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CPT code 64595: Generator revision, sacral or gastric system2026 Medicare rate & RVUs in Houston, TX

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.

CMS RVU26DEffective Oct 1, 2026One payment locality3.9K Medicare services in 2024

In Houston, TX, Medicare pays $354.49 for 64595 in the office and $217.18 when it’s performed in a hospital or facility.

$354.49Office (non-facility)
$217.18Hospital or facility
+1.9%vs the national office rate ($348.04)

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.

We’ll open 64595 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 64595 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 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 Houston, TX 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. Houston, TX pays $354.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

64595 in Houston, TX vs other payment areas
  1. Houston, TX · this page$354.49
  2. Austin, TX · Texas$358.14+$3.65
  3. Beaumont, TX · Texas$328.19−$26.30
  4. Brazoria, TX · Texas$343.13−$11.36
  5. Dallas, TX · Texas$345.72−$8.77
  6. Fort Worth, TX · Texas$343.89−$10.60
  7. Galveston, TX · Texas$344.42−$10.07

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

Every other payment area

64595 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$335.75$204.52
Los Angeles, CACalifornia$384.65$221.06
Washington, DC areaDistrict of Columbia$393.47$230.58
Miami, FLFlorida$384.58$240.63
Chicago, ILIllinois$373.72$234.75
Manhattan, NYNew York$400.10$239.42
AlaskaAlaska$414.98$267.71
AlabamaAlabama$314.30$193.31

64595 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.

$310.07

$414.98

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

View every state and territory as a table
64595 office rate range by state
State / territoryOffice rate rangeLocalities
AK$414.981
AL$314.301
AR$310.071
AZ$339.001
CA$361.40–$444.2029
CO$358.691
CT$370.241
DC$393.471
DE$344.331
FL$348.21–$384.583
GA$329.31–$355.402
GU$368.541
HI$368.541
IA$319.441
ID$321.871
IL$340.45–$373.724
IN$323.551
KS$319.141
KY$323.601
LA$323.57–$338.382
MA$357.21–$391.062
MD$350.24–$393.473
ME$324.61–$339.402
MI$332.48–$353.432
MN$341.081
MO$319.12–$338.183
MS$314.601
MT$348.001
NC$327.601
ND$337.131
NE$320.741
NH$354.191
NJ$373.72–$390.052
NM$334.621
NV$345.181
NY$332.28–$410.645
OH$330.261
OK$321.891
OR$341.76–$368.192
PA$330.13–$362.262
PR$350.031
RI$355.201
SC$329.621
SD$335.841
TN$320.781
TX$328.19–$358.148
UT$333.801
VA$339.13–$393.472
VI$350.031
VT$336.901
WA$356.18–$397.642
WI$326.671
WV$328.961
WY$343.261

See 64595 in every payment locality

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

Office or facility?

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 64595 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work3.70× 1.0083.7296
Practice expense6.17× 0.9936.1268
Malpractice0.55× 1.3760.7568
Total RVUs10.6132
Conversion factor× 33.4009

Office rate, Houston, TX$354.49

Office: (3.7 × 1.008 + 6.17 × 0.993 + 0.55 × 1.376) × $33.4009 = $354.49

Facility: (3.7 × 1.008 + 2.03 × 0.993 + 0.55 × 1.376) × $33.4009 = $217.18

Open 64595 in the RVU calculator

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

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 · 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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%).

When to use modifier 51

Codes related to 64595

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

Codes related to 64595
CodeHow it relatesOffice range, Houston, TX
Same family
64590Neurostimulator generator, pulse generator or receiverCovers insertion or replacement of the sacral or gastric system generator or receiver.$437.03
Used instead
64585Lead revision/removal, peripheral nerve electrode arrayAddresses revision or removal of a peripheral neurostimulator electrode array rather than the generator.$254.82
Often billed with
64561Sacral nerve lead, percutaneous approachImplants a percutaneous sacral nerve electrode array and may accompany generator work when both are performed.$749.89

How 64595 has changed in Houston, TX

64595 · Office / nonfacility

$354.49

Effective 2026-10-01

The base rate is $17.91 higher than on 2025-10-01, moving from $336.58 to $354.49 (5.3%).

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

    $336.58changed to$354.49

    • 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
    • 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

    $374.21changed to$336.58

    • 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.

  3. March 9, 2024

    RVU24AR

    $368.11changed to$374.21

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $240.53changed to$368.11

    • 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
    • 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

    $246.91changed to$240.53

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.93 changed to 4.91
    • 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

    $256.50changed to$246.91

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.14 changed to 4.93

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $249.78changed to$256.50

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.77 changed to 5.14
    • 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

    $251.17changed to$249.78

    • 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
    • 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

    $256.00changed to$251.17

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.02 changed to 4.88

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $253.66changed to$256.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.99 changed to 5.02
    • 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

    $251.82changed to$253.66

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.97 changed to 4.99
    • 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

    $253.07changed to$251.82

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.24 changed to 0.23

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $251.81changed to$253.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $247.96changed to$251.81

    • 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
    • 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

    $253.81changed to$247.96

    • 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
    • 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: $253.81

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$354.49$217.18RVU26D
2026-07-01$354.49$217.18RVU26C
2026-04-01$354.49$217.18RVU26B
2026-01-01$354.49$217.18RVU26A
2025-10-01$336.58$233.73RVU25D
2025-07-01$336.58$233.73RVU25C
2025-04-01$336.58$233.73RVU25B
2025-01-01$336.58$233.73RVU25A
2024-10-01$374.21$238.99RVU24D
2024-07-01$374.21$238.99RVU24C
2024-04-01$374.21$238.99RVU24B
2024-03-09$374.21$238.99RVU24AR
2024-01-01$368.11$235.09RVU24A
2023-10-01$240.53$132.08RVU23D
2023-07-01$240.53$132.08RVU23C
2023-04-01$240.53$132.08RVU23B
2023-01-01$240.53$132.08RVU23A
2022-10-01$246.91$131.89RVU22D
2022-07-01$246.91$131.89RVU22C
2022-04-01$246.91$131.89RVU22B
2022-01-01$246.91$131.89RVU22A
2021-10-01$256.50$132.63RVU21D
2021-07-01$256.50$132.63RVU21C
2021-04-01$256.50$132.63RVU21B
2021-01-01$256.50$132.63RVU21A
2020-10-01$249.78$133.46RVU20D
2020-07-01$249.78$133.46RVU20C
2020-04-01$249.78$133.46RVU20B
2020-01-01$249.78$133.46RVU20A
2019-10-01$251.17$132.28RVU19D
2019-07-01$251.17$132.28RVU19C
2019-04-01$251.17$132.28RVU19B
2019-01-01$251.17$132.28RVU19A
2018-10-01$256.00$132.86RVU18D
2018-07-01$256.00$132.86RVU18C
2018-04-01$256.00$132.86RVU18B
2018-01-01$256.00$132.86RVU18AR1
2017-10-01$253.66$131.63RVU17D
2017-07-01$253.66$131.63RVU17C
2017-04-01$253.66$131.63RVU17B
2017-01-01$253.66$131.63RVU17A
2016-10-01$251.82$131.16RVU16D
2016-07-01$251.82$131.16RVU16C
2016-04-01$251.82$131.16RVU16B
2016-01-01$251.82$131.16RVU16A
2015-10-01$253.07$131.97RVU15D
2015-07-01$253.07$131.97RVU15C
2015-04-01$251.81$131.32RVU15B
2015-01-01$251.81$131.32RVU15A
2014-10-01$247.96$129.63RVU14D
2014-07-01$247.96$129.63RVU14C
2014-04-01$247.96$129.63RVU14B
2014-01-01$247.96$129.63RVU14A
2013-10-01$253.81$128.01RVU13D
2013-07-01$253.81$128.01RVU13C
2013-04-01$253.81$128.01RVU13B
2013-01-01$253.81$128.01RVU13AR

Price 64595 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

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
RVUs for 64595PPRRVU2026_Oct_nonQPP.csv, line 7,161 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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