No office rate
Choose 64580 for electrode-array implantation at a neuromuscular target, such as for diaphragm pacing. Choose 64575 for open implantation at a peripheral nerve.
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CMS RVU26D · Effective 2026-10-01
64580 Neurostimulator implant Medicare reimbursement rates in California
Open surgical placement of a neurostimulator electrode array at a neuromuscular target, including diaphragm pacing electrode implantation when clinically indicated. Compare 64580 office and facility rates across CMS payment localities in California.
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.
What does Medicare pay for 64580 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$313.84–$375.55
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $61.71 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 64580 pays more and less in California
Neuromodulation surgery
About 64580: Open neuromuscular electrode implantation
Open surgical placement of a neurostimulator electrode array at a neuromuscular target, including diaphragm pacing electrode implantation when clinically indicated.
This service involves surgically placing a neurostimulator electrode array at a neuromuscular target so electrical stimulation can activate muscle function. A familiar application is electrode placement for diaphragm pacing in selected patients with impaired breathing. The procedure is performed by a surgeon in an operative setting; the operative report should identify the target and describe the array placement.
Report the code for the open electrode-array implantation, not for a percutaneous approach or for implantation at a different named nerve site. Documentation should support the neuromuscular target, surgical approach, and work performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted. Bilateral adjustment is inappropriate for this code.
CMS billing rules for 64580
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.09 · 43%
- Practice expense (office) RVU4.24 · 45%
- Malpractice RVU1.10 · 12%
40
Medicare services in 2024 · #5509 by national volume
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.
64580 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
64581 identifies open electrode-array implantation at the sacral nerve; 64580 is for a neuromuscular target.
$2,411.28–$3,126.41
64555 is the percutaneous peripheral-nerve electrode-array option. 64580 describes open implantation at a neuromuscular target.
$442.54–$540.26
64590 covers insertion or replacement of a neurostimulator generator or receiver, rather than the neuromuscular electrode-array implantation reported with 64580.
Compare 64580 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $316.80 |
| Chico | Office Unavailable | Facility $313.84 |
| El Centro | Office Unavailable | Facility $314.02 |
| Fresno | Office Unavailable | Facility $313.84 |
| Hanford-Corcoran | Office Unavailable | Facility $313.84 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $334.14 |
| Madera | Office Unavailable | Facility $313.84 |
| Merced | Office Unavailable | Facility $313.84 |
| Modesto | Office Unavailable | Facility $313.84 |
| Napa | Office Unavailable | Facility $350.54 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $330.72 |
| Redding | Office Unavailable | Facility $313.84 |
| Rest Of California | Office Unavailable | Facility $313.84 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $325.62 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $325.92 |
| Salinas | Office Unavailable | Facility $324.68 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $330.00 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $366.14 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $364.89 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $375.55 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $370.44 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $319.93 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $331.24 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $325.26 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $334.31 |
| Stockton | Office Unavailable | Facility $313.84 |
| Vallejo | Office Unavailable | Facility $348.74 |
| Visalia | Office Unavailable | Facility $313.84 |
| Yuba City | Office Unavailable | Facility $313.84 |
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64580 billing questions
How does this differ from 64575?
64580 is for an electrode array placed at a neuromuscular target, such as for diaphragm pacing. 64575 describes open electrode-array implantation at a peripheral nerve.
Can 64580 be reported with a pulse-generator code?
When a separate pulse generator or receiver is implanted, 64590 may also be relevant. The operative documentation should distinguish the electrode-array work from generator placement.
Does the 90-day global period include related postoperative care?
Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the major-surgery global period.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
Should modifier 50 be used for bilateral placement?
No. CMS identifies bilateral adjustment as inappropriate for this code's descriptor or anatomy.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
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.
7,15164569,,Revise/repl vagus n eltrd,A,,10.73,7.89,NA,7.89,,3.72,22.34,22.34,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15264570,,Remove vagus n eltrd,A,,8.87,10.33,NA,10.33,,3.74,22.94,22.94,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15364575,,Opn impltj nea perph nerve,A,,4.31,3.79,NA,3.79,,0.69,8.79,8.79,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15464580,,Opn impltj nea neuromuscular,A,,4.09,4.24,NA,4.24,,1.10,9.43,9.43,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15564581,,Opn impltj nea sacral nerve,A,,11.90,3.97,NA,3.97,,1.73,17.60,17.60,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15664582,,Opn mpltj hpglsl nstm ary pg,A,,13.65,6.00,NA,6.00,,1.99,21.64,21.64,0,090,0.11,0.76,0.13,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15764583,,Rev/rplct hpglsl nstm ary pg,A,,14.14,6.11,NA,6.11,,2.06,22.31,22.31,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00