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CPT code 64583: Stimulator revision, hypoglossal array and generator2026 Medicare rate & RVUs

Revision or replacement of an implanted hypoglossal nerve stimulation array and pulse generator, generally performed to address a problem with an existing system.

CMS RVU26DEffective Oct 1, 2026109 payment localities97 Medicare services in 2024

Medicare pays $745.17 for 64583 nationally in a facility.

Medicare rate · 64583

Stimulator revision, hypoglossal array and generator

Office or facility?

Work RVUs
14.14
Total RVUs
22.31
Global days
090

National rate · 2026

$745.17

Facility setting, before claim adjustments.

See every locality for 64583 →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 64583 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 64583 covers

This operating-room service revises or replaces an implanted hypoglossal nerve stimulation array and pulse generator. It is typically performed by an otolaryngologist or another surgeon experienced with hypoglossal nerve stimulation for obstructive sleep apnea. The work concerns an existing system, rather than the initial implantation used to treat a patient with sleep-disordered breathing.

Report 64583 when the operative work revises or replaces the hypoglossal array and pulse generator; document the existing device, the reason for the procedure, and the components addressed. The code has a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed 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, co-surgeon, and team-surgery payment requires supporting documentation; an assistant also requires documentation of medical necessity.

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 64583 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

64583 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$689.80
AlaskaUnavailable$963.69
ArizonaUnavailable$728.94
ArkansasUnavailable$683.03
Atlanta, GAUnavailable$763.69
Austin, TXUnavailable$750.11
Bakersfield, CAUnavailable$746.84
Baltimore area, MDUnavailable$783.94
Beaumont, TXUnavailable$721.92
Brazoria, TXUnavailable$731.98

64583 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
64583 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 64583 rate is calculated

Each of 64583’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 · 64583

RVUs × geographic indexes × conversion factor

Office or facility?

Work14.14

14.14 RVUs× 1.000 GPCI

Practice expense6.11

6.11 RVUs× 1.000 GPCI

Malpractice2.06

2.06 RVUs× 1.000 GPCI

Adjusted RVUs

22.3100

Conversion factor

$33.4009

Medicare rate

$745.17

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

Payment rules and modifiers for 64583

64583 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64583

Stimulator revision, hypoglossal array and 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)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
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 · 64583

Stimulator revision, hypoglossal array and 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

64583 without 50 · national facility

$745.17

Stimulator revision, hypoglossal array and generator

64583-50 · Bilateral: 150%

$1,117.76

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

64583 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 64583

    Stimulator revision, hypoglossal array and generator14.14 wRVU

    Not priced

  • 64582

    Nerve stimulator implant, hypoglossal nerve system13.65 wRVU

    Not priced

  • 64584

    Stimulator removal, hypoglossal array and generator11.7 wRVU

    Not priced

  • 64590

    Neurostimulator generator, pulse generator or receiver4.97 wRVU

    $428.20

How to choose

64582Nerve stimulator implantHypoglossal nerve system
Choose 64582 for initial implantation of a hypoglossal stimulation system. Choose 64583 when an existing array and pulse generator are revised or replaced.
64584Stimulator removalHypoglossal array and generator
64584 describes removal of the hypoglossal array and pulse generator; 64583 describes revision or replacement of those system components.
64590Neurostimulator generatorPulse generator or receiver
64590 addresses insertion or replacement of a pulse generator for specified peripheral or gastric neurostimulator systems. 64583 is specific to revision or replacement of the hypoglossal array and generator.

Codes related to 64583

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

Codes related to 64583
CodeHow it relatesNational office range
Same family
64582Nerve stimulator implant, hypoglossal nerve systemInitial implantation of the hypoglossal nerve stimulation array and pulse generator.No office rate
64584Stimulator removal, hypoglossal array and generatorRemoval of the hypoglossal nerve stimulation array and pulse generator.No office rate
Used instead
64590Neurostimulator generator, pulse generator or receiverGenerator insertion or replacement for qualifying peripheral or gastric neurostimulator systems.$382.84–$540.26

64583 billing questions

How is 64583 different from 64582?

64583 is for revision or replacement of an existing hypoglossal stimulation array and pulse generator. 64582 is for initial implantation of the system.

When is 64584 reported instead?

64584 describes removal of the hypoglossal nerve stimulation array and pulse generator. Use 64583 when the operative service is revision or replacement rather than removal.

Does 64583 cover both the array and pulse generator?

The code describes revision or replacement of the hypoglossal array and pulse generator. Document which components were addressed; do not treat the code as a separate charge for each component.

What documentation supports 64583?

The operative report should identify the existing hypoglossal system, the reason for revision or replacement, and the work performed on the array and pulse generator.

How are assistant and co-surgeon services handled?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment requires supporting documentation.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 64583PPRRVU2026_Oct_nonQPP.csv, line 7,157 (RVU26D)

Open CMS sourceHow we calculate rates

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