CPT code 64595: Generator revision, sacral or gastric system2026 Medicare rate & RVUs in Puerto Rico
Reports revision or removal of an implanted pulse generator or receiver for sacral neuromodulation or gastric electrical stimulation, rather than work on its electrode array.
In Puerto Rico, Medicare pays $350.03 for 64595 in the office and $210.23 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 64595 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 64595 covers
This service addresses the implanted pulse generator or receiver for a sacral neuromodulation system or a gastric electrical stimulation system. The surgeon may revise the generator or remove it; the work concerns the generator or receiver, not the electrode array. Typical cases include correcting a generator pocket problem or removing a failed or no-longer-needed generator. Urologic, colorectal, or foregut surgeons commonly perform these procedures in a procedural or operating-room setting. Device analysis, programming, and imaging are included when performed as part of the service.
Choose this code when the operative work is revision or removal, rather than insertion or replacement of the generator. Document the device type and site, the reason for surgery, and the generator work performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed 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. Medicare does not pay an assistant at surgery for this code; 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 Puerto Rico compares for 64595
Across 109 of 109 payment localities, the office rate for 64595 runs from $310.07 in Arkansas to $444.20 in San Benito County, CA. Puerto Rico pays $350.03. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$350.03
- Los Angeles, CA · California$384.65+$34.62
- Washington, DC area · District of Columbia$393.47+$43.44
- Miami, FL · Florida$384.58+$34.55
- Chicago, IL · Illinois$373.72+$23.69
- Manhattan, NY · New York$400.10+$50.07
- Alaska · Alaska$414.98+$64.95
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $314.30 | $193.31 |
| ArkansasArkansas | $310.07 | $191.29 |
| ArizonaArizona | $339.00 | $205.01 |
| Bakersfield, CACalifornia | $362.99 | $211.43 |
| Chico, CACalifornia | $361.40 | $209.84 |
| El Centro, CACalifornia | $361.49 | $209.94 |
| Fresno, CACalifornia | $361.40 | $209.84 |
| Hanford, CACalifornia | $361.40 | $209.84 |
| Madera, CACalifornia | $361.40 | $209.84 |
| Merced, CACalifornia | $361.40 | $209.84 |
| Modesto, CACalifornia | $361.40 | $209.84 |
| Napa, CACalifornia | $412.32 | $230.07 |
| Oxnard, CACalifornia | $382.08 | $218.63 |
| Redding, CACalifornia | $361.40 | $209.84 |
| Rest of CaliforniaCalifornia | $361.40 | $209.84 |
| Riverside, CACalifornia | $367.35 | $215.79 |
| Sacramento, CACalifornia | $377.55 | $216.73 |
| Salinas, CACalifornia | $376.11 | $215.85 |
| San Diego, CACalifornia | $383.72 | $218.34 |
| Marin County, CACalifornia | $434.33 | $239.36 |
| San Francisco, CACalifornia | $433.71 | $238.73 |
| San Benito County, CACalifornia | $444.20 | $244.80 |
| Santa Clara County, CACalifornia | $441.64 | $242.24 |
| San Luis Obispo, CACalifornia | $370.26 | $212.76 |
| Santa Cruz, CACalifornia | $386.42 | $218.41 |
| Santa Maria, CACalifornia | $377.18 | $215.95 |
| Santa Rosa, CACalifornia | $390.21 | $220.40 |
| Stockton, CACalifornia | $361.40 | $209.84 |
| Vallejo, CACalifornia | $411.42 | $229.17 |
| Visalia, CACalifornia | $361.40 | $209.84 |
| Yuba City, CACalifornia | $361.40 | $209.84 |
| ColoradoColorado | $358.69 | $211.56 |
| ConnecticutConnecticut | $370.24 | $221.31 |
| DelawareDelaware | $344.33 | $207.71 |
| Fort Lauderdale, FLFlorida | $365.56 | $225.48 |
| Rest of FloridaFlorida | $348.21 | $216.01 |
| Atlanta, GAGeorgia | $355.40 | $214.91 |
| Rest of GeorgiaGeorgia | $329.31 | $205.96 |
| Hawaii, Guam, HIHawaii | $368.54 | $211.31 |
| IowaIowa | $319.44 | $192.92 |
| IdahoIdaho | $321.87 | $194.65 |
| East St. Louis, ILIllinois | $350.18 | $222.96 |
| Rest of IllinoisIllinois | $340.45 | $214.20 |
| Suburban Chicago, ILIllinois | $368.65 | $226.64 |
| IndianaIndiana | $323.55 | $195.37 |
| KansasKansas | $319.14 | $194.14 |
| KentuckyKentucky | $323.60 | $200.67 |
| New Orleans, LALouisiana | $338.38 | $208.26 |
| Rest of LouisianaLouisiana | $323.57 | $201.19 |
| Metropolitan Boston, MAMassachusetts | $391.06 | $225.96 |
| Rest of MassachusettsMassachusetts | $357.21 | $211.60 |
| Baltimore area, MDMaryland | $369.41 | $221.04 |
| Rest of MarylandMaryland | $350.24 | $210.30 |
| Rest of MaineMaine | $324.61 | $197.39 |
| Southern Maine, MEMaine | $339.40 | $202.37 |
| Detroit, MIMichigan | $353.43 | $219.99 |
| Rest of MichiganMichigan | $332.48 | $206.23 |
| MinnesotaMinnesota | $341.08 | $198.79 |
| Metropolitan Kansas City, MOMissouri | $335.04 | $205.20 |
| Metropolitan St. Louis, MOMissouri | $338.18 | $206.54 |
| Rest of MissouriMissouri | $319.12 | $199.92 |
| MississippiMississippi | $314.60 | $195.54 |
| MontanaMontana | $348.00 | $209.72 |
| North CarolinaNorth Carolina | $327.60 | $198.58 |
| North DakotaNorth Dakota | $337.13 | $198.85 |
| NebraskaNebraska | $320.74 | $193.11 |
| New HampshireNew Hampshire | $354.19 | $210.24 |
| Northern New JerseyNew Jersey | $390.05 | $229.64 |
| Rest of New JerseyNew Jersey | $373.72 | $222.72 |
| New MexicoNew Mexico | $334.62 | $207.82 |
| NevadaNevada | $345.18 | $206.76 |
| NYC suburbs and Long Island, NYNew York | $410.64 | $246.23 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $377.03 | $225.62 |
| Queens, NYNew York | $401.57 | $238.13 |
| Rest of New YorkNew York | $332.28 | $200.91 |
| OhioOhio | $330.26 | $204.01 |
| OklahomaOklahoma | $321.89 | $198.41 |
| Portland, OROregon | $368.19 | $214.56 |
| Rest of OregonOregon | $341.76 | $204.03 |
| Metropolitan Philadelphia, PAPennsylvania | $362.26 | $218.31 |
| Rest of PennsylvaniaPennsylvania | $330.13 | $203.19 |
| Rhode IslandRhode Island | $355.20 | $212.36 |
| South CarolinaSouth Carolina | $329.62 | $201.85 |
| South DakotaSouth Dakota | $335.84 | $197.56 |
| TennesseeTennessee | $320.78 | $195.08 |
| Austin, TXTexas | $358.14 | $211.84 |
| Beaumont, TXTexas | $328.19 | $202.35 |
| Brazoria, TXTexas | $343.13 | $206.09 |
| Dallas, TXTexas | $345.72 | $207.99 |
| Fort Worth, TXTexas | $343.89 | $207.55 |
| Galveston, TXTexas | $344.42 | $207.11 |
| Houston, TXTexas | $354.49 | $217.18 |
| Rest of TexasTexas | $335.75 | $204.52 |
| UtahUtah | $333.80 | $203.82 |
| VirginiaVirginia | $339.13 | $203.20 |
| Virgin Islands, VIUnited States Virgin Islands | $350.03 | $210.23 |
| VermontVermont | $336.90 | $200.00 |
| Rest of WashingtonWashington | $356.18 | $210.57 |
| King County, WAWashington | $397.64 | $227.97 |
| WisconsinWisconsin | $326.67 | $194.20 |
| West VirginiaWest Virginia | $328.96 | $208.79 |
| WyomingWyoming | $343.26 | $204.98 |
64595 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.
$310.07
$414.98
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 | $414.98 | 1 |
| AL | $314.30 | 1 |
| AR | $310.07 | 1 |
| AZ | $339.00 | 1 |
| CA | $361.40–$444.20 | 29 |
| CO | $358.69 | 1 |
| CT | $370.24 | 1 |
| DC | $393.47 | 1 |
| DE | $344.33 | 1 |
| FL | $348.21–$384.58 | 3 |
| GA | $329.31–$355.40 | 2 |
| GU | $368.54 | 1 |
| HI | $368.54 | 1 |
| IA | $319.44 | 1 |
| ID | $321.87 | 1 |
| IL | $340.45–$373.72 | 4 |
| IN | $323.55 | 1 |
| KS | $319.14 | 1 |
| KY | $323.60 | 1 |
| LA | $323.57–$338.38 | 2 |
| MA | $357.21–$391.06 | 2 |
| MD | $350.24–$393.47 | 3 |
| ME | $324.61–$339.40 | 2 |
| MI | $332.48–$353.43 | 2 |
| MN | $341.08 | 1 |
| MO | $319.12–$338.18 | 3 |
| MS | $314.60 | 1 |
| MT | $348.00 | 1 |
| NC | $327.60 | 1 |
| ND | $337.13 | 1 |
| NE | $320.74 | 1 |
| NH | $354.19 | 1 |
| NJ | $373.72–$390.05 | 2 |
| NM | $334.62 | 1 |
| NV | $345.18 | 1 |
| NY | $332.28–$410.64 | 5 |
| OH | $330.26 | 1 |
| OK | $321.89 | 1 |
| OR | $341.76–$368.19 | 2 |
| PA | $330.13–$362.26 | 2 |
| PR | $350.03 | 1 |
| RI | $355.20 | 1 |
| SC | $329.62 | 1 |
| SD | $335.84 | 1 |
| TN | $320.78 | 1 |
| TX | $328.19–$358.14 | 8 |
| UT | $333.80 | 1 |
| VA | $339.13–$393.47 | 2 |
| VI | $350.03 | 1 |
| VT | $336.90 | 1 |
| WA | $356.18–$397.64 | 2 |
| WI | $326.67 | 1 |
| WV | $328.96 | 1 |
| WY | $343.26 | 1 |
How the 64595 rate is calculated
Each of 64595’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 · 64595
RVUs × geographic indexes × conversion factor
Work3.70
3.70 RVUs× 1.000 GPCI
Practice expense6.17
6.17 RVUs× 1.000 GPCI
Malpractice0.55
0.55 RVUs× 1.000 GPCI
Adjusted RVUs
10.4200
Conversion factor
$33.4009
Medicare rate
$348.04
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,161
- Code
- 64595
- Physician work
- 3.70
- Practice expense
- 6.17
- Malpractice
- 0.55
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.70 | × 1.000 | 3.7000 |
| Practice expense | 6.17 | × 1.011 | 6.2379 |
| Malpractice | 0.55 | × 0.985 | 0.5418 |
| Total RVUs | 10.4796 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$350.03
Office: (3.7 × 1 + 6.17 × 1.011 + 0.55 × 0.985) × $33.4009 = $350.03
Facility: (3.7 × 1 + 2.03 × 1.011 + 0.55 × 0.985) × $33.4009 = $210.23
Payment rules and modifiers for 64595
64595 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64595
Generator revision, sacral or gastric system
| 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) | 0 | Not permitted. |
| 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 · 64595
Generator revision, sacral or gastric system
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
64595 without 51 · national office
$348.04
Generator revision, sacral or gastric system
64595-51 · Second procedure: 50%
$174.02
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 64595 has changed in Puerto Rico
64595 · Office / nonfacility
$350.03
Effective 2026-10-01
The base rate is $22.02 higher than on 2025-10-01, moving from $328.01 to $350.03 (6.7%).
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
$328.01changed to$350.03
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.79 changed to 3.70
- Practice expense RVU 5.77 changed to 6.17
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$365.37changed to$328.01
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 6.59 changed to 5.77
- Malpractice RVU 0.56 changed to 0.55
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$359.40changed to$365.37
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$236.37changed to$359.40
- Conversion factor 33.8872 changed to 32.7442
- Work RVU 1.78 changed to 3.79
- Practice expense RVU 4.91 changed to 6.59
- Malpractice RVU 0.25 changed to 0.56
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$235.18changed to$236.37
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$242.10changed to$235.18
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 4.93 changed to 4.91
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$251.50changed to$242.10
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 5.14 changed to 4.93
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$246.68changed to$251.50
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 4.77 changed to 5.14
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$249.46changed to$246.68
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 4.88 changed to 4.77
- Malpractice RVU 0.23 changed to 0.25
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$254.26changed to$249.46
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 5.02 changed to 4.88
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$222.48changed to$254.26
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.99 changed to 5.02
- Practice expense GPCI 0.856 changed to 1.007
- Malpractice GPCI 0.642 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$191.60changed to$222.48
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 4.97 changed to 4.99
- Practice expense GPCI 0.705 changed to 0.856
- Malpractice GPCI 0.293 changed to 0.642
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$192.39changed to$191.60
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.24 changed to 0.23
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$191.44changed to$192.39
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$187.27changed to$191.44
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 4.90 changed to 4.97
- Malpractice RVU 0.21 changed to 0.24
- Practice expense GPCI 0.692 changed to 0.705
- Malpractice GPCI 0.271 changed to 0.293
Held through RVU15B.
January 1, 2014
RVU14A
$188.14changed to$187.27
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 5.45 changed to 4.90
- Malpractice RVU 0.22 changed to 0.21
- Practice expense GPCI 0.678 changed to 0.692
- Malpractice GPCI 0.249 changed to 0.271
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $188.14
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $350.03 | $210.23 | RVU26D |
| 2026-07-01 | $350.03 | $210.23 | RVU26C |
| 2026-04-01 | $350.03 | $210.23 | RVU26B |
| 2026-01-01 | $350.03 | $210.23 | RVU26A |
| 2025-10-01 | $328.01 | $224.75 | RVU25D |
| 2025-07-01 | $328.01 | $224.75 | RVU25C |
| 2025-04-01 | $328.01 | $224.75 | RVU25B |
| 2025-01-01 | $328.01 | $224.75 | RVU25A |
| 2024-10-01 | $365.37 | $229.61 | RVU24D |
| 2024-07-01 | $365.37 | $229.61 | RVU24C |
| 2024-04-01 | $365.37 | $229.61 | RVU24B |
| 2024-03-09 | $365.37 | $229.61 | RVU24AR |
| 2024-01-01 | $359.40 | $225.86 | RVU24A |
| 2023-10-01 | $236.37 | $128.77 | RVU23D |
| 2023-07-01 | $235.18 | $128.43 | RVU23C |
| 2023-04-01 | $235.18 | $128.43 | RVU23B |
| 2023-01-01 | $235.18 | $128.43 | RVU23A |
| 2022-10-01 | $242.10 | $129.43 | RVU22D |
| 2022-07-01 | $242.10 | $129.43 | RVU22C |
| 2022-04-01 | $242.10 | $129.43 | RVU22B |
| 2022-01-01 | $242.10 | $129.43 | RVU22A |
| 2021-10-01 | $251.50 | $130.15 | RVU21D |
| 2021-07-01 | $251.50 | $130.15 | RVU21C |
| 2021-04-01 | $251.50 | $130.15 | RVU21B |
| 2021-01-01 | $251.50 | $130.15 | RVU21A |
| 2020-10-01 | $246.68 | $131.72 | RVU20D |
| 2020-07-01 | $246.68 | $131.72 | RVU20C |
| 2020-04-01 | $246.68 | $131.72 | RVU20B |
| 2020-01-01 | $246.68 | $131.72 | RVU20A |
| 2019-10-01 | $249.46 | $131.15 | RVU19D |
| 2019-07-01 | $249.46 | $131.15 | RVU19C |
| 2019-04-01 | $249.46 | $131.15 | RVU19B |
| 2019-01-01 | $249.46 | $131.15 | RVU19A |
| 2018-10-01 | $254.26 | $131.73 | RVU18D |
| 2018-07-01 | $254.26 | $131.73 | RVU18C |
| 2018-04-01 | $254.26 | $131.73 | RVU18B |
| 2018-01-01 | $254.26 | $131.73 | RVU18AR1 |
| 2017-10-01 | $222.48 | $118.95 | RVU17D |
| 2017-07-01 | $222.48 | $118.95 | RVU17C |
| 2017-04-01 | $222.48 | $118.95 | RVU17B |
| 2017-01-01 | $222.48 | $118.95 | RVU17A |
| 2016-10-01 | $191.60 | $107.04 | RVU16D |
| 2016-07-01 | $191.60 | $107.04 | RVU16C |
| 2016-04-01 | $191.60 | $107.04 | RVU16B |
| 2016-01-01 | $191.60 | $107.04 | RVU16A |
| 2015-10-01 | $192.39 | $107.53 | RVU15D |
| 2015-07-01 | $192.39 | $107.53 | RVU15C |
| 2015-04-01 | $191.44 | $106.99 | RVU15B |
| 2015-01-01 | $191.44 | $106.99 | RVU15A |
| 2014-10-01 | $187.27 | $105.71 | RVU14D |
| 2014-07-01 | $187.27 | $105.71 | RVU14C |
| 2014-04-01 | $187.27 | $105.71 | RVU14B |
| 2014-01-01 | $187.27 | $105.71 | RVU14A |
| 2013-10-01 | $188.14 | $103.02 | RVU13D |
| 2013-07-01 | $188.14 | $103.02 | RVU13C |
| 2013-04-01 | $188.14 | $103.02 | RVU13B |
| 2013-01-01 | $188.14 | $103.02 | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
64595 billing questions
When should I report 64595 instead of 64590?
Report 64595 for revision or removal of the sacral or gastric system’s generator or receiver. Report 64590 when the generator or receiver is inserted or replaced.
Does this code cover work on the electrode array?
No. The service concerns the generator or receiver. If the operative work revises or removes a separate peripheral neurostimulator electrode array, consider 64585 instead.
Can device analysis, programming, or imaging be billed separately?
Analysis, programming, and imaging are included when performed as part of this generator revision or removal service.
Should I append modifier 50 for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Are an assistant surgeon or co-surgeons payable?
Medicare does not pay an assistant at surgery for 64595. Co-surgeons and team surgery are not permitted.
How does the global period affect postoperative visits?
The code has a 10-day global period. Related postoperative visits during those 10 days are included.
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
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