$396.32
Use 64590 for insertion or replacement of the generator or receiver; use 64595 for its revision or removal.
On this page
CMS RVU26D · Effective 2026-10-01
64595 Generator revision Medicare reimbursement rates in Idaho
Reports revision or removal of an implanted pulse generator or receiver for sacral neuromodulation or gastric electrical stimulation, rather than work on its electrode array. Compare 64595 office and facility rates across CMS payment localities in Idaho.
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 64595 in Idaho?
Idaho 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
$321.87
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
$194.65
1 of 1 localities have a supported rate.
Payment area: Idaho
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.
Neurostimulator procedures
About 64595: Sacral or gastric neurostimulator generator revision
Reports revision or removal of an implanted pulse generator or receiver for sacral neuromodulation or gastric electrical stimulation, rather than work on its electrode array.
This service addresses the implanted pulse generator or receiver for a sacral neuromodulation system or a gastric electrical stimulation system. The surgeon may revise the generator or remove it; the work concerns the generator or receiver, not the electrode array. Typical cases include correcting a generator pocket problem or removing a failed or no-longer-needed generator. Urologic, colorectal, or foregut surgeons commonly perform these procedures in a procedural or operating-room setting. Device analysis, programming, and imaging are included when performed as part of the service.
Choose this code when the operative work is revision or removal, rather than insertion or replacement of the generator. Document the device type and site, the reason for surgery, and the generator work performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed 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. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 64595
- 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 RVU3.70 · 36%
- Practice expense (office) RVU6.17 · 59%
- Malpractice RVU0.55 · 5%
3.9K
Medicare services in 2024 · #2004 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.
64595 compared with similar codes
Office rates for Idaho, from the same CMS release.
$232.87
64585 addresses revision or removal of a peripheral neurostimulator electrode array. 64595 addresses the generator or receiver in a sacral or gastric system.
$686.37
64561 covers percutaneous implantation of a sacral nerve electrode array. It is not the code for revising or removing the system generator.
Compare 64595 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
Idaho →
Office / nonfacility
$321.87
Facility
$194.65
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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 64595 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
7,161
- Code
- 64595
- Physician work
- 3.70
- Practice expense
- 6.17
- Malpractice
- 0.55
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.70 | × 1.000 | 3.7000 |
| Practice expense | 6.17 | × 0.920 | 5.6764 |
| Malpractice | 0.55 | × 0.473 | 0.2601 |
| Total RVUs | 9.6365 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$321.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.7 | 1 |
| Practice expense | 6.17 | 0.92 |
| Malpractice | 0.55 | 0.473 |
(3.7 × 1 + 6.17 × 0.92 + 0.55 × 0.473) × $33.4009 = $321.87
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.7 | 1 |
| Practice expense | 2.03 | 0.92 |
| Malpractice | 0.55 | 0.473 |
(3.7 × 1 + 2.03 × 0.92 + 0.55 × 0.473) × $33.4009 = $194.65
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.
64595 billing questions
When should I report 64595 instead of 64590?
Report 64595 for revision or removal of the sacral or gastric system’s generator or receiver. Report 64590 when the generator or receiver is inserted or replaced.
Does this code cover work on the electrode array?
No. The service concerns the generator or receiver. If the operative work revises or removes a separate peripheral neurostimulator electrode array, consider 64585 instead.
Can device analysis, programming, or imaging be billed separately?
Analysis, programming, and imaging are included when performed as part of this generator revision or removal service.
Should I append modifier 50 for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Are an assistant surgeon or co-surgeons payable?
Medicare does not pay an assistant at surgery for 64595. Co-surgeons and team surgery are not permitted.
How does the global period affect postoperative visits?
The code has a 10-day global period. Related postoperative visits during those 10 days are included.
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.
7,15864584,,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
7,16364597,,Ins/rplcm prq eltrd ra pn ea,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16464598,,Revj/rmvl nea pn w/int nstim,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
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772