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CPT code 64584: Stimulator removal, hypoglossal array and generator2026 Medicare rate & RVUs

Reports surgical removal of an implanted hypoglossal nerve stimulation array and pulse generator, commonly performed when an obstructive sleep apnea device must be explanted.

CMS RVU26DEffective Oct 1, 2026109 payment localities106 Medicare services in 2024

Medicare pays $631.61 for 64584 nationally in a facility.

Medicare rate · 64584

Stimulator removal, hypoglossal array and generator

Office or facility?

Work RVUs
11.7
Total RVUs
18.91
Global days
090

National rate · 2026

$631.61

Facility setting, before claim adjustments.

See every locality for 64584 →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 64584 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 64584 covers

This operation removes the implanted hypoglossal nerve stimulation system, including its electrode array and pulse generator. It is typically performed by an otolaryngologist or another surgeon experienced in sleep-related airway procedures, usually in an operating room. The system is used to stimulate the hypoglossal nerve during sleep for selected patients with obstructive sleep apnea; removal may be needed when the device must be explanted rather than revised or replaced.

Report 64584 when the procedure removes the hypoglossal array and pulse generator, not for initial implantation or revision/replacement. The operative report should identify the hypoglossal system and document the components removed. CMS 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery, co-surgeon, and team-surgery payment require the applicable supporting documentation.

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 64584 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

64584 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$583.96
AlaskaUnavailable$813.47
ArizonaUnavailable$617.73
ArkansasUnavailable$578.12
Atlanta, GAUnavailable$647.14
Austin, TXUnavailable$636.59
Bakersfield, CAUnavailable$634.50
Baltimore area, MDUnavailable$664.76
Beaumont, TXUnavailable$611.02
Brazoria, TXUnavailable$620.59

64584 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
64584 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 64584 rate is calculated

Each of 64584’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 · 64584

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.70

11.70 RVUs× 1.000 GPCI

Practice expense5.51

5.51 RVUs× 1.000 GPCI

Malpractice1.70

1.70 RVUs× 1.000 GPCI

Adjusted RVUs

18.9100

Conversion factor

$33.4009

Medicare rate

$631.61

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

Payment rules and modifiers for 64584

64584 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64584

Stimulator removal, 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 · 64584

Stimulator removal, 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

64584 without 50 · national facility

$631.61

Stimulator removal, hypoglossal array and generator

64584-50 · Bilateral: 150%

$947.42

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

64584 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 64584

    Stimulator removal, hypoglossal array and generator11.7 wRVU

    Not priced

  • 64582

    Nerve stimulator implant, hypoglossal nerve system13.65 wRVU

    Not priced

  • 64583

    Stimulator revision, hypoglossal array and generator14.14 wRVU

    Not priced

  • 64570

    Vagus stimulator removal, electrode array and generator8.87 wRVU

    Not priced

  • 64595

    Generator revision, sacral or gastric system3.7 wRVU

    $348.04

How to choose

64582Nerve stimulator implantHypoglossal nerve system
64582 reports initial implantation of the hypoglossal array and pulse generator; 64584 reports removal of that system.
64583Stimulator revisionHypoglossal array and generator
64583 is for revision or replacement of a hypoglossal system. Choose 64584 when the array and pulse generator are removed instead.
64570Vagus stimulator removalElectrode array and generator
64570 concerns removal of a vagus nerve stimulation electrode. It is not the code for explanting a hypoglossal nerve system.
64595Generator revisionSacral or gastric system
64595 addresses revision or removal of specified peripheral, sacral, or gastric neurostimulator generators or receivers; 64584 is specific to the hypoglossal array and pulse generator.

Codes related to 64584

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

Codes related to 64584
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
64583Stimulator revision, hypoglossal array and generatorRevision or replacement of the hypoglossal system rather than complete removal.No office rate
Used instead
64570Vagus stimulator removal, electrode array and generatorRemoval code for a vagus nerve stimulation electrode, not a hypoglossal system.No office rate
64595Generator revision, sacral or gastric systemRevision or removal code for specified peripheral, sacral, or gastric neurostimulator generators or receivers.$310.07–$444.20

64584 billing questions

How is removal distinguished from revision or replacement?

Use 64584 when removing the hypoglossal nerve array and pulse generator. Code 64583 describes revision or replacement of the hypoglossal system rather than its removal.

Can 64584 be used for removal of a vagus nerve stimulator?

No. Code 64584 is specific to a hypoglossal nerve stimulation system; 64570 describes removal of a vagus nerve stimulation electrode.

What documentation supports reporting 64584?

Document the implanted hypoglossal system and the components removed, identifying the array and pulse generator in the operative report.

Does the 90-day global period include related postoperative care?

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

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%.

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 64584PPRRVU2026_Oct_nonQPP.csv, line 7,158 (RVU26D)

Open CMS sourceHow we calculate rates

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