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

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, 2026One payment locality210 Medicare services in 2024

In Nevada, Medicare pays $642.97 for 64568 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$642.97Hospital or facility

Check a contract rate as a % of Medicare · 64568 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 64568 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 64568 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 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.

How Nevada compares for 64568

Across 109 of 109 payment localities, the facility rate for 64568 runs from $572.67 in Arkansas to $829.11 in Miami, FL. Nevada pays $642.97. The RVUs are the same everywhere; the geographic indexes change the dollars.

64568 in Nevada vs other payment areas
  1. Nevada · this page$642.97
  2. Los Angeles, CA · California$685.40+$42.43
  3. Washington, DC area · District of Columbia$734.39+$91.42
  4. Miami, FL · Florida$829.11+$186.14
  5. Chicago, IL · Illinois$797.46+$154.49
  6. Manhattan, NY · New York$782.08+$139.11
  7. Alaska · Alaska$777.25+$134.28

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

Every other payment area

64568 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$582.16
ArkansasArkansas—$572.67
ArizonaArizona—$636.93
Bakersfield, CACalifornia—$650.36
Chico, CACalifornia—$642.21
El Centro, CACalifornia—$642.73
Fresno, CACalifornia—$642.21
Hanford, CACalifornia—$642.21

64568 rates by state

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

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.

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

See 64568 in every payment locality

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.

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,150

Code
64568
Physician work
8.78
Practice expense
7.88
Malpractice
3.10

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Facility calculation for 64568 in Nevada
ComponentRVULocality factorAdjusted
Physician work8.78× 1.0008.7800
Practice expense7.88× 1.0017.8879
Malpractice3.10× 0.8332.5823
Total RVUs19.2502
Conversion factor× 33.4009

Facility rate, Nevada$642.97

Facility: (8.78 × 1 + 7.88 × 1.001 + 3.1 × 0.833) × $33.4009 = $642.97

Open 64568 in the RVU calculator

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

How 64568 has changed in Nevada

64568 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$642.97RVU26D
2026-07-01Not available in this setting$642.97RVU26C
2026-04-01Not available in this setting$642.97RVU26B
2026-01-01Not available in this setting$642.97RVU26A
2025-10-01Not available in this setting$583.97RVU25D
2025-07-01Not available in this setting$583.97RVU25C
2025-04-01Not available in this setting$583.97RVU25B
2025-01-01Not available in this setting$583.97RVU25A
2024-10-01Not available in this setting$596.86RVU24D
2024-07-01Not available in this setting$596.86RVU24C
2024-04-01Not available in this setting$596.86RVU24B
2024-03-09Not available in this setting$596.86RVU24AR
2024-01-01Not available in this setting$587.12RVU24A
2023-10-01Not available in this setting$615.98RVU23D
2023-07-01Not available in this setting$615.98RVU23C
2023-04-01Not available in this setting$615.98RVU23B
2023-01-01Not available in this setting$615.98RVU23A
2022-10-01Not available in this setting$654.58RVU22D
2022-07-01Not available in this setting$654.58RVU22C
2022-04-01Not available in this setting$654.58RVU22B
2022-01-01Not available in this setting$654.58RVU22A
2021-10-01Not available in this setting$663.81RVU21D
2021-07-01Not available in this setting$663.81RVU21C
2021-04-01Not available in this setting$663.81RVU21B
2021-01-01Not available in this setting$663.81RVU21A
2020-10-01Not available in this setting$664.01RVU20D
2020-07-01Not available in this setting$664.01RVU20C
2020-04-01Not available in this setting$664.01RVU20B
2020-01-01Not available in this setting$664.01RVU20A
2019-10-01Not available in this setting$660.31RVU19D
2019-07-01Not available in this setting$660.31RVU19C
2019-04-01Not available in this setting$660.31RVU19B
2019-01-01Not available in this setting$660.31RVU19A
2018-10-01Not available in this setting$662.73RVU18D
2018-07-01Not available in this setting$662.73RVU18C
2018-04-01Not available in this setting$662.73RVU18B
2018-01-01Not available in this setting$662.73RVU18AR1
2017-10-01Not available in this setting$681.68RVU17D
2017-07-01Not available in this setting$681.68RVU17C
2017-04-01Not available in this setting$681.68RVU17B
2017-01-01Not available in this setting$681.68RVU17A
2016-10-01Not available in this setting$696.85RVU16D
2016-07-01Not available in this setting$696.85RVU16C
2016-04-01Not available in this setting$696.85RVU16B
2016-01-01Not available in this setting$696.85RVU16A
2015-10-01Not available in this setting$706.62RVU15D
2015-07-01Not available in this setting$706.62RVU15C
2015-04-01Not available in this setting$703.10RVU15B
2015-01-01Not available in this setting$703.10RVU15A
2014-10-01Not available in this setting$647.34RVU14D
2014-07-01Not available in this setting$647.34RVU14C
2014-04-01Not available in this setting$647.34RVU14B
2014-01-01Not available in this setting$647.34RVU14A
2013-10-01Not available in this setting$646.93RVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 64568 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

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)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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