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CPT code 64582: Nerve stimulator implant, hypoglossal nerve system2026 Medicare rate & RVUs

Open implantation of a hypoglossal nerve stimulation system for obstructive sleep apnea, including its stimulation array, respiratory sensing lead, and pulse generator.

CMS RVU26DEffective Oct 1, 2026109 payment localities6.8K Medicare services in 2024

Medicare pays $722.80 for 64582 nationally in a facility.

Medicare rate · 64582

Nerve stimulator implant, hypoglossal nerve system

Office or facility?

Work RVUs
13.65
Total RVUs
21.64
Global days
090

National rate · 2026

$722.80

Facility setting, before claim adjustments.

See every locality for 64582 →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 64582 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 64582 covers

A surgeon implants a stimulation lead at the hypoglossal nerve, a respiratory sensing lead, and a pulse generator, generally during an operating-room procedure for a patient selected for hypoglossal nerve stimulation to treat obstructive sleep apnea. System testing and programming performed during implantation, and imaging guidance when used, are part of the service. Otolaryngologists and surgeons specializing in sleep-disordered breathing commonly perform the operation.

Report this code for the initial open implantation of the system, not for later revision, replacement, or removal. The operative report should identify the implanted components and document the procedure performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. CMS pays a bilateral procedure reported with modifier 50 at 150%. 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 64582 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

64582 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$668.90
AlaskaUnavailable$933.94
ArizonaUnavailable$707.01
ArkansasUnavailable$662.30
Atlanta, GAUnavailable$740.73
Austin, TXUnavailable$727.75
Bakersfield, CAUnavailable$724.71
Baltimore area, MDUnavailable$760.47
Beaumont, TXUnavailable$700.04
Brazoria, TXUnavailable$710.02

64582 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
64582 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 64582 rate is calculated

Each of 64582’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 · 64582

RVUs × geographic indexes × conversion factor

Office or facility?

Work13.65

13.65 RVUs× 1.000 GPCI

Practice expense6.00

6.00 RVUs× 1.000 GPCI

Malpractice1.99

1.99 RVUs× 1.000 GPCI

Adjusted RVUs

21.6400

Conversion factor

$33.4009

Medicare rate

$722.80

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

Payment rules and modifiers for 64582

64582 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64582

Nerve stimulator implant, hypoglossal nerve system

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 · 64582

Nerve stimulator implant, hypoglossal nerve system

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

64582 without 50 · national facility

$722.80

Nerve stimulator implant, hypoglossal nerve system

64582-50 · Bilateral: 150%

$1,084.20

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

64582 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 64582

    Nerve stimulator implant, hypoglossal nerve system13.65 wRVU

    Not priced

  • 64583

    Stimulator revision, hypoglossal array and generator14.14 wRVU

    Not priced

  • 64584

    Stimulator removal, hypoglossal array and generator11.7 wRVU

    Not priced

  • 64568

    Nerve stimulator, electrode array and pulse generator8.78 wRVU

    Not priced

How to choose

64583Stimulator revisionHypoglossal array and generator
Use 64582 for initial open implantation of the hypoglossal nerve stimulation system. Use 64583 when revising or replacing an existing system.
64584Stimulator removalHypoglossal array and generator
64584 describes removal of an existing hypoglossal nerve stimulation system; it is not the initial implantation code.
64568Nerve stimulatorElectrode array and pulse generator
64568 is an open cranial-nerve neurostimulator implant code for a vagus nerve system. Code 64582 identifies the hypoglossal nerve system used for hypoglossal nerve stimulation.

Codes related to 64582

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

Codes related to 64582
CodeHow it relatesNational office range
Same family
64583Stimulator revision, hypoglossal array and generatorRevision or replacement of the implanted hypoglossal nerve stimulation system.No office rate
64584Stimulator removal, hypoglossal array and generatorRemoval of the implanted hypoglossal nerve stimulation system.No office rate
64568Nerve stimulator, electrode array and pulse generatorOpen cranial-nerve neurostimulator implantation code; it targets the vagus nerve.No office rate

64582 billing questions

How does this differ from code 64583?

64582 describes the initial open implantation. Code 64583 is for revision or replacement of the hypoglossal nerve stimulation system.

Is the pulse generator separately reported?

The initial implantation service includes the pulse generator along with the nerve stimulation system. Do not separately report a generator implantation code for that same system placement.

What documentation supports the initial implantation?

The operative report should show that the hypoglossal nerve stimulation system was implanted and identify the components placed. It should distinguish initial implantation from revision, replacement, or removal.

What postoperative care is included?

CMS assigns a 90-day global period. It includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon be reported?

CMS allows assistant-at-surgery payment only when medical necessity is documented. 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 64582PPRRVU2026_Oct_nonQPP.csv, line 7,156 (RVU26D)

Open CMS sourceHow we calculate rates

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