Billing code 63650: Neurostimulator leadMedicare rate & RVUs
Percutaneous epidural neurostimulator lead placement is reported when a clinician advances an electrode array through a needle, commonly for spinal cord stimulation.
Medicare pays $2,388.50 for 63650 nationally in the office and $375.43 in a hospital or facility. Local office rates run $2,075.47–$3,343.02.
Medicare rate · 63650
Neurostimulator lead
Swap in your local Medicare rate.
- Work RVUs
- 6.97
- Total RVUs
- 71.51
- Global days
- 010
National rate · 2026
$2,388.50
Office setting, before claim adjustments.
See every locality for 63650 → · Billed by an NP, PA or therapist? →
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 10 sections
What 63650 covers
The clinician advances a neurostimulator electrode array through a percutaneous needle into the epidural space, positioning it to deliver spinal cord stimulation. Pain medicine physicians, anesthesiologists, and neurosurgeons commonly perform the procedure for patients with persistent pain, including during a temporary stimulation trial before a permanent system is considered. The lead may connect to an external stimulator during a trial or to an implanted pulse generator for ongoing therapy.
Report 63650 for percutaneous epidural array placement, rather than the open laminectomy approach in 63655. The operative or procedure note should support the percutaneous approach, epidural placement, and array work performed. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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.
Where 63650 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$2075.47 to $3343.02
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $2,110.88 | $349.44 |
| Alaska* | $2,631.46 | $487.54 |
| Arizona | $2,318.69 | $368.02 |
| Arkansas | $2,075.47 | $346.24 |
| Atlanta | $2,428.57 | $383.29 |
| Austin | $2,509.46 | $379.63 |
| Bakersfield | $2,587.02 | $380.69 |
| Baltimore/Surr. Cntys | $2,553.92 | $393.89 |
| Beaumont | $2,194.99 | $363.09 |
| Brazoria | $2,365.39 | $370.44 |
| Chicago | $2,434.95 | $411.81 |
| Chico | $2,584.63 | $378.30 |
| Colorado | $2,521.79 | $379.88 |
| Connecticut | $2,562.65 | $394.57 |
| Dallas | $2,378.33 | $373.31 |
| Dc + Md/Va Suburbs | $2,783.07 | $411.67 |
| Delaware | $2,361.45 | $372.53 |
| Detroit | $2,332.07 | $389.46 |
| East St. Louis | $2,244.91 | $392.88 |
| El Centro | $2,584.76 | $378.43 |
| Fort Lauderdale | $2,437.50 | $398.26 |
| Fort Worth | $2,357.38 | $372.49 |
| Fresno | $2,584.63 | $378.30 |
| Galveston | $2,370.92 | $371.94 |
| Hanford-Corcoran | $2,584.63 | $378.30 |
| Hawaii, Guam | $2,669.10 | $380.24 |
| Houston | $2,385.38 | $386.40 |
| Idaho | $2,204.25 | $352.22 |
| Indiana | $2,219.50 | $353.38 |
| Iowa | $2,191.60 | $349.63 |
| Kansas | $2,171.00 | $351.18 |
| Kentucky | $2,149.90 | $360.28 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $2,778.84 | $397.38 |
| Madera | $2,584.63 | $378.30 |
| Manhattan | $2,763.81 | $424.62 |
| Merced | $2,584.63 | $378.30 |
| Metropolitan Boston | $2,808.23 | $404.62 |
| Metropolitan Kansas City | $2,258.00 | $367.73 |
| Metropolitan Philadelphia | $2,485.08 | $389.47 |
| Metropolitan St. Louis | $2,286.34 | $369.90 |
| Miami | $2,516.15 | $420.54 |
| Minnesota | $2,431.67 | $360.22 |
| Mississippi | $2,085.64 | $352.38 |
| Modesto | $2,584.63 | $378.30 |
| Montana** | $2,388.45 | $375.37 |
| Napa | $3,067.30 | $414.07 |
| Nebraska | $2,208.13 | $350.06 |
| Nevada** | $2,386.22 | $371.14 |
| New Hampshire | $2,472.50 | $376.89 |
| New Mexico | $2,217.07 | $371.08 |
| New Orleans | $2,266.46 | $372.16 |
| North Carolina | $2,236.31 | $358.11 |
| North Dakota** | $2,372.82 | $359.75 |
| Northern Nj | $2,745.65 | $410.48 |
| Nyc Suburbs/Long Island | $2,828.45 | $434.91 |
| Ohio | $2,203.46 | $365.52 |
| Oklahoma | $2,154.78 | $357.10 |
| Oxnard-Thousand Oaks-Ventura | $2,772.60 | $393.15 |
| Portland | $2,621.82 | $385.30 |
| Poughkpsie/N Nyc Suburbs | $2,606.80 | $402.49 |
| Puerto Rico | $2,411.52 | $376.31 |
| Queens | $2,802.59 | $423.14 |
| Redding | $2,584.63 | $378.30 |
| Rest Of California | $2,584.63 | $378.30 |
| Rest Of Florida | $2,308.08 | $383.58 |
| Rest Of Georgia | $2,163.60 | $367.94 |
| Rest Of Illinois | $2,218.10 | $380.17 |
| Rest Of Louisiana | $2,142.52 | $360.95 |
| Rest Of Maine | $2,208.18 | $356.15 |
| Rest Of Maryland | $2,414.21 | $376.99 |
| Rest Of Massachusetts | $2,499.72 | $379.95 |
| Rest Of Michigan | $2,206.65 | $368.72 |
| Rest Of Missouri | $2,093.97 | $358.70 |
| Rest Of New Jersey | $2,596.27 | $397.99 |
| Rest Of New York | $2,274.20 | $361.78 |
| Rest Of Oregon | $2,372.14 | $367.12 |
| Rest Of Pennsylvania | $2,212.44 | $364.44 |
| Rest Of Texas | $2,277.34 | $366.94 |
| Rest Of Washington | $2,498.07 | $378.31 |
| Rhode Island | $2,460.34 | $380.84 |
| Riverside-San Bernardino-Ontario | $2,593.22 | $386.90 |
| Sacramento-Roseville-Folsom | $2,731.71 | $390.51 |
| Salinas | $2,722.03 | $388.88 |
| San Diego-Chula Vista-Carlsbad | $2,800.74 | $393.11 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $3,269.36 | $430.92 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $3,268.46 | $430.03 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $3,343.02 | $440.17 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $3,339.35 | $436.50 |
| San Luis Obispo-Paso Robles | $2,676.19 | $383.30 |
| Santa Cruz-Watsonville | $2,838.94 | $393.06 |
| Santa Maria-Santa Barbara | $2,736.24 | $389.00 |
| Santa Rosa-Petaluma | $2,868.72 | $396.67 |
| Seattle (King Cnty) | $2,878.66 | $408.62 |
| South Carolina | $2,222.71 | $362.63 |
| South Dakota** | $2,370.98 | $357.91 |
| Southern Maine | $2,359.60 | $364.64 |
| Stockton | $2,584.63 | $378.30 |
| Suburban Chicago | $2,467.99 | $400.56 |
| Tennessee | $2,182.51 | $352.63 |
| Utah | $2,258.05 | $365.76 |
| Vallejo | $3,066.01 | $412.78 |
| Vermont | $2,354.17 | $361.23 |
| Virgin Islands | $2,411.52 | $376.31 |
| Virginia | $2,344.54 | $365.69 |
| Visalia | $2,584.63 | $378.30 |
| West Virginia | $2,120.93 | $371.57 |
| Wisconsin | $2,280.81 | $352.28 |
| Wyoming** | $2,381.64 | $368.57 |
| Yuba City | $2,584.63 | $378.30 |
63650 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.
$2,075.47
$2,963.83
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 | $2,631.46 | 1 |
| AL | $2,110.88 | 1 |
| AR | $2,075.47 | 1 |
| AZ | $2,318.69 | 1 |
| CA | $2,584.63–$3,343.02 | 29 |
| CO | $2,521.79 | 1 |
| CT | $2,562.65 | 1 |
| DC | $2,783.07 | 1 |
| DE | $2,361.45 | 1 |
| FL | $2,308.08–$2,516.15 | 3 |
| GA | $2,163.60–$2,428.57 | 2 |
| GU | $2,669.10 | 1 |
| HI | $2,669.10 | 1 |
| IA | $2,191.60 | 1 |
| ID | $2,204.25 | 1 |
| IL | $2,218.10–$2,467.99 | 4 |
| IN | $2,219.50 | 1 |
| KS | $2,171.00 | 1 |
| KY | $2,149.90 | 1 |
| LA | $2,142.52–$2,266.46 | 2 |
| MA | $2,499.72–$2,808.23 | 2 |
| MD | $2,414.21–$2,783.07 | 3 |
| ME | $2,208.18–$2,359.60 | 2 |
| MI | $2,206.65–$2,332.07 | 2 |
| MN | $2,431.67 | 1 |
| MO | $2,093.97–$2,286.34 | 3 |
| MS | $2,085.64 | 1 |
| MT | $2,388.45 | 1 |
| NC | $2,236.31 | 1 |
| ND | $2,372.82 | 1 |
| NE | $2,208.13 | 1 |
| NH | $2,472.50 | 1 |
| NJ | $2,596.27–$2,745.65 | 2 |
| NM | $2,217.07 | 1 |
| NV | $2,386.22 | 1 |
| NY | $2,274.20–$2,828.45 | 5 |
| OH | $2,203.46 | 1 |
| OK | $2,154.78 | 1 |
| OR | $2,372.14–$2,621.82 | 2 |
| PA | $2,212.44–$2,485.08 | 2 |
| PR | $2,411.52 | 1 |
| RI | $2,460.34 | 1 |
| SC | $2,222.71 | 1 |
| SD | $2,370.98 | 1 |
| TN | $2,182.51 | 1 |
| TX | $2,194.99–$2,509.46 | 8 |
| UT | $2,258.05 | 1 |
| VA | $2,344.54–$2,783.07 | 2 |
| VI | $2,411.52 | 1 |
| VT | $2,354.17 | 1 |
| WA | $2,498.07–$2,878.66 | 2 |
| WI | $2,280.81 | 1 |
| WV | $2,120.93 | 1 |
| WY | $2,381.64 | 1 |
How the 63650 rate is calculated
Each of 63650’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 · 63650
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.97Practice expense 63.75Malpractice 0.79
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63650
63650 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63650
Neurostimulator lead
| 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 · 63650
Neurostimulator lead
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
63650 without 51 · national office
$2,388.50
Neurostimulator lead
63650-51 · Second procedure: 50%
$1,194.25
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%).
63650 compared with similar codes
Compare codes
63650 vs 63655 vs 63663 vs 63685: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63655Paddle lead implant
- Choose 63650 for percutaneous epidural array placement; 63655 describes placement by a laminectomy approach.
- 63663Lead revision
- 63650 describes placement of a percutaneous array, while 63663 addresses revision or replacement of an existing percutaneous array.
- 63685Neurostimulator generator
- 63650 is for epidural lead placement; 63685 is for insertion or replacement of the implanted pulse generator or receiver.
63650 billing questions
How is 63650 different from 63655?
63650 describes percutaneous placement through a needle. Use 63655 for epidural electrode placement through a laminectomy approach.
Can 63650 be reported with an implanted pulse generator code?
It may be reported with 63685 when percutaneous lead placement and pulse generator insertion are performed as part of the same permanent system procedure. A temporary trial typically uses an external stimulator rather than an implanted generator.
Should modifier 50 be appended for bilateral placement?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure's payment.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for 63650. Co-surgeons and team surgery are not permitted.
What documentation supports 63650?
Document the percutaneous approach, epidural electrode array placement, and the clinical purpose, such as a spinal cord stimulation trial or permanent lead placement.
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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