Billing code 64570: Vagus stimulator removalMedicare rate & RVUs in Illinois
Removal of an implanted vagus nerve stimulation electrode array and pulse generator, reported when the complete cranial nerve stimulation system is surgically taken out.
CMS doesn’t publish an office rate for 64570 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 64570 covers
This operation removes the implanted electrode array from the vagus nerve and the associated pulse generator. It is typically performed by a surgeon in a facility setting for a patient with an existing vagus nerve stimulation system, often used to treat epilepsy. Removal may involve dissection of the lead from the nerve and removal of the generator from its implant pocket.
Report the code when both the electrode array and pulse generator are removed; removal is distinct from revising or replacing the array. The operative report should identify the vagus nerve system and document the components taken out. 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 one session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery, co-surgeon, and team-surgery payment requires supporting documentation as applicable.
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.
Where 64570 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $931.79 |
| East St. Louis | Unavailable | $865.28 |
| Rest Of Illinois | Unavailable | $806.53 |
| Suburban Chicago | Unavailable | $874.04 |
How the 64570 rate is calculated
Each of 64570’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 64570
RVUs × geographic indexes × conversion factor
Work8.87
8.87 RVUs× 1.000 GPCI
Practice expense10.33
10.33 RVUs× 1.000 GPCI
Malpractice3.74
3.74 RVUs× 1.000 GPCI
Adjusted RVUs
22.9400
Conversion factor
$33.4009
Medicare rate
$766.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64570
64570 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64570
Vagus stimulator removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 64570
Vagus stimulator removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
64570 without 50 · national facility
$766.22
Vagus stimulator removal
64570-50 · Bilateral: 150%
$1,149.33
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
64570 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64569Vagus nerve electrode
- Choose 64569 for revision or replacement of the vagus nerve electrode array. Choose 64570 when the array and pulse generator are removed.
- 64568Nerve stimulator
- 64568 describes implantation of a cranial nerve stimulation array and pulse generator; 64570 describes removal of the vagus nerve system.
- 64584Stimulator removal
- 64584 concerns removal of a hypoglossal nerve stimulation system. Use 64570 for removal of the vagus nerve system.
64570 billing questions
How does removal differ from revision or replacement?
Use this code when the vagus nerve electrode array and pulse generator are removed. Revision or replacement of the array is a different service.
Does this code include removal of the pulse generator?
Yes. The service includes removal of the electrode array and its associated pulse generator; document which implanted components were removed.
What documentation supports reporting this code?
The operative report should identify the vagus nerve stimulation system and describe removal of both its electrode array and pulse generator.
How is bilateral removal reported?
For a bilateral procedure, CMS pays this code with modifier 50 at 150%, according to the supplied fee schedule rule.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon or team-surgery payment requires supporting documentation.
What postoperative care is included?
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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