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CPT code 64585: Lead revision/removal, peripheral nerve electrode array2026 Medicare rate & RVUs in Houston, TX

Reports surgical revision or removal of an implanted peripheral nerve neurostimulator electrode array, such as when a lead requires repositioning or explantation.

CMS RVU26DEffective Oct 1, 2026One payment locality5.1K Medicare services in 2024

In Houston, TX, Medicare pays $254.82 for 64585 in the office and $139.73 when it’s performed in a hospital or facility.

$254.82Office (non-facility)
$139.73Hospital or facility
+1.2%vs the national office rate ($251.84)

Check a contract rate as a % of Medicare · 64585 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 64585 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 64585 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 64585 covers

This service addresses an implanted electrode array that delivers neurostimulation to a peripheral nerve. A surgeon may revise the array to correct its position or resolve a lead problem, or remove it when stimulation is no longer needed or the device requires explantation. It is distinct from work on the pulse generator or receiver. The procedure is generally performed by a surgeon experienced in peripheral nerve or neuromodulation procedures, such as a neurosurgeon or pain specialist, in an operative setting.

Report the service for the electrode array work, not simply for programming or checking the system. The operative report should identify the peripheral nerve and implanted array, explain whether the array was revised or removed, and describe the work performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service; 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 Houston, TX compares for 64585

Across 109 of 109 payment localities, the office rate for 64585 runs from $222.70 in Arkansas to $331.54 in San Benito County, CA. Houston, TX pays $254.82. The RVUs are the same everywhere; the geographic indexes change the dollars.

64585 in Houston, TX vs other payment areas
  1. Houston, TX · this page$254.82
  2. Austin, TX · Texas$260.93+$6.11
  3. Beaumont, TX · Texas$235.55−$19.27
  4. Brazoria, TX · Texas$248.70−$6.12
  5. Dallas, TX · Texas$250.39−$4.43
  6. Fort Worth, TX · Texas$248.79−$6.03
  7. Galveston, TX · Texas$249.51−$5.31

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

Every other payment area

64585 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$242.06$132.07
Los Angeles, CACalifornia$283.13$146.02
Washington, DC areaDistrict of Columbia$287.51$150.98
Miami, FLFlorida$273.76$153.11
Chicago, ILIllinois$265.73$149.25
Manhattan, NYNew York$290.01$155.33
AlaskaAlaska$293.16$169.73
AlabamaAlabama$225.97$124.56

64585 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$222.70

$298.35

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
64585 office rate range by state
State / territoryOffice rate rangeLocalities
AK$293.161
AL$225.971
AR$222.701
AZ$245.071
CA$265.16–$331.5429
CO$261.641
CT$268.601
DC$287.511
DE$249.131
FL$249.09–$273.763
GA$234.98–$256.772
GU$271.511
HI$271.511
IA$231.271
ID$232.871
IL$242.21–$265.734
IN$234.211
KS$230.401
KY$231.781
LA$231.50–$242.932
MA$260.16–$287.232
MD$253.82–$287.513
ME$234.31–$246.712
MI$238.01–$252.422
MN$250.051
MO$227.67–$243.543
MS$225.221
MT$251.821
NC$236.731
ND$246.091
NE$232.471
NH$257.741
NJ$271.48–$284.572
NM$239.401
NV$250.401
NY$240.30–$297.315
OH$236.841
OK$231.131
OR$248.27–$269.712
PA$237.10–$262.062
PR$253.601
RI$257.821
SC$237.221
SD$245.411
TN$231.581
TX$235.55–$260.938
UT$240.451
VA$246.05–$287.512
VI$253.601
VT$245.321
WA$259.61–$292.862
WI$237.861
WV$233.311
WY$249.321

See 64585 in every payment locality

How the 64585 rate is calculated

Each of 64585’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 · 64585

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.06

2.06 RVUs× 1.000 GPCI

Practice expense5.19

5.19 RVUs× 1.000 GPCI

Malpractice0.29

0.29 RVUs× 1.000 GPCI

Adjusted RVUs

7.5400

Conversion factor

$33.4009

Medicare rate

$251.84

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

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,159

Code
64585
Physician work
2.06
Practice expense
5.19
Malpractice
0.29

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 64585 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work2.06× 1.0082.0765
Practice expense5.19× 0.9935.1537
Malpractice0.29× 1.3760.3990
Total RVUs7.6292
Conversion factor× 33.4009

Office rate, Houston, TX$254.82

Office: (2.06 × 1.008 + 5.19 × 0.993 + 0.29 × 1.376) × $33.4009 = $254.82

Facility: (2.06 × 1.008 + 1.72 × 0.993 + 0.29 × 1.376) × $33.4009 = $139.73

Open 64585 in the RVU calculator

Payment rules and modifiers for 64585

64585 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64585

Lead revision/removal, peripheral nerve electrode array

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 64585

Lead revision/removal, peripheral nerve electrode array

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

64585 without 51 · national office

$251.84

Lead revision/removal, peripheral nerve electrode array

64585-51 · Second procedure: 50%

$125.92

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 64585

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

Codes related to 64585
CodeHow it relatesOffice range, Houston, TX
Often billed with
64590Neurostimulator generator, pulse generator or receiverFor separate insertion or replacement of a peripheral neurostimulator pulse generator or receiver.$437.03
64595Generator revision, sacral or gastric systemFor separate revision or removal of the pulse generator or receiver during the encounter.$354.49
Used instead
64598Stimulator revision/removal, integrated neurostimulatorCovers revision or removal of a percutaneous peripheral lead with an integrated neurostimulator.No office rate
64569Vagus nerve electrode, revision or replacementFor revision or replacement of a vagus nerve electrode array rather than a general peripheral nerve array.No office rate
64570Vagus stimulator removal, electrode array and generatorFor removal of a vagus nerve electrode array.No office rate

How 64585 has changed in Houston, TX

64585 · Office / nonfacility

$254.82

Effective 2026-10-01

The base rate is $17.32 higher than on 2025-10-01, moving from $237.50 to $254.82 (7.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

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

  1. January 1, 2026

    RVU26A

    $237.50changed to$254.82

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.11 changed to 2.06
    • Practice expense RVU 4.78 changed to 5.19
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $247.89changed to$237.50

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.87 changed to 4.78
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $243.84changed to$247.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $251.47changed to$243.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.85 changed to 4.87
    • Malpractice RVU 0.29 changed to 0.30
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $259.99changed to$251.47

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.94 changed to 4.85
    • Malpractice RVU 0.28 changed to 0.29
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $267.93changed to$259.99

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.11 changed to 4.94
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $258.95changed to$267.93

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.66 changed to 5.11
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $256.26changed to$258.95

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.65 changed to 4.66
    • Malpractice RVU 0.27 changed to 0.28
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $254.92changed to$256.26

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.63 changed to 4.65
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $253.00changed to$254.92

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.61 changed to 4.63
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $251.20changed to$253.00

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.59 changed to 4.61
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $252.81changed to$251.20

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.60 changed to 4.59
    • Malpractice RVU 0.27 changed to 0.26

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $251.55changed to$252.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $249.04changed to$251.55

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.55 changed to 4.60
    • Malpractice RVU 0.26 changed to 0.27
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $253.76changed to$249.04

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.07 changed to 4.55
    • Malpractice RVU 0.27 changed to 0.26
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $253.76

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$254.82$139.73RVU26D
2026-07-01$254.82$139.73RVU26C
2026-04-01$254.82$139.73RVU26B
2026-01-01$254.82$139.73RVU26A
2025-10-01$237.50$145.69RVU25D
2025-07-01$237.50$145.69RVU25C
2025-04-01$237.50$145.69RVU25B
2025-01-01$237.50$145.69RVU25A
2024-10-01$247.89$149.39RVU24D
2024-07-01$247.89$149.39RVU24C
2024-04-01$247.89$149.39RVU24B
2024-03-09$247.89$149.39RVU24AR
2024-01-01$243.84$146.96RVU24A
2023-10-01$251.47$148.53RVU23D
2023-07-01$251.47$148.53RVU23C
2023-04-01$251.47$148.53RVU23B
2023-01-01$251.47$148.53RVU23A
2022-10-01$259.99$149.24RVU22D
2022-07-01$259.99$149.24RVU22C
2022-04-01$259.99$149.24RVU22B
2022-01-01$259.99$149.24RVU22A
2021-10-01$267.93$149.81RVU21D
2021-07-01$267.93$149.81RVU21C
2021-04-01$267.93$149.81RVU21B
2021-01-01$267.93$149.81RVU21A
2020-10-01$258.95$151.83RVU20D
2020-07-01$258.95$151.83RVU20C
2020-04-01$258.95$151.83RVU20B
2020-01-01$258.95$151.83RVU20A
2019-10-01$256.26$150.86RVU19D
2019-07-01$256.26$150.86RVU19C
2019-04-01$256.26$150.86RVU19B
2019-01-01$256.26$150.86RVU19A
2018-10-01$254.92$150.36RVU18D
2018-07-01$254.92$150.36RVU18C
2018-04-01$254.92$150.36RVU18B
2018-01-01$254.92$150.36RVU18AR1
2017-10-01$253.00$149.44RVU17D
2017-07-01$253.00$149.44RVU17C
2017-04-01$253.00$149.44RVU17B
2017-01-01$253.00$149.44RVU17A
2016-10-01$251.20$148.55RVU16D
2016-07-01$251.20$148.55RVU16C
2016-04-01$251.20$148.55RVU16B
2016-01-01$251.20$148.55RVU16A
2015-10-01$252.81$149.79RVU15D
2015-07-01$252.81$149.79RVU15C
2015-04-01$251.55$149.04RVU15B
2015-01-01$251.55$149.04RVU15A
2014-10-01$249.04$147.61RVU14D
2014-07-01$249.04$147.61RVU14C
2014-04-01$249.04$147.61RVU14B
2014-01-01$249.04$147.61RVU14A
2013-10-01$253.76$146.37RVU13D
2013-07-01$253.76$146.37RVU13C
2013-04-01$253.76$146.37RVU13B
2013-01-01$253.76$146.37RVU13AR

Price 64585 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

64585 billing questions

Is this code for the electrode array or the pulse generator?

64585 describes revision or removal of the peripheral nerve electrode array. Use the separate generator or receiver code when that component is also revised, removed, inserted, or replaced.

How is 64585 different from 64575?

64575 describes open implantation of a peripheral nerve electrode array. Use 64585 when the service is revision or removal of an array that is already implanted.

Can the generator service be reported on the same date?

A separate generator or receiver procedure may be reported when it is actually performed during the encounter. The operative documentation should distinguish the work on the electrode array from the work on the generator.

Can modifier 50 be used for bilateral electrode arrays?

No. CMS identifies modifier 50 as inappropriate for this code; do not use it to represent bilateral service.

Are postoperative visits included?

Related postoperative visits during the 10-day global period are included in the procedure payment.

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this service, and 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 64585PPRRVU2026_Oct_nonQPP.csv, line 7,159 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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