CPT code 64568: Nerve stimulator, electrode array and pulse generator2026 Medicare rate & RVUs in Louisiana
Reports open implantation of a cranial nerve stimulation system, commonly a vagus nerve electrode array and pulse generator for refractory epilepsy.
CMS doesn’t publish an office rate for 64568 in Louisiana.
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 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 in Louisiana
| Payment locality | Office | Facility |
|---|---|---|
| New Orleans, LA | Unavailable | $658.55 |
| Rest of Louisiana | Unavailable | $625.39 |
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
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
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
| 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 · 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.
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).
64568 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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