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

In Vermont, Medicare pays $336.90 for 64595 in the office and $200.00 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.

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 Vermont 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. Vermont pays $336.90. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

64595 rates by state

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

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.

Payment rules and modifiers for 64595

64595 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 64595

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

How 64595 has changed in Vermont

Price 64595 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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

Open CMS sourceHow we calculate rates