No office rate
64575 is for open implantation of a peripheral nerve electrode array. Choose 64585 for revision or removal of an array already in place.
On this page
CMS RVU26D · Effective 2026-10-01
64585 Lead revision/removal Medicare reimbursement rates in Hawaii
Reports surgical revision or removal of an implanted peripheral nerve neurostimulator electrode array, such as when a lead requires repositioning or explantation. Compare 64585 office and facility rates across CMS payment localities in Hawaii.
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 64585 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$271.51
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$139.73
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
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.
Neurostimulation surgery
About 64585: Peripheral neurostimulator lead revision or removal
Reports surgical revision or removal of an implanted peripheral nerve neurostimulator electrode array, such as when a lead requires repositioning or explantation.
This service addresses an implanted electrode array that delivers neurostimulation to a peripheral nerve. A surgeon may revise the array to correct its position or resolve a lead problem, or remove it when stimulation is no longer needed or the device requires explantation. It is distinct from work on the pulse generator or receiver. The procedure is generally performed by a surgeon experienced in peripheral nerve or neuromodulation procedures, such as a neurosurgeon or pain specialist, in an operative setting.
Report the service for the electrode array work, not simply for programming or checking the system. The operative report should identify the peripheral nerve and implanted array, explain whether the array was revised or removed, and describe the work performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 64585
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.06 · 27%
- Practice expense (office) RVU5.19 · 69%
- Malpractice RVU0.29 · 4%
5.1K
Medicare services in 2024 · #1853 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.
64585 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$368.54
64595 applies to revision or removal of the peripheral neurostimulator pulse generator or receiver; 64585 applies to the electrode array.
64598
No office rateRevj/rmvl nea pn w/int nstim
64598 is for revision or removal of a percutaneous peripheral electrode array with an integrated neurostimulator. 64585 describes the peripheral nerve electrode-array service outside that specific percutaneous integrated-device context.
No office rate
64570 is specific to removal of a vagus nerve electrode array. 64585 is used for peripheral nerve electrode-array revision or removal outside that vagus-specific service.
Compare 64585 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.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$271.51
Facility
$139.73
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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 64585 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
7,159
- Code
- 64585
- Physician work
- 2.06
- Practice expense
- 5.19
- Malpractice
- 0.29
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.06 | × 1.000 | 2.0600 |
| Practice expense | 5.19 | × 1.137 | 5.9010 |
| Malpractice | 0.29 | × 0.579 | 0.1679 |
| Total RVUs | 8.1289 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$271.51
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.06 | 1 |
| Practice expense | 5.19 | 1.137 |
| Malpractice | 0.29 | 0.579 |
(2.06 × 1 + 5.19 × 1.137 + 0.29 × 0.579) × $33.4009 = $271.51
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.06 | 1 |
| Practice expense | 1.72 | 1.137 |
| Malpractice | 0.29 | 0.579 |
(2.06 × 1 + 1.72 × 1.137 + 0.29 × 0.579) × $33.4009 = $139.73
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.
64585 billing questions
Is this code for the electrode array or the pulse generator?
64585 describes revision or removal of the peripheral nerve electrode array. Use the separate generator or receiver code when that component is also revised, removed, inserted, or replaced.
How is 64585 different from 64575?
64575 describes open implantation of a peripheral nerve electrode array. Use 64585 when the service is revision or removal of an array that is already implanted.
Can the generator service be reported on the same date?
A separate generator or receiver procedure may be reported when it is actually performed during the encounter. The operative documentation should distinguish the work on the electrode array from the work on the generator.
Can modifier 50 be used for bilateral electrode arrays?
No. CMS identifies modifier 50 as inappropriate for this code; do not use it to represent bilateral service.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
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.
7,15664582,,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
7,15864584,,Rmvl hpglsl nstim ary pg,A,,11.70,5.51,NA,5.51,,1.70,18.91,18.91,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15964585,,Rev/rmv perph nstim eltrd ra,A,,2.06,5.19,,1.72,,0.29,7.54,4.07,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16064590,,Ins/rpl prph sac/gstr npg/r,A,,4.97,7.12,,2.29,,0.73,12.82,7.99,0,010,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16164595,,Rev/rmv prph sac/gstr npg/r,A,,3.70,6.17,,2.03,,0.55,10.42,6.28,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16264596,,Ins/rplcmt prq eltrd ra pn 1,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014