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CPT code 64590: Neurostimulator generator, pulse generator or receiver2026 Medicare rate & RVUs in Oxnard, CA

Reports placement or replacement of an implanted pulse generator or receiver for peripheral, sacral, or gastric neurostimulation, including connection to an electrode array.

CMS RVU26DEffective Oct 1, 2026One payment locality26.7K Medicare services in 2024

In Oxnard, CA, Medicare pays $466.94 for 64590 in the office and $276.25 when it’s performed in a hospital or facility.

$466.94Office (non-facility)
$276.25Hospital or facility
+9.0%vs the national office rate ($428.20)

Check a contract rate as a % of Medicare · 64590 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 64590 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Oxnard, CA
  2. What 64590 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 64590 covers

This service places or replaces the implanted power unit that drives a peripheral, sacral, or gastric neurostimulator. The surgeon or other qualified proceduralist typically creates or reopens a pocket, positions the generator or receiver, and connects it to the implanted electrode array. Examples include generator replacement for a patient receiving sacral neuromodulation for urinary or bowel symptoms, or for gastric stimulation for gastroparesis. The work is commonly performed in an operating room or procedure facility; the generator procedure is distinct from placing or revising the nerve electrode.

Report this code when the implanted generator or receiver is inserted or replaced, not for lead work alone. The operative report should identify the device, the reason for insertion or replacement, the pocket and connection work, and any electrode-array procedure performed. Medicare includes related postoperative visits for 10 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team-surgery billing is 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 Oxnard, CA compares for 64590

Across 109 of 109 payment localities, the office rate for 64590 runs from $382.84 in Arkansas to $540.26 in San Benito County, CA. Oxnard, CA pays $466.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

64590 in Oxnard, CA vs other payment areas
  1. Oxnard, CA · this page$466.94
  2. Bakersfield, CA · California$444.65−$22.29
  3. Chico, CA · California$442.54−$24.40
  4. El Centro, CA · California$442.66−$24.28
  5. Fresno, CA · California$442.54−$24.40
  6. Hanford, CA · California$442.54−$24.40
  7. Los Angeles, CA · California$470.33+$3.39

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

Every other payment area

64590 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$442.54$265.72
Merced, CACalifornia$442.54$265.72
Modesto, CACalifornia$442.54$265.72
Napa, CACalifornia$502.29$289.66
Redding, CACalifornia$442.54$265.72
Rest of CaliforniaCalifornia$442.54$265.72
Riverside, CACalifornia$450.43$273.62
Sacramento, CACalifornia$461.63$274.00

64590 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.

$382.84

$515.71

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

View every state and territory as a table
64590 office rate range by state
State / territoryOffice rate rangeLocalities
AK$515.711
AL$387.891
AR$382.841
AZ$417.321
CA$442.54–$540.2629
CO$440.071
CT$454.951
DC$482.251
DE$423.711
FL$430.00–$475.233
GA$407.20–$437.402
GU$450.521
HI$450.521
IA$393.281
ID$396.321
IL$421.24–$462.134
IN$398.311
KS$393.281
KY$399.731
LA$399.83–$417.482
MA$438.51–$478.462
MD$430.71–$482.253
ME$399.96–$417.062
MI$410.66–$436.602
MN$417.931
MO$394.75–$416.833
MS$388.781
MT$428.151
NC$403.461
ND$413.721
NE$394.721
NH$434.901
NJ$459.08–$478.372
NM$413.361
NV$424.371
NY$409.07–$504.675
OH$407.701
OK$397.321
OR$420.01–$451.012
PA$407.36–$445.642
PR$430.451
RI$436.571
SC$406.471
SD$412.011
TN$395.271
TX$405.07–$439.558
UT$411.441
VA$416.99–$482.252
VI$430.451
VT$413.781
WA$437.13–$486.022
WI$401.341
WV$407.551
WY$421.861

See 64590 in every payment locality

How the 64590 rate is calculated

Each of 64590’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 · 64590

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.97

4.97 RVUs× 1.000 GPCI

Practice expense7.12

7.12 RVUs× 1.000 GPCI

Malpractice0.73

0.73 RVUs× 1.000 GPCI

Adjusted RVUs

12.8200

Conversion factor

$33.4009

Medicare rate

$428.20

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

The exact Oxnard, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,160

Code
64590
Physician work
4.97
Practice expense
7.12
Malpractice
0.73

GPCI2026.csv

18

Locality
Oxnard, CA
Physician work
1.028
Practice expense
1.182
Malpractice
0.623
Office calculation for 64590 in Oxnard, CA
ComponentRVULocality factorAdjusted
Physician work4.97× 1.0285.1092
Practice expense7.12× 1.1828.4158
Malpractice0.73× 0.6230.4548
Total RVUs13.9798
Conversion factor× 33.4009

Office rate, Oxnard, CA$466.94

Office: (4.97 × 1.028 + 7.12 × 1.182 + 0.73 × 0.623) × $33.4009 = $466.94

Facility: (4.97 × 1.028 + 2.29 × 1.182 + 0.73 × 0.623) × $33.4009 = $276.25

Open 64590 in the RVU calculator

Payment rules and modifiers for 64590

64590 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64590

Neurostimulator generator, pulse generator or receiver

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)1Permitted with supporting documentation.
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 · 64590

Neurostimulator generator, pulse generator or receiver

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

64590 without 51 · national office

$428.20

Neurostimulator generator, pulse generator or receiver

64590-51 · Second procedure: 50%

$214.10

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 64590

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

Codes related to 64590
CodeHow it relatesOffice range, Oxnard, CA
Same family
64595Generator revision, sacral or gastric systemCovers revision or removal of the peripheral, sacral, or gastric generator or receiver.$382.08
Often billed with
64561Sacral nerve lead, percutaneous approachMay accompany permanent percutaneous sacral electrode-array placement when both are implanted in one session.$836.77
64581Sacral nerve lead, open approachMay accompany open sacral electrode-array placement during a one-session permanent implantation.No office rate

How 64590 has changed in Oxnard, CA

64590 · Office / nonfacility

$466.94

Effective 2026-10-01

The base rate is $29.41 higher than on 2025-10-01, moving from $437.53 to $466.94 (6.7%).

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

    $437.53changed to$466.94

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.10 changed to 4.97
    • Practice expense RVU 6.62 changed to 7.12
    • Malpractice RVU 0.71 changed to 0.73
    • Work GPCI 1.026 changed to 1.028
    • Practice expense GPCI 1.183 changed to 1.182
    • Malpractice GPCI 0.651 changed to 0.623

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $482.98changed to$437.53

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.44 changed to 6.62
    • Malpractice RVU 0.73 changed to 0.71

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $475.10changed to$482.98

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $296.34changed to$475.10

    • Conversion factor 33.8872 changed to 32.7442
    • Work RVU 2.45 changed to 5.10
    • Practice expense RVU 5.07 changed to 7.44
    • Malpractice RVU 0.35 changed to 0.73
    • Work GPCI 1.027 changed to 1.026
    • Practice expense GPCI 1.181 changed to 1.183
    • Malpractice GPCI 0.689 changed to 0.651

  5. January 1, 2023

    RVU23A

    $304.11changed to$296.34

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.11 changed to 5.07
    • Malpractice RVU 0.34 changed to 0.35
    • Practice expense GPCI 1.179 changed to 1.181
    • Malpractice GPCI 0.726 changed to 0.689

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $311.98changed to$304.11

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.24 changed to 5.11

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $302.95changed to$311.98

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.79 changed to 5.24
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.178 changed to 1.179
    • Malpractice GPCI 0.700 changed to 0.726

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $302.88changed to$302.95

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.83 changed to 4.79
    • Malpractice RVU 0.32 changed to 0.34
    • Work GPCI 1.024 changed to 1.026
    • Practice expense GPCI 1.176 changed to 1.178
    • Malpractice GPCI 0.673 changed to 0.700

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $303.58changed to$302.88

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.86 changed to 4.83
    • Malpractice RVU 0.31 changed to 0.32

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $301.62changed to$303.58

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.80 changed to 4.86
    • Work GPCI 1.027 changed to 1.024
    • Practice expense GPCI 1.178 changed to 1.176
    • Malpractice GPCI 0.754 changed to 0.673

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $301.14changed to$301.62

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.77 changed to 4.80
    • Work GPCI 1.030 changed to 1.027
    • Practice expense GPCI 1.180 changed to 1.178
    • Malpractice GPCI 0.834 changed to 0.754

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $302.52changed to$301.14

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.32 changed to 0.31

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $301.02changed to$302.52

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $297.65changed to$301.02

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.70 changed to 4.77
    • Malpractice RVU 0.28 changed to 0.32
    • Work GPCI 1.032 changed to 1.030
    • Practice expense GPCI 1.187 changed to 1.180
    • Malpractice GPCI 0.720 changed to 0.834

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $299.98changed to$297.65

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.12 changed to 4.70
    • Malpractice RVU 0.29 changed to 0.28
    • Work GPCI 1.034 changed to 1.032
    • Practice expense GPCI 1.193 changed to 1.187
    • Malpractice GPCI 0.605 changed to 0.720

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$299.98

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$466.94$276.25RVU26D
2026-07-01$466.94$276.25RVU26C
2026-04-01$466.94$276.25RVU26B
2026-01-01$466.94$276.25RVU26A
2025-10-01$437.53$301.30RVU25D
2025-07-01$437.53$301.30RVU25C
2025-04-01$437.53$301.30RVU25B
2025-01-01$437.53$301.30RVU25A
2024-10-01$482.98$308.14RVU24D
2024-07-01$482.98$308.14RVU24C
2024-04-01$482.98$308.14RVU24B
2024-03-09$482.98$308.14RVU24AR
2024-01-01$475.10$303.11RVU24A
2023-10-01$296.34$173.08RVU23D
2023-07-01$296.34$173.08RVU23C
2023-04-01$296.34$173.08RVU23B
2023-01-01$296.34$173.08RVU23A
2022-10-01$304.11$174.77RVU22D
2022-07-01$304.11$174.77RVU22C
2022-04-01$304.11$174.77RVU22B
2022-01-01$304.11$174.77RVU22A
2021-10-01$311.98$175.40RVU21D
2021-07-01$311.98$175.40RVU21C
2021-04-01$311.98$175.40RVU21B
2021-01-01$311.98$175.40RVU21A
2020-10-01$302.95$177.53RVU20D
2020-07-01$302.95$177.53RVU20C
2020-04-01$302.95$177.53RVU20B
2020-01-01$302.95$177.53RVU20A
2019-10-01$302.88$177.43RVU19D
2019-07-01$302.88$177.43RVU19C
2019-04-01$302.88$177.43RVU19B
2019-01-01$302.88$177.43RVU19A
2018-10-01$303.58$177.84RVU18D
2018-07-01$303.58$177.84RVU18C
2018-04-01$303.58$177.84RVU18B
2018-01-01$303.58$177.84RVU18AR1
2017-10-01$301.62$177.75RVU17D
2017-07-01$301.62$177.75RVU17C
2017-04-01$301.62$177.75RVU17B
2017-01-01$301.62$177.75RVU17A
2016-10-01$301.14$177.77RVU16D
2016-07-01$301.14$177.77RVU16C
2016-04-01$301.14$177.77RVU16B
2016-01-01$301.14$177.77RVU16A
2015-10-01$302.52$179.13RVU15D
2015-07-01$302.52$179.13RVU15C
2015-04-01$301.02$178.24RVU15B
2015-01-01$301.02$178.24RVU15A
2014-10-01$297.65$175.61RVU14D
2014-07-01$297.65$175.61RVU14C
2014-04-01$297.65$175.61RVU14B
2014-01-01$297.65$175.61RVU14A
2013-10-01$299.98$172.53RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 64590 for an earlier date of service

Where the Oxnard, CA rate applies

Oxnard, CA is a Medicare payment area, not a city. Our Census mapping connects it to 26 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Oxnard
  • Thousand Oaks
  • Bell Canyon
  • Camarillo
  • Casa Conejo
  • Channel Islands Beach
  • El Rio
  • Fillmore

Browse all communities in California

64590 billing questions

How is this different from 64595?

64590 is for inserting or replacing the generator or receiver. Use 64595 when the generator or receiver is revised or removed without insertion or replacement.

Does this code include placement of the electrode array?

No. This code represents generator or receiver work; electrode-array placement, revision, or removal is a separate service when performed and supported by the operative documentation.

Can it be reported with a sacral electrode-array code?

It may be reported with 64561 or 64581 when the electrode array and implanted generator are placed during the same permanent implantation encounter. The record should describe both services.

What documentation supports generator replacement?

Document the existing device and its indication, why replacement was performed, the generator or receiver work, and its connection to the electrode array.

Should modifier 50 be used for bilateral treatment?

No. Modifier 50 is inappropriate for this generator or receiver service.

Are postoperative visits included?

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

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 64590PPRRVU2026_Oct_nonQPP.csv, line 7,160 (RVU26D)
Geographic factors for Oxnard, CAGPCI2026.csv, line 18 (RVU26D)

Open CMS sourceHow we calculate rates

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