No office rate
64654 is for initial open implantation of a BAT modulation system. Choose 64655 when the surgery revises or replaces an existing system lead.
On this page
CMS RVU26D · Effective 2026-10-01
64655 BAT lead revision Medicare reimbursement rates in California
Surgical revision or replacement of a lead in an implanted baroreflex activation therapy system, such as when the lead requires repair or exchange. Compare 64655 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 64655 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
$627.89–$725.40
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $97.51 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 64655 pays more and less in California
Cardiovascular surgery
About 64655: Baroreflex therapy lead revision
Surgical revision or replacement of a lead in an implanted baroreflex activation therapy system, such as when the lead requires repair or exchange.
This surgery addresses a lead in an implanted baroreflex activation therapy (BAT) system, which stimulates baroreceptors near the carotid sinus. The surgeon revises the existing lead or replaces it; this is lead work, not pulse-generator revision or removal. The system is used for baroreflex activation therapy, including treatment of hypertension. The procedure is performed in an operating room by a surgeon experienced with the implanted system and its lead placement.
Report 64655 when the operative work is revision or replacement of the BAT system lead. The operative report should identify the system component treated, describe the lead work performed, and support the medical reason for the procedure. 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 the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery, co-surgeon, and team-surgery payment each require supporting documentation; assistant payment also requires medical necessity documentation.
CMS billing rules for 64655
- 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 RVU11.30 · 59%
- Practice expense (office) RVU5.40 · 28%
- Malpractice RVU2.59 · 13%
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.
64655 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
64656 covers revision or replacement of the pulse generator. 64655 is for work on the lead.
No office rate
64658 describes lead removal only. 64655 is for lead revision or replacement, not removal alone.
No office rate
64659 is for removal of the pulse generator only; 64655 concerns revision or replacement of the system lead.
Compare 64655 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 $634.96 |
| Chico | Office Unavailable | Facility $627.89 |
| El Centro | Office Unavailable | Facility $628.33 |
| Fresno | Office Unavailable | Facility $627.89 |
| Hanford-Corcoran | Office Unavailable | Facility $627.89 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $663.72 |
| Madera | Office Unavailable | Facility $627.89 |
| Merced | Office Unavailable | Facility $627.89 |
| Modesto | Office Unavailable | Facility $627.89 |
| Napa | Office Unavailable | Facility $682.88 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $655.08 |
| Redding | Office Unavailable | Facility $627.89 |
| Rest Of California | Office Unavailable | Facility $627.89 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $655.70 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $647.15 |
| Salinas | Office Unavailable | Facility $644.54 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $651.36 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $707.31 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $704.37 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $725.40 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $713.38 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $635.65 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $650.87 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $644.67 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $656.61 |
| Stockton | Office Unavailable | Facility $627.89 |
| Vallejo | Office Unavailable | Facility $678.64 |
| Visalia | Office Unavailable | Facility $627.89 |
| Yuba City | Office Unavailable | Facility $627.89 |
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64655 billing questions
How does 64655 differ from 64656?
64655 is for revision or replacement of the BAT system lead. 64656 addresses revision or replacement of the pulse generator.
Should 64655 be used for the initial BAT system implant?
No. Use 64655 for lead revision or replacement, not initial implantation. Code 64654 describes the initial open implant procedure.
Does 64655 include pulse-generator work?
The service represented by 64655 is lead work. If the pulse generator is also revised or replaced, document that work separately and consider the applicable generator code.
How is bilateral lead work reported?
CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150% under the stated fee schedule rule.
What documentation supports assistant-at-surgery payment?
Document the assistant's role and the medical necessity for assistance. CMS payment for an assistant at surgery requires medical-necessity documentation.
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.
7,19164650,,Chemodenerv eccrine glands,A,,0.68,1.80,,0.21,,0.11,2.59,1.00,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19264653,,Chemodenerv eccrine glands,A,,0.86,2.03,,0.26,,0.17,3.06,1.29,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19364654,,1st opn implt bat modulj sys,A,,11.00,2.96,NA,2.96,,2.79,16.75,16.75,0,090,0.11,0.76,0.13,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19464655,,Revj/rplcmt bat mod sys lead,A,,11.30,5.40,NA,5.40,,2.59,19.29,19.29,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,19564656,,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