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CPT code 64566: Tibial nerve stimulation, single treatment2026 Medicare rate & RVUs in Washington, DC area

Reports a single percutaneous posterior tibial nerve stimulation treatment, commonly used for urinary urgency, frequency, or urge incontinence associated with overactive bladder.

CMS RVU26DEffective Oct 1, 2026One payment locality157.3K Medicare services in 2024

In Washington, DC area, Medicare pays $135.51 for 64566 in the office and $28.09 when it’s performed in a hospital or facility.

$135.51Office (non-facility)
$28.09Hospital or facility
+15.6%vs the national office rate ($117.24)

Check a contract rate as a % of Medicare · 64566 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 64566 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 64566 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 64566 covers

A clinician places a fine needle electrode near the posterior tibial nerve at the ankle and delivers electrical stimulation during the treatment. Urologists and urogynecologists commonly use this office-based procedure for patients with overactive bladder symptoms, including urinary urgency, frequency, and urge incontinence. The treatment stimulates the tibial nerve pathway; it does not implant a permanent lead or pulse generator.

Report 64566 for each treatment session, supported by documentation of the indication, the percutaneous stimulation performed, and the treatment date. The needle-electrode placement and stimulation are part of the service. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When performed in the same session as other procedures subject to the multiple procedure rule, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 Washington, DC area compares for 64566

Across 109 of 109 payment localities, the office rate for 64566 runs from $102.68 in Arkansas to $160.40 in San Benito County, CA. Washington, DC area pays $135.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

64566 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$135.51
  2. Los Angeles, CA · California$134.68−$0.83
  3. Miami, FL · Florida$124.71−$10.80
  4. Chicago, IL · Illinois$120.88−$14.63
  5. Manhattan, NY · New York$135.29−$0.22
  6. Alaska · Alaska$132.23−$3.28
  7. Alabama · Alabama$104.32−$31.19

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

64566 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$102.68$24.35
ArizonaArizona$113.95$25.59
Bakersfield, CACalifornia$125.84$25.90
Chico, CACalifornia$125.63$25.69
El Centro, CACalifornia$125.64$25.70
Fresno, CACalifornia$125.63$25.69
Hanford, CACalifornia$125.63$25.69
Madera, CACalifornia$125.63$25.69

64566 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.

$102.68

$143.02

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

View every state and territory as a table
64566 office rate range by state
State / territoryOffice rate rangeLocalities
AK$132.231
AL$104.321
AR$102.681
AZ$113.951
CA$125.63–$160.4029
CO$123.051
CT$125.451
DC$135.511
DE$115.961
FL$114.22–$124.713
GA$107.41–$119.292
GU$129.291
HI$129.291
IA$107.741
ID$108.391
IL$110.27–$121.754
IN$109.091
KS$106.941
KY$106.471
LA$106.19–$111.942
MA$122.12–$136.262
MD$118.38–$135.513
ME$108.74–$115.522
MI$109.26–$115.512
MN$118.351
MO$104.04–$112.673
MS$103.401
MT$117.231
NC$110.021
ND$115.851
NE$108.451
NH$120.851
NJ$127.01–$133.872
NM$109.811
NV$116.941
NY$111.78–$138.495
OH$108.971
OK$106.531
OR$116.16–$127.522
PA$109.30–$121.952
PR$118.251
RI$120.501
SC$109.651
SD$115.681
TN$107.491
TX$108.50–$122.538
UT$111.291
VA$114.93–$135.512
VI$118.251
VT$115.131
WA$121.98–$139.402
WI$111.621
WV$105.771
WY$116.631

See 64566 in every payment locality

How the 64566 rate is calculated

Each of 64566’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 · 64566

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.59

0.59 RVUs× 1.000 GPCI

Practice expense2.85

2.85 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

3.5100

Conversion factor

$33.4009

Medicare rate

$117.24

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,148

Code
64566
Physician work
0.59
Practice expense
2.85
Malpractice
0.07

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 64566 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0540.6219
Practice expense2.85× 1.1783.3573
Malpractice0.07× 1.1130.0779
Total RVUs4.0571
Conversion factor× 33.4009

Office rate, Washington, DC area$135.51

Office: (0.59 × 1.054 + 2.85 × 1.178 + 0.07 × 1.113) × $33.4009 = $135.51

Facility: (0.59 × 1.054 + 0.12 × 1.178 + 0.07 × 1.113) × $33.4009 = $28.09

Open 64566 in the RVU calculator

Payment rules and modifiers for 64566

The CMS indicators that decide how 64566 is paid alongside other services.

CMS payment indicators · 64566

Tibial nerve stimulation, single treatment

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

64566 without 51 · national office

$117.24

Tibial nerve stimulation, single treatment

64566-51 · Second procedure: 50%

$58.62

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 64566

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

Codes related to 64566
CodeHow it relatesOffice range, Washington, DC area
Used instead
64561Sacral nerve lead, percutaneous approachSacral nerve electrode implantation is an implanted neuromodulation option rather than a tibial stimulation session.$851.48
64581Sacral nerve lead, open approachOpen sacral nerve electrode implantation is a different approach to implanted neuromodulation.No office rate
52287Bladder chemodenervation, cystoscopic injectionBladder chemodenervation is another treatment approach for overactive bladder symptoms.$414.63

How 64566 has changed in Washington, DC area

64566 · Office / nonfacility

$135.51

Effective 2026-10-01

The base rate is $7.48 higher than on 2025-10-01, moving from $128.03 to $135.51 (5.8%).

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

    $128.03changed to$135.51

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.60 changed to 0.59
    • Practice expense RVU 2.72 changed to 2.85
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $136.12changed to$128.03

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.82 changed to 2.72
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $133.89changed to$136.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $141.23changed to$133.89

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.83 changed to 2.82
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $149.53changed to$141.23

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.89 changed to 2.83
    • Malpractice RVU 0.09 changed to 0.08
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $157.67changed to$149.53

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.05 changed to 2.89

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $154.65changed to$157.67

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.90 changed to 3.05
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $153.87changed to$154.65

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.96 changed to 2.90
    • Malpractice RVU 0.06 changed to 0.09
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $156.30changed to$153.87

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.02 changed to 2.96

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $152.88changed to$156.30

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.95 changed to 3.02
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $152.20changed to$152.88

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.93 changed to 2.95
    • Malpractice RVU 0.07 changed to 0.06
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $145.79changed to$152.20

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.78 changed to 2.93
    • Malpractice RVU 0.06 changed to 0.07

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $145.07changed to$145.79

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $141.85changed to$145.07

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.72 changed to 2.78
    • Malpractice RVU 0.05 changed to 0.06
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $145.21changed to$141.85

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.99 changed to 2.72
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $145.21

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$135.51$28.09RVU26D
2026-07-01$135.51$28.09RVU26C
2026-04-01$135.51$28.09RVU26B
2026-01-01$135.51$28.09RVU26A
2025-10-01$128.03$31.64RVU25D
2025-07-01$128.03$31.64RVU25C
2025-04-01$128.03$31.64RVU25B
2025-01-01$128.03$31.64RVU25A
2024-10-01$136.12$32.95RVU24D
2024-07-01$136.12$32.95RVU24C
2024-04-01$136.12$32.95RVU24B
2024-03-09$136.12$32.95RVU24AR
2024-01-01$133.89$32.41RVU24A
2023-10-01$141.23$33.45RVU23D
2023-07-01$141.23$33.45RVU23C
2023-04-01$141.23$33.45RVU23B
2023-01-01$141.23$33.45RVU23A
2022-10-01$149.53$34.90RVU22D
2022-07-01$149.53$34.90RVU22C
2022-04-01$149.53$34.90RVU22B
2022-01-01$149.53$34.90RVU22A
2021-10-01$157.67$35.19RVU21D
2021-07-01$157.67$35.19RVU21C
2021-04-01$157.67$35.19RVU21B
2021-01-01$157.67$35.19RVU21A
2020-10-01$154.65$36.12RVU20D
2020-07-01$154.65$36.12RVU20C
2020-04-01$154.65$36.12RVU20B
2020-01-01$154.65$36.12RVU20A
2019-10-01$153.87$34.44RVU19D
2019-07-01$153.87$34.44RVU19C
2019-04-01$153.87$34.44RVU19B
2019-01-01$153.87$34.44RVU19A
2018-10-01$156.30$34.84RVU18D
2018-07-01$156.30$34.84RVU18C
2018-04-01$156.30$34.84RVU18B
2018-01-01$156.30$34.84RVU18AR1
2017-10-01$152.88$34.39RVU17D
2017-07-01$152.88$34.39RVU17C
2017-04-01$152.88$34.39RVU17B
2017-01-01$152.88$34.39RVU17A
2016-10-01$152.20$34.85RVU16D
2016-07-01$152.20$34.85RVU16C
2016-04-01$152.20$34.85RVU16B
2016-01-01$152.20$34.85RVU16A
2015-10-01$145.79$34.51RVU15D
2015-07-01$145.79$34.51RVU15C
2015-04-01$145.07$34.34RVU15B
2015-01-01$145.07$34.34RVU15A
2014-10-01$141.85$33.77RVU14D
2014-07-01$141.85$33.77RVU14C
2014-04-01$141.85$33.77RVU14B
2014-01-01$141.85$33.77RVU14A
2013-10-01$145.21$32.30RVU13D
2013-07-01$145.21$32.30RVU13C
2013-04-01$145.21$32.30RVU13B
2013-01-01$145.21$32.30RVU13AR

Price 64566 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

64566 billing questions

When should 64566 be selected instead of sacral neuromodulation?

Use 64566 for a percutaneous tibial nerve stimulation treatment at the ankle. Sacral neuromodulation codes describe placement of an implanted electrode rather than this single treatment.

Is the needle electrode separately reported?

No. Needle-electrode placement and the electrical stimulation are components of the 64566 treatment.

How many units should be reported?

The code represents one treatment session. Document the date and the stimulation treatment performed; it is not reported by elapsed time.

Should modifier 50 be appended for both ankles?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other affected procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 64566PPRRVU2026_Oct_nonQPP.csv, line 7,148 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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