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Billing code 64570: Vagus stimulator removalMedicare rate & RVUs

Removal of an implanted vagus nerve stimulation electrode array and pulse generator, reported when the complete cranial nerve stimulation system is surgically taken out.

CMS RVU26DEffective Oct 1, 2026109 payment localities111 Medicare services in 2024

Medicare pays $766.22 for 64570 nationally in a facility.

Medicare rate · 64570

Vagus stimulator removal

Swap in your local Medicare rate.

Work RVUs
8.87
Total RVUs
22.94
Global days
090

National rate · 2026

$766.22

Facility setting, before claim adjustments.

See every locality for 64570 → · 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 64570 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 64570 covers

This operation removes the implanted electrode array from the vagus nerve and the associated pulse generator. It is typically performed by a surgeon in a facility setting for a patient with an existing vagus nerve stimulation system, often used to treat epilepsy. Removal may involve dissection of the lead from the nerve and removal of the generator from its implant pocket.

Report the code when both the electrode array and pulse generator are removed; removal is distinct from revising or replacing the array. The operative report should identify the vagus nerve system and document the components taken out. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery, co-surgeon, and team-surgery payment requires supporting documentation as applicable.

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 64570 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

64570 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$668.87
Alaska*Unavailable$880.69
ArizonaUnavailable$737.53
ArkansasUnavailable$656.98
AtlantaUnavailable$797.73
AustinUnavailable$772.58
BakersfieldUnavailable$756.13
Baltimore/Surr. CntysUnavailable$825.75
BeaumontUnavailable$726.29
BrazoriaUnavailable$738.00

64570 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
64570 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 64570 rate is calculated

Each of 64570’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 · 64570

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.87Practice expense 10.33Malpractice 3.74

22.9400 adjusted RVUs×$33.4009 conversion factor=$766.22

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

Payment rules and modifiers for 64570

64570 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64570

Vagus stimulator removal

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
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 · 64570

Vagus stimulator removal

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 50 · payment effect

With and without the modifier

64570 without 50 · national facility

$766.22

Vagus stimulator removal

64570-50 · Bilateral: 150%

$1,149.33

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

64570 compared with similar codes

Compare codes

64570 vs 64569 vs 64568 vs 64584: national Medicare rates

Swap in your local Medicare rate.

  • 64570
    Vagus stimulator removal · 8.87 wRVU
    —
  • 64569
    Vagus nerve electrode · 10.73 wRVU
    —
  • 64568
    Nerve stimulator · 8.78 wRVU
    —
  • 64584
    Stimulator removal · 11.7 wRVU
    —

How to choose

64569Vagus nerve electrode
Choose 64569 for revision or replacement of the vagus nerve electrode array. Choose 64570 when the array and pulse generator are removed.
64568Nerve stimulator
64568 describes implantation of a cranial nerve stimulation array and pulse generator; 64570 describes removal of the vagus nerve system.
64584Stimulator removal
64584 concerns removal of a hypoglossal nerve stimulation system. Use 64570 for removal of the vagus nerve system.

Codes related to 64570

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

Codes related to 64570
CodeHow it relatesNational office range
Same family
64568Nerve stimulatorImplants a cranial nerve stimulation array and pulse generator rather than removing the system.No office rate
64569Vagus nerve electrodeUsed for revision or replacement of the vagus nerve electrode array, not complete system removal.No office rate
Used instead
64584Stimulator removalRemoval of a hypoglossal nerve stimulation system; the targeted nerve distinguishes it.No office rate

64570 billing questions

How does removal differ from revision or replacement?

Use this code when the vagus nerve electrode array and pulse generator are removed. Revision or replacement of the array is a different service.

Does this code include removal of the pulse generator?

Yes. The service includes removal of the electrode array and its associated pulse generator; document which implanted components were removed.

What documentation supports reporting this code?

The operative report should identify the vagus nerve stimulation system and describe removal of both its electrode array and pulse generator.

How is bilateral removal reported?

For a bilateral procedure, CMS pays this code with modifier 50 at 150%, according to the supplied fee schedule rule.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon or team-surgery payment requires supporting documentation.

What postoperative care is included?

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

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 64570PPRRVU2026_Oct_nonQPP.csv, line 7,152 (RVU26D)

Open CMS sourceHow we calculate rates

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