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Billing code 63655: Paddle lead implantMedicare rate & RVUs

Reports surgical placement of an epidural paddle electrode for spinal cord stimulation, typically for a patient receiving a permanent implant after a successful trial.

CMS RVU26DEffective Oct 1, 2026109 payment localities10.7K Medicare services in 2024

Medicare pays $838.70 for 63655 nationally in a facility.

Medicare rate · 63655

Paddle lead implant

Swap in your local Medicare rate.

Work RVUs
10.65
Total RVUs
25.11
Global days
090

National rate · 2026

$838.70

Facility setting, before claim adjustments.

See every locality for 63655 → · 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
  1. Medicare rate
  2. What 63655 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 63655 covers

A surgeon places an epidural paddle electrode along the spinal cord through a laminotomy or laminectomy. Neurosurgeons and other surgeons experienced in spinal cord stimulation perform this procedure in an operating room, commonly for chronic pain when a patient is proceeding to permanent stimulation after a temporary trial. This code distinguishes surgical paddle-lead placement from percutaneous electrode placement.

Report the service when the operative record supports surgical exposure and epidural placement of a paddle electrode; document the approach, lead placement, and indication. Report pulse-generator placement separately when performed, using 63685. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. When multiple procedures occur 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. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery 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.

Where 63655 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

63655 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$738.80
Alaska*Unavailable$982.20
ArizonaUnavailable$809.27
ArkansasUnavailable$726.59
AtlantaUnavailable$871.16
AustinUnavailable$845.42
BakersfieldUnavailable$829.52
Baltimore/Surr. CntysUnavailable$900.63
BeaumontUnavailable$797.66
BrazoriaUnavailable$810.20

63655 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
63655 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 63655 rate is calculated

Each of 63655’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 · 63655

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.65Practice expense 10.63Malpractice 3.83

25.1100 adjusted RVUs×$33.4009 conversion factor=$838.70

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 63655

63655 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63655

Paddle lead implant

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 63655

Paddle lead implant

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

63655 without 51 · national facility

$838.70

Paddle lead implant

63655-51 · Second procedure: 50%

$419.35

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

63655 compared with similar codes

Compare codes

63655 vs 63650 vs 63685 vs 63664 vs 63662: national Medicare rates

Swap in your local Medicare rate.

  • 63655
    Paddle lead implant · 10.65 wRVU
    —
  • 63650
    Neurostimulator lead · 6.97 wRVU
    $2,388.50
  • 63685
    Neurostimulator generator · 5.06 wRVU
    —
  • 63664
    Paddle lead revision · 11.23 wRVU
    —
  • 63662
    Paddle lead removal · 10.73 wRVU
    —

How to choose

63650Neurostimulator lead
Use 63655 for paddle placement through surgical spinal exposure; use 63650 for percutaneous epidural electrode-array placement.
63685Neurostimulator generator
63655 covers placement of the epidural paddle electrode. Code 63685 covers placement or replacement of the pulse generator or receiver.
63664Paddle lead revision
63655 is for initial surgical placement of a paddle electrode; 63664 is for revision or replacement of an existing paddle electrode.
63662Paddle lead removal
63655 reports paddle-electrode implantation. Code 63662 reports removal of an existing paddle electrode.

Codes related to 63655

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

Codes related to 63655
CodeHow it relatesNational office range
Used instead
63650Neurostimulator leadPercutaneous epidural electrode placement is the alternative approach to surgical paddle-lead placement.$2,075.47–$3,343.02
Often billed with
63685Neurostimulator generatorSeparately reports placement of the spinal neurostimulator pulse generator or receiver when performed.No office rate
Same family
63664Paddle lead revisionCovers revision or replacement of an existing epidural paddle electrode, rather than initial placement.No office rate

63655 billing questions

How does 63655 differ from 63650?

63655 is for paddle-electrode placement through a laminotomy or laminectomy. Code 63650 describes percutaneous placement of an epidural electrode array.

Can the pulse generator be reported separately?

Yes. When a spinal neurostimulator pulse generator or receiver is also implanted, report that service separately with 63685.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Should modifier 50 be used for bilateral paddle leads?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 63655PPRRVU2026_Oct_nonQPP.csv, line 7,078 (RVU26D)

Open CMS sourceHow we calculate rates

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