No office rate
Use 64656 for revision or replacement of the pulse generator. Use 64659 when the generator is removed rather than revised or replaced.
On this page
CMS RVU26D · Effective 2026-10-01
64659 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$423.41
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Neurostimulator surgery
About 64659: Battery-powered neurostimulator generator removal
Removal of the pulse generator from a battery-powered neuromodulation system, reported when the generator is removed while the system’s lead remains.
This service removes the implanted pulse generator from a battery-powered neuromodulation system while leaving the system’s lead in place. A surgeon or other qualified physician accesses the generator, typically in a procedural or operating-room setting, disconnects it from the lead, and removes it. The operative report should identify the system and document that the pulse generator—not the lead or the entire system—was removed.
Choose this code for generator-only removal; use the related removal codes when the lead alone or the complete system is removed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral procedures reported with modifier 50, CMS pays at 150%. Assistant-at-surgery, co-surgeon, and team-surgery payment requires supporting documentation; assistant payment also requires medical necessity.
CMS billing rules for 64659
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU8.23 · 62%
- Practice expense (office) RVU2.90 · 22%
- Malpractice RVU2.09 · 16%
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.
64659 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
The same code, a different location
How does Wyoming** compare?
64659 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 64659
Office
Unavailable
Facility
$399.16
No comparable office rate is available.
Arkansas
Arkansas · 64659
Office
Unavailable
Facility
$394.05
No comparable office rate is available.
Arizona
Arizona · 64659
Office
Unavailable
Facility
$428.50
No comparable office rate is available.
Bakersfield
California · 64659
Office
Unavailable
Facility
$428.79
No comparable office rate is available.
Chico
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
El Centro
California · 64659
Office
Unavailable
Facility
$423.49
No comparable office rate is available.
Fresno
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Hanford-Corcoran
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Madera
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Merced
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Modesto
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Napa
California · 64659
Office
Unavailable
Facility
$455.33
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 64659
Office
Unavailable
Facility
$440.57
No comparable office rate is available.
Redding
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Rest Of California
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 64659
Office
Unavailable
Facility
$445.54
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 64659
Office
Unavailable
Facility
$434.85
No comparable office rate is available.
Salinas
California · 64659
Office
Unavailable
Facility
$433.09
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 64659
Office
Unavailable
Facility
$436.82
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 64659
Office
Unavailable
Facility
$469.62
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 64659
Office
Unavailable
Facility
$467.25
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 64659
Office
Unavailable
Facility
$482.22
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 64659
Office
Unavailable
Facility
$472.52
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 64659
Office
Unavailable
Facility
$427.31
No comparable office rate is available.
Santa Cruz-Watsonville
California · 64659
Office
Unavailable
Facility
$435.77
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 64659
Office
Unavailable
Facility
$432.95
No comparable office rate is available.
Santa Rosa-Petaluma
California · 64659
Office
Unavailable
Facility
$439.50
No comparable office rate is available.
Stockton
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Vallejo
California · 64659
Office
Unavailable
Facility
$451.91
No comparable office rate is available.
Visalia
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Yuba City
California · 64659
Office
Unavailable
Facility
$423.14
No comparable office rate is available.
Colorado
Colorado · 64659
Office
Unavailable
Facility
$435.77
No comparable office rate is available.
Connecticut
Connecticut · 64659
Office
Unavailable
Facility
$469.18
No comparable office rate is available.
Delaware
Delaware · 64659
Office
Unavailable
Facility
$434.72
No comparable office rate is available.
Fort Lauderdale
Florida · 64659
Office
Unavailable
Facility
$499.22
No comparable office rate is available.
Rest Of Florida
Florida · 64659
Office
Unavailable
Facility
$472.41
No comparable office rate is available.
Atlanta
Georgia · 64659
Office
Unavailable
Facility
$457.97
No comparable office rate is available.
Rest Of Georgia
Georgia · 64659
Office
Unavailable
Facility
$444.50
No comparable office rate is available.
Hawaii, Guam
Hawaii · 64659
Office
Unavailable
Facility
$425.44
No comparable office rate is available.
Iowa
Iowa · 64659
Office
Unavailable
Facility
$391.23
No comparable office rate is available.
Idaho
Idaho · 64659
Office
Unavailable
Facility
$397.02
No comparable office rate is available.
East St. Louis
Illinois · 64659
Office
Unavailable
Facility
$504.60
No comparable office rate is available.
Rest Of Illinois
Illinois · 64659
Office
Unavailable
Facility
$472.43
No comparable office rate is available.
Suburban Chicago
Illinois · 64659
Office
Unavailable
Facility
$499.99
No comparable office rate is available.
Indiana
Indiana · 64659
Office
Unavailable
Facility
$398.61
No comparable office rate is available.
Kansas
Kansas · 64659
Office
Unavailable
Facility
$397.64
No comparable office rate is available.
Kentucky
Kentucky · 64659
Office
Unavailable
Facility
$424.87
No comparable office rate is available.
New Orleans
Louisiana · 64659
Office
Unavailable
Facility
$445.34
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 64659
Office
Unavailable
Facility
$427.49
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 64659
Office
Unavailable
Facility
$463.94
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 64659
Office
Unavailable
Facility
$436.92
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 64659
Office
Unavailable
Facility
$469.57
No comparable office rate is available.
Rest Of Maryland
Maryland · 64659
Office
Unavailable
Facility
$439.75
No comparable office rate is available.
Rest Of Maine
Maine · 64659
Office
Unavailable
Facility
$407.42
No comparable office rate is available.
Southern Maine
Maine · 64659
Office
Unavailable
Facility
$414.93
No comparable office rate is available.
Detroit
Michigan · 64659
Office
Unavailable
Facility
$486.06
No comparable office rate is available.
Rest Of Michigan
Michigan · 64659
Office
Unavailable
Facility
$442.14
No comparable office rate is available.
Minnesota
Minnesota · 64659
Office
Unavailable
Facility
$395.22
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 64659
Office
Unavailable
Facility
$434.05
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 64659
Office
Unavailable
Facility
$437.05
No comparable office rate is available.
Rest Of Missouri
Missouri · 64659
Office
Unavailable
Facility
$426.38
No comparable office rate is available.
Mississippi
Mississippi · 64659
Office
Unavailable
Facility
$409.88
No comparable office rate is available.
Montana**
Montana · 64659
Office
Unavailable
Facility
$441.42
No comparable office rate is available.
North Carolina
North Carolina · 64659
Office
Unavailable
Facility
$409.87
No comparable office rate is available.
North Dakota**
North Dakota · 64659
Office
Unavailable
Facility
$400.09
No comparable office rate is available.
Nebraska
Nebraska · 64659
Office
Unavailable
Facility
$390.68
No comparable office rate is available.
New Hampshire
New Hampshire · 64659
Office
Unavailable
Facility
$436.81
No comparable office rate is available.
Northern Nj
New Jersey · 64659
Office
Unavailable
Facility
$479.12
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 64659
Office
Unavailable
Facility
$468.24
No comparable office rate is available.
New Mexico
New Mexico · 64659
Office
Unavailable
Facility
$447.55
No comparable office rate is available.
Nevada**
Nevada · 64659
Office
Unavailable
Facility
$430.00
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 64659
Office
Unavailable
Facility
$537.29
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 64659
Office
Unavailable
Facility
$477.79
No comparable office rate is available.
Queens
New York · 64659
Office
Unavailable
Facility
$507.64
No comparable office rate is available.
Rest Of New York
New York · 64659
Office
Unavailable
Facility
$415.98
No comparable office rate is available.
Ohio
Ohio · 64659
Office
Unavailable
Facility
$433.69
No comparable office rate is available.
Oklahoma
Oklahoma · 64659
Office
Unavailable
Facility
$415.63
No comparable office rate is available.
Portland
Oregon · 64659
Office
Unavailable
Facility
$438.84
No comparable office rate is available.
Rest Of Oregon
Oregon · 64659
Office
Unavailable
Facility
$420.44
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 64659
Office
Unavailable
Facility
$463.95
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 64659
Office
Unavailable
Facility
$429.78
No comparable office rate is available.
Puerto Rico
Puerto Rico · 64659
Office
Unavailable
Facility
$441.58
No comparable office rate is available.
Rhode Island
Rhode Island · 64659
Office
Unavailable
Facility
$442.44
No comparable office rate is available.
South Carolina
South Carolina · 64659
Office
Unavailable
Facility
$423.73
No comparable office rate is available.
South Dakota**
South Dakota · 64659
Office
Unavailable
Facility
$395.21
No comparable office rate is available.
Tennessee
Tennessee · 64659
Office
Unavailable
Facility
$400.42
No comparable office rate is available.
Austin
Texas · 64659
Office
Unavailable
Facility
$439.77
No comparable office rate is available.
Beaumont
Texas · 64659
Office
Unavailable
Facility
$427.89
No comparable office rate is available.
Brazoria
Texas · 64659
Office
Unavailable
Facility
$427.53
No comparable office rate is available.
Dallas
Texas · 64659
Office
Unavailable
Facility
$433.73
No comparable office rate is available.
Fort Worth
Texas · 64659
Office
Unavailable
Facility
$433.67
No comparable office rate is available.
Galveston
Texas · 64659
Office
Unavailable
Facility
$431.07
No comparable office rate is available.
Houston
Texas · 64659
Office
Unavailable
Facility
$469.33
No comparable office rate is available.
Rest Of Texas
Texas · 64659
Office
Unavailable
Facility
$429.85
No comparable office rate is available.
Utah
Utah · 64659
Office
Unavailable
Facility
$428.63
No comparable office rate is available.
Virginia
Virginia · 64659
Office
Unavailable
Facility
$419.39
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 64659
Office
Unavailable
Facility
$441.58
No comparable office rate is available.
Vermont
Vermont · 64659
Office
Unavailable
Facility
$406.11
No comparable office rate is available.
Rest Of Washington
Washington · 64659
Office
Unavailable
Facility
$433.58
No comparable office rate is available.
Seattle (King Cnty)
Washington · 64659
Office
Unavailable
Facility
$464.52
No comparable office rate is available.
Wisconsin
Wisconsin · 64659
Office
Unavailable
Facility
$389.18
No comparable office rate is available.
West Virginia
West Virginia · 64659
Office
Unavailable
Facility
$458.96
No comparable office rate is available.
See how rates vary across the country
64659 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 64659 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$465.75
$423.41 × 110% = $465.75
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64659 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,198
- Code
- 64659
- Physician work
- 8.23
- Practice expense
- 2.90
- Malpractice
- 2.09
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.23 | × 1.000 | 8.2300 |
| Practice expense | 2.90 | × 1.000 | 2.9000 |
| Malpractice | 2.09 | × 0.740 | 1.5466 |
| Total RVUs | 12.6766 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$423.41
Open 64659 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.23 | 1 |
| Practice expense | 2.9 | 1 |
| Malpractice | 2.09 | 0.74 |
(8.23 × 1 + 2.9 × 1 + 2.09 × 0.74) × $33.4009 = $423.41
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
64659 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
No ratechanged toNo rate
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: No rate
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $423.41 | RVU26D |
| 2026-07-01 | Not available in this setting | $423.41 | RVU26C |
| 2026-04-01 | Not available in this setting | $423.41 | RVU26B |
| 2026-01-01 | Not available in this setting | $423.41 | RVU26A |
| 2025-10-01 | Not in this release | Not in this release | RVU25D |
| 2025-07-01 | Not in this release | Not in this release | RVU25C |
| 2025-04-01 | Not in this release | Not in this release | RVU25B |
| 2025-01-01 | Not in this release | Not in this release | RVU25A |
64659 billing questions
How is this different from removal of the complete system?
Report 64659 when only the pulse generator is removed and the lead remains. Removal of both generator and lead is the complete-system service, 64657.
When would 64658 be used instead?
64658 is for removal of the lead alone. Use 64659 when the generator is removed and the lead is left in place.
Can generator removal be reported with lead removal?
If both components are removed as part of complete-system removal, compare the service with 64657 rather than reporting generator-only removal alongside lead-only removal.
What documentation supports 64659?
Document the battery-powered system, removal of the pulse generator, and whether the lead was retained or also removed.
What are the payment rules for multiple procedures and bilateral reporting?
In the same session, CMS pays the highest-valued procedure in full and other procedures at 50%. For bilateral procedures reported with modifier 50, CMS pays at 150%.
Is related postoperative care included?
Yes. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,19564656,,Revj/rplcmt bat mod sys pg,A,,8.01,2.80,NA,2.80,,1.98,12.79,12.79,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19664657,,Rmvl bat modulj sys tot sys,A,,12.13,3.76,NA,3.76,,3.04,18.93,18.93,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19764658,,Rmvl bat modul sys lead only,A,,8.95,3.03,NA,3.03,,2.27,14.25,14.25,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19864659,,Rmvl bat modulj sys pg only,A,,8.23,2.90,NA,2.90,,2.09,13.22,13.22,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19964680,,Injection treatment of nerve,A,,2.60,7.52,,1.53,,0.26,10.38,4.39,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20064681,,Injection treatment of nerve,A,,3.69,9.85,,1.79,,0.30,13.84,5.78,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20164702,,Revise finger/toe nerve,A,,6.10,7.44,NA,7.44,,1.09,14.63,14.63,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,