CPT code 64566: Tibial nerve stimulation, single treatment2026 Medicare rate & RVUs in Missouri
Reports a single percutaneous posterior tibial nerve stimulation treatment, commonly used for urinary urgency, frequency, or urge incontinence associated with overactive bladder.
Medicare pays $104.04–$112.67 for 64566 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
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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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.
Where 64566 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.
3 payment localities
$104.04 to $112.67
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $111.38 | $25.75 |
| Metropolitan St. Louis, MO | $112.67 | $25.86 |
| Rest of Missouri | $104.04 | $25.44 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
64566 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64561Sacral nerve leadPercutaneous approach
- 64566 describes a percutaneous tibial nerve stimulation treatment at the ankle. 64561 is for implantation of a sacral nerve electrode.
- 64581Sacral nerve leadOpen approach
- 64581 describes open implantation of a sacral nerve electrode; it is not a single-session tibial nerve stimulation treatment.
- 52287Bladder chemodenervationCystoscopic injection
- 52287 describes cystoscopic bladder chemodenervation. Choose it for the bladder injection procedure, not percutaneous tibial nerve stimulation.
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
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