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CPT code 64568: Nerve stimulator, electrode array and pulse generator2026 Medicare rate & RVUs

Reports open implantation of a cranial nerve stimulation system, commonly a vagus nerve electrode array and pulse generator for refractory epilepsy.

CMS RVU26DEffective Oct 1, 2026109 payment localities210 Medicare services in 2024

Medicare pays $660.00 for 64568 nationally in a facility.

Medicare rate · 64568

Nerve stimulator, electrode array and pulse generator

Office or facility?

Work RVUs
8.78
Total RVUs
19.76
Global days
090

National rate · 2026

$660.00

Facility setting, before claim adjustments.

See every locality for 64568 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 64568 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 64568 covers

A surgeon implants a stimulation lead on a cranial nerve and places the pulse generator, typically in a subcutaneous chest pocket. Vagus nerve stimulation for medically refractory epilepsy is a common example. The operation generally involves a neck incision to expose the nerve and a separate site for the generator, and is performed in an operating room by a neurosurgeon or another surgeon experienced with the implant.

Report 64568 for the initial open implantation of the cranial nerve electrode array and pulse generator. The operative report should identify the nerve targeted, the open implantation approach, and placement of both the lead and generator. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of 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 64568 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

64568 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$582.16
AlaskaUnavailable$777.25
ArizonaUnavailable$636.93
ArkansasUnavailable$572.67
Atlanta, GAUnavailable$685.90
Austin, TXUnavailable$664.05
Bakersfield, CAUnavailable$650.36
Baltimore area, MDUnavailable$708.45
Beaumont, TXUnavailable$628.96
Brazoria, TXUnavailable$637.20

64568 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
64568 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 64568 rate is calculated

Each of 64568’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 · 64568

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.78

8.78 RVUs× 1.000 GPCI

Practice expense7.88

7.88 RVUs× 1.000 GPCI

Malpractice3.10

3.10 RVUs× 1.000 GPCI

Adjusted RVUs

19.7600

Conversion factor

$33.4009

Medicare rate

$660.00

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

Payment rules and modifiers for 64568

64568 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64568

Nerve stimulator, electrode array and pulse generator

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 64568

Nerve stimulator, electrode array and pulse generator

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

64568 without 50 · national facility

$660.00

Nerve stimulator, electrode array and pulse generator

64568-50 · Bilateral: 150%

$990.00

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

64568 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 64568

    Nerve stimulator, electrode array and pulse generator8.78 wRVU

    Not priced

  • 64567

    Nerve field stimulation, cranial nerves1.5 wRVU

    $1,239.51

  • 64569

    Vagus nerve electrode, revision or replacement10.73 wRVU

    Not priced

  • 64570

    Vagus stimulator removal, electrode array and generator8.87 wRVU

    Not priced

  • 64582

    Nerve stimulator implant, hypoglossal nerve system13.65 wRVU

    Not priced

How to choose

64567Nerve field stimulationCranial nerves
64568 is the open cranial nerve implantation that includes the array and pulse generator; 64567 is the percutaneous cranial nerve electrode-array approach.
64569Vagus nerve electrodeRevision or replacement
64568 describes initial implantation. Use 64569 for revision or replacement of an existing cranial nerve array and pulse generator.
64570Vagus stimulator removalElectrode array and generator
64570 is for removal of a cranial nerve stimulation array and pulse generator, not initial placement.
64582Nerve stimulator implantHypoglossal nerve system
64582 is specific to open implantation of a hypoglossal nerve stimulation system; 64568 covers other cranial nerve stimulation implantation, such as vagus nerve stimulation.

Codes related to 64568

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

Codes related to 64568
CodeHow it relatesNational office range
Used instead
64567Nerve field stimulation, cranial nervesPercutaneous cranial nerve electrode-array implantation, rather than the open approach.$1,069.96–$1,765.89
64575Nerve stimulation, open peripheral nerve placementOpen implantation for a peripheral nerve target rather than a cranial nerve.No office rate
64582Nerve stimulator implant, hypoglossal nerve systemOpen hypoglossal nerve stimulation-system implantation.No office rate
Same family
64569Vagus nerve electrode, revision or replacementRevision or replacement service for an existing cranial nerve stimulation system.No office rate
64570Vagus stimulator removal, electrode array and generatorRemoval service for a cranial nerve stimulation system.No office rate

64568 billing questions

When should 64568 be chosen over 64567?

Use 64568 for open implantation of the cranial nerve electrode array and pulse generator. Code 64567 describes a percutaneous cranial nerve electrode-array approach.

Does 64568 include the pulse generator?

Yes. The service covers implantation of both the cranial nerve electrode array and the pulse generator.

How is a revision or replacement reported?

For revision or replacement of an existing cranial nerve stimulation array and pulse generator, compare 64569 rather than reporting the initial-implant code.

What does the 90-day global period include?

It includes the day-before preoperative visit and 90 days of related postoperative care.

How are multiple procedures and bilateral services paid?

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%.

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.

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 64568PPRRVU2026_Oct_nonQPP.csv, line 7,150 (RVU26D)

Open CMS sourceHow we calculate rates

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