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CPT code 64561: Sacral nerve lead, percutaneous approach2026 Medicare rate & RVUs in Iowa

Reports percutaneous placement of a sacral nerve stimulation lead, commonly for a sacral neuromodulation trial addressing urinary or bowel dysfunction.

CMS RVU26DEffective Oct 1, 2026One payment locality41K Medicare services in 2024

In Iowa, Medicare pays $681.77 for 64561 in the office and $250.23 when it’s performed in a hospital or facility.

$681.77Office (non-facility)
$250.23Hospital or facility
−8.2%vs the national office rate ($742.84)

Check a contract rate as a % of Medicare · 64561 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 64561 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 64561 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 64561 covers

The clinician advances an electrode lead through a sacral foramen to stimulate a sacral nerve, commonly the S3 nerve. Urologists, urogynecologists, and other clinicians performing sacral neuromodulation use this approach to assess or treat conditions such as urinary urgency, nonobstructive retention, or fecal incontinence. Placement is generally performed in an operating or procedure room with stimulation used to assess lead position and response.

Choose this code when the sacral lead is placed percutaneously; an open approach is reported differently. The record should identify the sacral target, percutaneous technique, lead placement, and the clinical indication. CMS assigns a 10-day global period, so related postoperative visits during that period are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 Iowa compares for 64561

Across 109 of 109 payment localities, the office rate for 64561 runs from $654.44 in Arkansas to $989.70 in San Benito County, CA. Iowa pays $681.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

64561 in Iowa vs other payment areas
  1. Iowa · this page$681.77
  2. Los Angeles, CA · California$840.64+$158.87
  3. Washington, DC area · District of Columbia$851.48+$169.71
  4. Miami, FL · Florida$803.31+$121.54
  5. Chicago, IL · Illinois$779.22+$97.45
  6. Manhattan, NY · New York$856.45+$174.68
  7. Alaska · Alaska$855.25+$173.48

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

Every other payment area

64561 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$664.37$251.70
ArkansasArkansas$654.44$249.32
ArizonaArizona$722.47$265.46
Bakersfield, CACalifornia$788.32$271.42
Chico, CACalifornia$786.13$269.24
El Centro, CACalifornia$786.26$269.36
Fresno, CACalifornia$786.13$269.24
Hanford, CACalifornia$786.13$269.24

64561 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.

$654.44

$887.92

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

View every state and territory as a table
64561 office rate range by state
State / territoryOffice rate rangeLocalities
AK$855.251
AL$664.371
AR$654.441
AZ$722.471
CA$786.13–$989.7029
CO$774.081
CT$793.281
DC$851.481
DE$734.701
FL$731.64–$803.313
GA$689.24–$757.052
GU$806.371
HI$806.371
IA$681.771
ID$686.371
IL$709.89–$779.224
IN$690.481
KS$678.501
KY$680.681
LA$679.60–$714.342
MA$769.24–$852.252
MD$749.04–$851.483
ME$690.11–$728.732
MI$699.02–$741.092
MN$740.881
MO$667.56–$716.933
MS$661.131
MT$742.791
NC$697.561
ND$727.961
NE$685.621
NH$761.881
NJ$802.10–$842.212
NM$702.991
NV$739.191
NY$708.36–$877.845
OH$695.991
OK$679.391
OR$733.23–$799.282
PA$697.12–$773.032
PR$748.411
RI$761.341
SC$697.981
SD$726.201
TN$682.031
TX$692.39–$771.708
UT$707.841
VA$726.28–$851.482
VI$748.411
VT$725.051
WA$767.81–$869.862
WI$702.791
WV$682.791
WY$736.321

See 64561 in every payment locality

How the 64561 rate is calculated

Each of 64561’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 · 64561

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.30

5.30 RVUs× 1.000 GPCI

Practice expense16.19

16.19 RVUs× 1.000 GPCI

Malpractice0.75

0.75 RVUs× 1.000 GPCI

Adjusted RVUs

22.2400

Conversion factor

$33.4009

Medicare rate

$742.84

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,147

Code
64561
Physician work
5.30
Practice expense
16.19
Malpractice
0.75

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 64561 in Iowa
ComponentRVULocality factorAdjusted
Physician work5.30× 1.0005.3000
Practice expense16.19× 0.91514.8139
Malpractice0.75× 0.3970.2978
Total RVUs20.4116
Conversion factor× 33.4009

Office rate, Iowa$681.77

Office: (5.3 × 1 + 16.19 × 0.915 + 0.75 × 0.397) × $33.4009 = $681.77

Facility: (5.3 × 1 + 2.07 × 0.915 + 0.75 × 0.397) × $33.4009 = $250.23

Open 64561 in the RVU calculator

Payment rules and modifiers for 64561

64561 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64561

Sacral nerve lead, percutaneous approach

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 64561

Sacral nerve lead, percutaneous approach

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 50 · payment effect

With and without the modifier

64561 without 50 · national office

$742.84

Sacral nerve lead, percutaneous approach

64561-50 · Bilateral: 150%

$1,114.26

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 64561

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

Codes related to 64561
CodeHow it relatesOffice range, Iowa
Used instead
64581Sacral nerve lead, open approachSacral lead placement using an open rather than percutaneous approach.No office rate
64566Tibial nerve stimulation, single treatmentProvides tibial nerve stimulation rather than sacral nerve lead placement.$107.74
64555Nerve stimulation, percutaneous peripheral nervePercutaneous electrode placement for a peripheral nerve other than the sacral nerve.$2,040.42
Often billed with
64590Neurostimulator generator, pulse generator or receiverMay be reported with lead placement when a pulse generator is also implanted.$393.28

How 64561 has changed in Iowa

64561 · Office / nonfacility

$681.77

Effective 2026-10-01

The base rate is $44.79 higher than on 2025-10-01, moving from $636.98 to $681.77 (7.0%).

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

    $636.98changed to$681.77

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.44 changed to 5.30
    • Practice expense RVU 15.25 changed to 16.19
    • Malpractice RVU 0.72 changed to 0.75
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $673.13changed to$636.98

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 15.82 changed to 15.25
    • Malpractice RVU 0.74 changed to 0.72

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $662.15changed to$673.13

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $689.74changed to$662.15

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 16.04 changed to 15.82
    • Malpractice RVU 0.72 changed to 0.74
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $713.92changed to$689.74

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 16.41 changed to 16.04
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $728.57changed to$713.92

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 16.70 changed to 16.41
    • Malpractice RVU 0.69 changed to 0.72

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $705.94changed to$728.57

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 15.26 changed to 16.70
    • Malpractice RVU 0.66 changed to 0.69
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $691.24changed to$705.94

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 14.86 changed to 15.26
    • Malpractice RVU 0.62 changed to 0.66
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $780.93changed to$691.24

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 17.63 changed to 14.86

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $767.40changed to$780.93

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 17.36 changed to 17.63
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $756.22changed to$767.40

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 17.16 changed to 17.36
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $758.16changed to$756.22

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 17.13 changed to 17.16
    • Malpractice RVU 0.63 changed to 0.62

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $754.39changed to$758.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $737.34changed to$754.39

    • Conversion factor 35.8228 changed to 35.7547
    • Work RVU 7.15 changed to 5.44
    • Practice expense RVU 14.66 changed to 17.13
    • Malpractice RVU 0.75 changed to 0.63
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $737.62changed to$737.34

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 15.98 changed to 14.66
    • Malpractice RVU 0.78 changed to 0.75
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $737.62

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$681.77$250.23RVU26D
2026-07-01$681.77$250.23RVU26C
2026-04-01$681.77$250.23RVU26B
2026-01-01$681.77$250.23RVU26A
2025-10-01$636.98$273.14RVU25D
2025-07-01$636.98$273.14RVU25C
2025-04-01$636.98$273.14RVU25B
2025-01-01$636.98$273.14RVU25A
2024-10-01$673.13$279.87RVU24D
2024-07-01$673.13$279.87RVU24C
2024-04-01$673.13$279.87RVU24B
2024-03-09$673.13$279.87RVU24AR
2024-01-01$662.15$275.30RVU24A
2023-10-01$689.74$282.07RVU23D
2023-07-01$689.74$282.07RVU23C
2023-04-01$689.74$282.07RVU23B
2023-01-01$689.74$282.07RVU23A
2022-10-01$713.92$285.16RVU22D
2022-07-01$713.92$285.16RVU22C
2022-04-01$713.92$285.16RVU22B
2022-01-01$713.92$285.16RVU22A
2021-10-01$728.57$286.77RVU21D
2021-07-01$728.57$286.77RVU21C
2021-04-01$728.57$286.77RVU21B
2021-01-01$728.57$286.77RVU21A
2020-10-01$705.94$293.82RVU20D
2020-07-01$705.94$293.82RVU20C
2020-04-01$705.94$293.82RVU20B
2020-01-01$705.94$293.82RVU20A
2019-10-01$691.24$293.43RVU19D
2019-07-01$691.24$293.43RVU19C
2019-04-01$691.24$293.43RVU19B
2019-01-01$691.24$293.43RVU19A
2018-10-01$780.93$293.44RVU18D
2018-07-01$780.93$293.44RVU18C
2018-04-01$780.93$293.44RVU18B
2018-01-01$780.93$293.44RVU18AR1
2017-10-01$767.40$292.18RVU17D
2017-07-01$767.40$292.18RVU17C
2017-04-01$767.40$292.18RVU17B
2017-01-01$767.40$292.18RVU17A
2016-10-01$756.22$290.09RVU16D
2016-07-01$756.22$290.09RVU16C
2016-04-01$756.22$290.09RVU16B
2016-01-01$756.22$290.09RVU16A
2015-10-01$758.16$291.32RVU15D
2015-07-01$758.16$291.32RVU15C
2015-04-01$754.39$289.87RVU15B
2015-01-01$754.39$289.87RVU15A
2014-10-01$737.34$380.09RVU14D
2014-07-01$737.34$380.09RVU14C
2014-04-01$737.34$380.09RVU14B
2014-01-01$737.34$380.09RVU14A
2013-10-01$737.62$367.03RVU13D
2013-07-01$737.62$367.03RVU13C
2013-04-01$737.62$367.03RVU13B
2013-01-01$737.62$367.03RVU13AR

Price 64561 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

64561 billing questions

How does this differ from 64581?

64561 is for percutaneous sacral lead placement. 64581 describes sacral lead placement through an open approach.

Is the pulse generator included?

No. The pulse generator is a separate service, reported with 64590 when it is implanted or replaced.

What documentation supports 64561?

Document the indication, sacral nerve target, percutaneous placement technique, and lead location or stimulation findings.

How does Medicare handle bilateral reporting?

The CMS rule specifies modifier 50 for a bilateral procedure, with payment at 150%.

Are postoperative visits separately reported during the global period?

Related postoperative visits for 10 days are included in the 10-day global period.

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 64561PPRRVU2026_Oct_nonQPP.csv, line 7,147 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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