the epidural paddle electrode. Code 63685 covers placement or replacement of the pulse generator or receiver.
- 63664Paddle lead revisionSurgically exposed electrode
- 63655 is for initial surgical placement of a paddle electrode; 63664 is for revision or replacement of an existing paddle electrode.
- 63662Paddle lead removalLaminotomy or laminectomy approach
- 63655 reports paddle-electrode implantation. Code 63662 reports removal of an existing paddle electrode.
63655 billing questions
How does 63655 differ from 63650?
63655 is for paddle-electrode placement through a laminotomy or laminectomy. Code 63650 describes percutaneous placement of an epidural electrode array.
Can the pulse generator be reported separately?
Yes. When a spinal neurostimulator pulse generator or receiver is also implanted, report that service separately with 63685.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Should modifier 50 be used for bilateral paddle leads?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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
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