Billing code 64553: Neurostimulator leadMedicare rate & RVUs
Reports percutaneous placement of a neurostimulator electrode array at a cranial nerve for a patient receiving cranial nerve stimulation.
Medicare pays $4,841.46 for 64553 nationally in the office and $450.91 in a hospital or facility. Local office rates run $4,158.02–$6,838.81.
Medicare rate · 64553
Neurostimulator lead
Swap in your local Medicare rate.
- Work RVUs
- 5.98
- Total RVUs
- 144.95
- Global days
- 010
National rate · 2026
$4,841.46
Office setting, before claim adjustments.
See every locality for 64553 → · 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 64553 covers
A neurosurgeon or pain specialist uses a percutaneous approach to place a neurostimulator electrode array at a cranial nerve. The service may be performed in a surgical or procedure setting when cranial nerve stimulation is planned, including cases involving a targeted branch of the trigeminal nerve. This code identifies electrode-array placement, not an open implantation approach that includes a pulse generator.
Select the code based on the nerve targeted and the percutaneous technique documented. The operative or procedure note should identify the cranial nerve, describe the percutaneous placement, and document the array implanted. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, CMS pays the highest-valued procedure in full and applies the standard reduction to the others. Modifier 50 is inappropriate for this descriptor or anatomy. Assistant-at-surgery payment requires documentation of medical necessity; 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 64553 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
$4158.02 to $6838.81
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $4,235.24 | $393.51 |
| Alaska* | $5,199.78 | $523.84 |
| Arizona | $4,688.06 | $433.61 |
| Arkansas | $4,158.02 | $386.54 |
| Atlanta | $4,931.90 | $471.10 |
| Austin | $5,096.60 | $451.40 |
| Bakersfield | $5,249.87 | $437.83 |
| Baltimore/Surr. Cntys | $5,197.31 | $486.25 |
| Beaumont | $4,425.30 | $429.91 |
| Brazoria | $4,783.52 | $432.49 |
| Chicago | $4,974.65 | $562.15 |
| Chico | $5,243.33 | $431.29 |
| Colorado | $5,117.11 | $445.56 |
| Connecticut | $5,214.06 | $485.44 |
| Dallas | $4,813.08 | $440.09 |
| Dc + Md/Va Suburbs | $5,673.00 | $500.94 |
| Delaware | $4,779.27 | $441.41 |
| Detroit | $4,739.69 | $502.81 |
| East St. Louis | $4,562.20 | $522.90 |
| El Centro | $5,243.75 | $431.71 |
| Fort Lauderdale | $4,968.72 | $521.09 |
| Fort Worth | $4,768.59 | $439.51 |
| Fresno | $5,243.33 | $431.29 |
| Galveston | $4,796.68 | $436.86 |
| Hanford-Corcoran | $5,243.33 | $431.29 |
| Hawaii, Guam | $5,430.41 | $438.36 |
| Houston | $4,842.80 | $482.99 |
| Idaho | $4,432.50 | $393.19 |
| Indiana | $4,465.50 | $395.46 |
| Iowa | $4,403.31 | $385.96 |
| Kansas | $4,362.19 | $393.13 |
| Kentucky | $4,328.42 | $425.22 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $5,655.40 | $461.38 |
| Madera | $5,243.33 | $431.29 |
| Manhattan | $5,641.89 | $540.07 |
| Merced | $5,243.33 | $431.29 |
| Metropolitan Boston | $5,724.56 | $482.24 |
| Metropolitan Kansas City | $4,561.51 | $438.79 |
| Metropolitan Philadelphia | $5,048.16 | $477.60 |
| Metropolitan St. Louis | $4,622.87 | $443.06 |
| Miami | $5,157.02 | $586.46 |
| Minnesota | $4,914.37 | $396.50 |
| Mississippi | $4,185.99 | $405.73 |
| Modesto | $5,243.33 | $431.29 |
| Montana** | $4,841.29 | $450.74 |
| Napa | $6,261.93 | $475.19 |
| Nebraska | $4,438.17 | $385.70 |
| Nevada** | $4,831.96 | $437.02 |
| New Hampshire | $5,017.80 | $447.24 |
| New Mexico | $4,480.10 | $453.97 |
| New Orleans | $4,584.01 | $452.51 |
| North Carolina | $4,505.72 | $409.34 |
| North Dakota** | $4,791.46 | $400.92 |
| Northern Nj | $5,588.98 | $495.94 |
| Nyc Suburbs/Long Island | $5,787.76 | $567.39 |
| Ohio | $4,445.63 | $437.06 |
| Oklahoma | $4,335.03 | $414.27 |
| Oxnard-Thousand Oaks-Ventura | $5,644.80 | $455.17 |
| Portland | $5,329.00 | $451.10 |
| Poughkpsie/N Nyc Suburbs | $5,301.09 | $493.44 |
| Puerto Rico | $4,890.33 | $451.49 |
| Queens | $5,720.92 | $531.29 |
| Redding | $5,243.33 | $431.29 |
| Rest Of California | $5,243.33 | $431.29 |
| Rest Of Florida | $4,683.27 | $485.90 |
| Rest Of Georgia | $4,365.41 | $449.04 |
| Rest Of Illinois | $4,492.34 | $483.77 |
| Rest Of Louisiana | $4,313.81 | $428.17 |
| Rest Of Maine | $4,445.04 | $405.74 |
| Rest Of Maryland | $4,891.25 | $448.01 |
| Rest Of Massachusetts | $5,069.12 | $445.87 |
| Rest Of Michigan | $4,455.81 | $447.24 |
| Rest Of Missouri | $4,210.33 | $425.68 |
| Rest Of New Jersey | $5,276.91 | $482.43 |
| Rest Of New York | $4,588.58 | $417.56 |
| Rest Of Oregon | $4,798.23 | $425.25 |
| Rest Of Pennsylvania | $4,463.11 | $432.59 |
| Rest Of Texas | $4,600.86 | $434.23 |
| Rest Of Washington | $5,065.49 | $442.24 |
| Rhode Island | $4,986.56 | $451.13 |
| Riverside-San Bernardino-Ontario | $5,270.21 | $458.17 |
| Sacramento-Roseville-Folsom | $5,552.48 | $446.27 |
| Salinas | $5,533.25 | $444.60 |
| San Diego-Chula Vista-Carlsbad | $5,702.18 | $451.09 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $6,683.50 | $492.82 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $6,680.63 | $489.96 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $6,838.81 | $507.64 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $6,827.12 | $495.94 |
| San Luis Obispo-Paso Robles | $5,439.30 | $438.47 |
| Santa Cruz-Watsonville | $5,786.47 | $451.96 |
| Santa Maria-Santa Barbara | $5,564.55 | $445.17 |
| Santa Rosa-Petaluma | $5,847.52 | $455.93 |
| Seattle (King Cnty) | $5,870.61 | $483.41 |
| South Carolina | $4,482.46 | $425.59 |
| South Dakota** | $4,785.57 | $395.02 |
| Southern Maine | $4,769.38 | $418.35 |
| Stockton | $5,243.33 | $431.29 |
| Suburban Chicago | $5,030.89 | $521.80 |
| Tennessee | $4,387.75 | $396.74 |
| Utah | $4,559.42 | $432.31 |
| Vallejo | $6,257.81 | $471.07 |
| Vermont | $4,754.30 | $407.66 |
| Virgin Islands | $4,890.33 | $451.49 |
| Virginia | $4,739.24 | $423.33 |
| Visalia | $5,243.33 | $431.29 |
| West Virginia | $4,280.70 | $465.31 |
| Wisconsin | $4,591.80 | $385.65 |
| Wyoming** | $4,819.58 | $429.03 |
| Yuba City | $5,243.33 | $431.29 |
64553 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.
$4,158.02
$6,041.07
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 | $5,199.78 | 1 |
| AL | $4,235.24 | 1 |
| AR | $4,158.02 | 1 |
| AZ | $4,688.06 | 1 |
| CA | $5,243.33–$6,838.81 | 29 |
| CO | $5,117.11 | 1 |
| CT | $5,214.06 | 1 |
| DC | $5,673.00 | 1 |
| DE | $4,779.27 | 1 |
| FL | $4,683.27–$5,157.02 | 3 |
| GA | $4,365.41–$4,931.90 | 2 |
| GU | $5,430.41 | 1 |
| HI | $5,430.41 | 1 |
| IA | $4,403.31 | 1 |
| ID | $4,432.50 | 1 |
| IL | $4,492.34–$5,030.89 | 4 |
| IN | $4,465.50 | 1 |
| KS | $4,362.19 | 1 |
| KY | $4,328.42 | 1 |
| LA | $4,313.81–$4,584.01 | 2 |
| MA | $5,069.12–$5,724.56 | 2 |
| MD | $4,891.25–$5,673.00 | 3 |
| ME | $4,445.04–$4,769.38 | 2 |
| MI | $4,455.81–$4,739.69 | 2 |
| MN | $4,914.37 | 1 |
| MO | $4,210.33–$4,622.87 | 3 |
| MS | $4,185.99 | 1 |
| MT | $4,841.29 | 1 |
| NC | $4,505.72 | 1 |
| ND | $4,791.46 | 1 |
| NE | $4,438.17 | 1 |
| NH | $5,017.80 | 1 |
| NJ | $5,276.91–$5,588.98 | 2 |
| NM | $4,480.10 | 1 |
| NV | $4,831.96 | 1 |
| NY | $4,588.58–$5,787.76 | 5 |
| OH | $4,445.63 | 1 |
| OK | $4,335.03 | 1 |
| OR | $4,798.23–$5,329.00 | 2 |
| PA | $4,463.11–$5,048.16 | 2 |
| PR | $4,890.33 | 1 |
| RI | $4,986.56 | 1 |
| SC | $4,482.46 | 1 |
| SD | $4,785.57 | 1 |
| TN | $4,387.75 | 1 |
| TX | $4,425.30–$5,096.60 | 8 |
| UT | $4,559.42 | 1 |
| VA | $4,739.24–$5,673.00 | 2 |
| VI | $4,890.33 | 1 |
| VT | $4,754.30 | 1 |
| WA | $5,065.49–$5,870.61 | 2 |
| WI | $4,591.80 | 1 |
| WV | $4,280.70 | 1 |
| WY | $4,819.58 | 1 |
How the 64553 rate is calculated
Each of 64553’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 · 64553
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.98Practice expense 136.45Malpractice 2.52
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64553
64553 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64553
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) | 0 | Not paid without supporting documentation. |
| 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 · 64553
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
64553 without 51 · national office
$4,841.46
Neurostimulator lead
64553-51 · Second procedure: 50%
$2,420.73
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%).
64553 compared with similar codes
Compare codes
64553 vs 64555 vs 64568 vs 64569: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64555Nerve stimulation
- Choose 64553 for percutaneous electrode-array placement at a cranial nerve; choose 64555 when the documented target is a peripheral nerve.
- 64568Nerve stimulator
- 64568 describes open cranial nerve implantation and includes a pulse generator. 64553 describes percutaneous placement of the electrode array.
- 64569Vagus nerve electrode
- 64569 is for revision or replacement of a vagus nerve electrode. 64553 is for initial percutaneous electrode-array placement at a cranial nerve.
64553 billing questions
How is 64553 distinguished from 64555?
64553 is for percutaneous electrode-array placement at a cranial nerve. 64555 is for a peripheral nerve, so the documented target nerve determines the choice.
When would 64568 be considered instead?
64568 describes an open cranial nerve implantation approach that includes an electrode array and pulse generator. Use 64553 when the documented service is percutaneous electrode-array placement.
Can modifier 50 be appended for bilateral placement?
CMS identifies modifier 50 as inappropriate for this descriptor or anatomy. Report the service according to the documented cranial nerve procedure rather than treating it as a bilateral service.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
What documentation supports 64553?
The record should identify the cranial nerve targeted and describe the percutaneous approach and electrode-array placement. It should distinguish this service from peripheral-nerve placement or open implantation.
How are other procedures in the same session paid?
Under the CMS multiple-procedure rule, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% 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
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