CPT code 64590: Neurostimulator generator, pulse generator or receiver2026 Medicare rate & RVUs in Fort Worth, TX
Reports placement or replacement of an implanted pulse generator or receiver for peripheral, sacral, or gastric neurostimulation, including connection to an electrode array.
In Fort Worth, TX, Medicare pays $423.22 for 64590 in the office and $264.15 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Fort Worth, TX 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. Fort Worth, TX pays $423.22. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Fort Worth, TX · this page$423.22
- Austin, TX · Texas$439.55+$16.33
- Beaumont, TX · Texas$405.07−$18.15
- Brazoria, TX · Texas$422.02−$1.20
- Dallas, TX · Texas$425.28+$2.06
- Galveston, TX · Texas$423.67+$0.45
- Houston, TX · Texas$437.03+$13.81
Other areas in Texas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Rest of TexasTexas | $413.71 | $260.61 |
| Los Angeles, CACalifornia | $470.33 | $279.48 |
| Washington, DC areaDistrict of Columbia | $482.25 | $292.21 |
| Miami, FLFlorida | $475.23 | $307.29 |
| Chicago, ILIllinois | $462.13 | $299.99 |
| Manhattan, NYNew York | $491.64 | $304.18 |
| AlaskaAlaska | $515.71 | $343.90 |
| AlabamaAlabama | $387.89 | $246.73 |
| ArkansasArkansas | $382.84 | $244.26 |
| ArizonaArizona | $417.32 | $260.99 |
| Bakersfield, CACalifornia | $444.65 | $267.84 |
| Chico, CACalifornia | $442.54 | $265.72 |
| El Centro, CACalifornia | $442.66 | $265.85 |
| Fresno, CACalifornia | $442.54 | $265.72 |
| Hanford, CACalifornia | $442.54 | $265.72 |
| Madera, CACalifornia | $442.54 | $265.72 |
| Merced, CACalifornia | $442.54 | $265.72 |
| Modesto, CACalifornia | $442.54 | $265.72 |
| Napa, CACalifornia | $502.29 | $289.66 |
| Oxnard, CACalifornia | $466.94 | $276.25 |
| 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 |
| Salinas, CACalifornia | $459.84 | $272.87 |
| San Diego, CACalifornia | $468.62 | $275.68 |
| Marin County, CACalifornia | $528.28 | $300.81 |
| San Francisco, CACalifornia | $527.45 | $299.98 |
| San Benito County, CACalifornia | $540.26 | $307.63 |
| Santa Clara County, CACalifornia | $536.87 | $304.24 |
| San Luis Obispo, CACalifornia | $452.76 | $269.01 |
| Santa Cruz, CACalifornia | $471.50 | $275.49 |
| Santa Maria, CACalifornia | $461.01 | $272.90 |
| Santa Rosa, CACalifornia | $476.09 | $277.98 |
| Stockton, CACalifornia | $442.54 | $265.72 |
| Vallejo, CACalifornia | $501.09 | $288.46 |
| Visalia, CACalifornia | $442.54 | $265.72 |
| Yuba City, CACalifornia | $442.54 | $265.72 |
| ColoradoColorado | $440.07 | $268.42 |
| ConnecticutConnecticut | $454.95 | $281.20 |
| DelawareDelaware | $423.71 | $264.32 |
| Fort Lauderdale, FLFlorida | $450.99 | $287.57 |
| Rest of FloridaFlorida | $430.00 | $275.77 |
| Atlanta, GAGeorgia | $437.40 | $273.50 |
| Rest of GeorgiaGeorgia | $407.20 | $263.29 |
| Hawaii, Guam, HIHawaii | $450.52 | $267.09 |
| IowaIowa | $393.28 | $245.67 |
| IdahoIdaho | $396.32 | $247.90 |
| East St. Louis, ILIllinois | $433.90 | $285.48 |
| Rest of IllinoisIllinois | $421.24 | $273.95 |
| Suburban Chicago, ILIllinois | $454.61 | $288.92 |
| IndianaIndiana | $398.31 | $248.76 |
| KansasKansas | $393.28 | $247.44 |
| KentuckyKentucky | $399.73 | $256.31 |
| New Orleans, LALouisiana | $417.48 | $265.68 |
| Rest of LouisianaLouisiana | $399.83 | $257.05 |
| Metropolitan Boston, MAMassachusetts | $478.46 | $285.84 |
| Rest of MassachusettsMassachusetts | $438.51 | $268.63 |
| Baltimore area, MDMaryland | $453.99 | $280.89 |
| Rest of MarylandMaryland | $430.71 | $267.45 |
| Rest of MaineMaine | $399.96 | $251.54 |
| Southern Maine, MEMaine | $417.06 | $257.19 |
| Detroit, MIMichigan | $436.60 | $280.92 |
| Rest of MichiganMichigan | $410.66 | $263.36 |
| MinnesotaMinnesota | $417.93 | $251.93 |
| Metropolitan Kansas City, MOMissouri | $413.13 | $261.65 |
| Metropolitan St. Louis, MOMissouri | $416.83 | $263.25 |
| Rest of MissouriMissouri | $394.75 | $255.68 |
| MississippiMississippi | $388.78 | $249.88 |
| MontanaMontana | $428.15 | $266.82 |
| North CarolinaNorth Carolina | $403.46 | $252.95 |
| North DakotaNorth Dakota | $413.72 | $252.39 |
| NebraskaNebraska | $394.72 | $245.82 |
| New HampshireNew Hampshire | $434.90 | $266.96 |
| Northern New JerseyNew Jersey | $478.37 | $291.23 |
| Rest of New JerseyNew Jersey | $459.08 | $282.92 |
| New MexicoNew Mexico | $413.36 | $265.43 |
| NevadaNevada | $424.37 | $262.88 |
| NYC suburbs and Long Island, NYNew York | $504.67 | $312.85 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $463.38 | $286.73 |
| Queens, NYNew York | $492.88 | $302.20 |
| Rest of New YorkNew York | $409.07 | $255.81 |
| OhioOhio | $407.70 | $260.41 |
| OklahomaOklahoma | $397.32 | $253.25 |
| Portland, OROregon | $451.01 | $271.78 |
| Rest of OregonOregon | $420.01 | $259.33 |
| Metropolitan Philadelphia, PAPennsylvania | $445.64 | $277.70 |
| Rest of PennsylvaniaPennsylvania | $407.36 | $259.26 |
| Puerto RicoPuerto Rico | $430.45 | $267.35 |
| Rhode IslandRhode Island | $436.57 | $269.92 |
| South CarolinaSouth Carolina | $406.47 | $257.40 |
| South DakotaSouth Dakota | $412.01 | $250.68 |
| TennesseeTennessee | $395.27 | $248.62 |
| UtahUtah | $411.44 | $259.80 |
| VirginiaVirginia | $416.99 | $258.40 |
| Virgin Islands, VIUnited States Virgin Islands | $430.45 | $267.35 |
| VermontVermont | $413.78 | $254.06 |
| Rest of WashingtonWashington | $437.13 | $267.26 |
| King County, WAWashington | $486.02 | $288.07 |
| WisconsinWisconsin | $401.34 | $246.79 |
| West VirginiaWest Virginia | $407.55 | $267.36 |
| WyomingWyoming | $421.86 | $260.53 |
64590 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $515.71 | 1 |
| AL | $387.89 | 1 |
| AR | $382.84 | 1 |
| AZ | $417.32 | 1 |
| CA | $442.54–$540.26 | 29 |
| CO | $440.07 | 1 |
| CT | $454.95 | 1 |
| DC | $482.25 | 1 |
| DE | $423.71 | 1 |
| FL | $430.00–$475.23 | 3 |
| GA | $407.20–$437.40 | 2 |
| GU | $450.52 | 1 |
| HI | $450.52 | 1 |
| IA | $393.28 | 1 |
| ID | $396.32 | 1 |
| IL | $421.24–$462.13 | 4 |
| IN | $398.31 | 1 |
| KS | $393.28 | 1 |
| KY | $399.73 | 1 |
| LA | $399.83–$417.48 | 2 |
| MA | $438.51–$478.46 | 2 |
| MD | $430.71–$482.25 | 3 |
| ME | $399.96–$417.06 | 2 |
| MI | $410.66–$436.60 | 2 |
| MN | $417.93 | 1 |
| MO | $394.75–$416.83 | 3 |
| MS | $388.78 | 1 |
| MT | $428.15 | 1 |
| NC | $403.46 | 1 |
| ND | $413.72 | 1 |
| NE | $394.72 | 1 |
| NH | $434.90 | 1 |
| NJ | $459.08–$478.37 | 2 |
| NM | $413.36 | 1 |
| NV | $424.37 | 1 |
| NY | $409.07–$504.67 | 5 |
| OH | $407.70 | 1 |
| OK | $397.32 | 1 |
| OR | $420.01–$451.01 | 2 |
| PA | $407.36–$445.64 | 2 |
| PR | $430.45 | 1 |
| RI | $436.57 | 1 |
| SC | $406.47 | 1 |
| SD | $412.01 | 1 |
| TN | $395.27 | 1 |
| TX | $405.07–$439.55 | 8 |
| UT | $411.44 | 1 |
| VA | $416.99–$482.25 | 2 |
| VI | $430.45 | 1 |
| VT | $413.78 | 1 |
| WA | $437.13–$486.02 | 2 |
| WI | $401.34 | 1 |
| WV | $407.55 | 1 |
| WY | $421.86 | 1 |
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
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 Fort Worth, TX 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
100
- Locality
- Fort Worth, TX
- Physician work
- 1.009
- Practice expense
- 0.986
- Malpractice
- 0.871
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.97 | × 1.009 | 5.0147 |
| Practice expense | 7.12 | × 0.986 | 7.0203 |
| Malpractice | 0.73 | × 0.871 | 0.6358 |
| Total RVUs | 12.6709 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Fort Worth, TX$423.22
Office: (4.97 × 1.009 + 7.12 × 0.986 + 0.73 × 0.871) × $33.4009 = $423.22
Facility: (4.97 × 1.009 + 2.29 × 0.986 + 0.73 × 0.871) × $33.4009 = $264.15
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
How 64590 has changed in Fort Worth, TX
64590 · Office / nonfacility
$423.22
Effective 2026-10-01
The base rate is $22.02 higher than on 2025-10-01, moving from $401.20 to $423.22 (5.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$401.20changed to$423.22
- 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 1.011 changed to 1.009
- Practice expense GPCI 0.998 changed to 0.986
- Malpractice GPCI 0.902 changed to 0.871
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$440.72changed to$401.20
- 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.
March 9, 2024
RVU24AR
$433.52changed to$440.72
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$263.78changed to$433.52
- 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 1.013 changed to 1.011
- Practice expense GPCI 0.996 changed to 0.998
- Malpractice GPCI 0.721 changed to 0.902
January 1, 2023
RVU23A
$268.44changed to$263.78
- 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
- Work GPCI 1.016 changed to 1.013
- Practice expense GPCI 0.995 changed to 0.996
- Malpractice GPCI 0.539 changed to 0.721
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$275.18changed to$268.44
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 5.24 changed to 5.11
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$268.60changed to$275.18
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 4.79 changed to 5.24
- Work GPCI 1.011 changed to 1.016
- Practice expense GPCI 0.991 changed to 0.995
- Malpractice GPCI 0.643 changed to 0.539
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$269.16changed to$268.60
- 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 1.007 changed to 1.011
- Practice expense GPCI 0.986 changed to 0.991
- Malpractice GPCI 0.747 changed to 0.643
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$269.66changed to$269.16
- 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.
January 1, 2018
RVU18AR1
$267.63changed to$269.66
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.80 changed to 4.86
- Work GPCI 1.006 changed to 1.007
- Practice expense GPCI 0.991 changed to 0.986
- Malpractice GPCI 0.760 changed to 0.747
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$266.66changed to$267.63
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 4.77 changed to 4.80
- Work GPCI 1.005 changed to 1.006
- Practice expense GPCI 0.995 changed to 0.991
- Malpractice GPCI 0.772 changed to 0.760
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$267.90changed to$266.66
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.32 changed to 0.31
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$266.57changed to$267.90
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$262.13changed to$266.57
- 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 1.002 changed to 1.005
- Practice expense GPCI 0.987 changed to 0.995
- Malpractice GPCI 0.799 changed to 0.772
Held through RVU15B.
January 1, 2014
RVU14A
$262.05changed to$262.13
- 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 1.000 changed to 1.002
- Practice expense GPCI 0.979 changed to 0.987
- Malpractice GPCI 0.826 changed to 0.799
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $262.05
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $423.22 | $264.15 | RVU26D |
| 2026-07-01 | $423.22 | $264.15 | RVU26C |
| 2026-04-01 | $423.22 | $264.15 | RVU26B |
| 2026-01-01 | $423.22 | $264.15 | RVU26A |
| 2025-10-01 | $401.20 | $286.28 | RVU25D |
| 2025-07-01 | $401.20 | $286.28 | RVU25C |
| 2025-04-01 | $401.20 | $286.28 | RVU25B |
| 2025-01-01 | $401.20 | $286.28 | RVU25A |
| 2024-10-01 | $440.72 | $293.21 | RVU24D |
| 2024-07-01 | $440.72 | $293.21 | RVU24C |
| 2024-04-01 | $440.72 | $293.21 | RVU24B |
| 2024-03-09 | $440.72 | $293.21 | RVU24AR |
| 2024-01-01 | $433.52 | $288.43 | RVU24A |
| 2023-10-01 | $263.78 | $159.82 | RVU23D |
| 2023-07-01 | $263.78 | $159.82 | RVU23C |
| 2023-04-01 | $263.78 | $159.82 | RVU23B |
| 2023-01-01 | $263.78 | $159.82 | RVU23A |
| 2022-10-01 | $268.44 | $159.28 | RVU22D |
| 2022-07-01 | $268.44 | $159.28 | RVU22C |
| 2022-04-01 | $268.44 | $159.28 | RVU22B |
| 2022-01-01 | $268.44 | $159.28 | RVU22A |
| 2021-10-01 | $275.18 | $159.91 | RVU21D |
| 2021-07-01 | $275.18 | $159.91 | RVU21C |
| 2021-04-01 | $275.18 | $159.91 | RVU21B |
| 2021-01-01 | $275.18 | $159.91 | RVU21A |
| 2020-10-01 | $268.60 | $163.09 | RVU20D |
| 2020-07-01 | $268.60 | $163.09 | RVU20C |
| 2020-04-01 | $268.60 | $163.09 | RVU20B |
| 2020-01-01 | $268.60 | $163.09 | RVU20A |
| 2019-10-01 | $269.16 | $163.98 | RVU19D |
| 2019-07-01 | $269.16 | $163.98 | RVU19C |
| 2019-04-01 | $269.16 | $163.98 | RVU19B |
| 2019-01-01 | $269.16 | $163.98 | RVU19A |
| 2018-10-01 | $269.66 | $164.24 | RVU18D |
| 2018-07-01 | $269.66 | $164.24 | RVU18C |
| 2018-04-01 | $269.66 | $164.24 | RVU18B |
| 2018-01-01 | $269.66 | $164.24 | RVU18AR1 |
| 2017-10-01 | $267.63 | $163.42 | RVU17D |
| 2017-07-01 | $267.63 | $163.42 | RVU17C |
| 2017-04-01 | $267.63 | $163.42 | RVU17B |
| 2017-01-01 | $267.63 | $163.42 | RVU17A |
| 2016-10-01 | $266.66 | $162.63 | RVU16D |
| 2016-07-01 | $266.66 | $162.63 | RVU16C |
| 2016-04-01 | $266.66 | $162.63 | RVU16B |
| 2016-01-01 | $266.66 | $162.63 | RVU16A |
| 2015-10-01 | $267.90 | $163.86 | RVU15D |
| 2015-07-01 | $267.90 | $163.86 | RVU15C |
| 2015-04-01 | $266.57 | $163.04 | RVU15B |
| 2015-01-01 | $266.57 | $163.04 | RVU15A |
| 2014-10-01 | $262.13 | $160.66 | RVU14D |
| 2014-07-01 | $262.13 | $160.66 | RVU14C |
| 2014-04-01 | $262.13 | $160.66 | RVU14B |
| 2014-01-01 | $262.13 | $160.66 | RVU14A |
| 2013-10-01 | $262.05 | $157.46 | RVU13D |
| 2013-07-01 | $262.05 | $157.46 | RVU13C |
| 2013-04-01 | $262.05 | $157.46 | RVU13B |
| 2013-01-01 | $262.05 | $157.46 | RVU13AR |
Where the Fort Worth, TX rate applies
Fort Worth, TX is a Medicare payment area, not a city. Our Census mapping connects it to 45 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.
- 64590 in Fort Worth · multiple payment areas
- Arlington
- 64590 in Azle · multiple payment areas
- Bedford
- Benbrook
- Blue Mound
- 64590 in Briar · multiple payment areas
- 64590 in Burleson · multiple payment areas
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
Fee sheets · Coming soon
Put 64590 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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