$2,499.72–$2,808.23
63650 covers percutaneous implantation of spinal stimulation electrodes. Use 63685 for the generator or receiver placed in a pocket.
On this page
CMS RVU26D · Effective 2026-10-01
63685 Neurostimulator generator Medicare reimbursement rates in Massachusetts
Placement or replacement of an implanted spinal neurostimulator generator or receiver in a pocket, commonly paired with epidural stimulation-lead implantation. Compare 63685 office and facility rates across CMS payment localities in Massachusetts.
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 63685 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$320.30–$343.94
2 of 2 localities have a supported rate.
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
About 63685: Spinal neurostimulator generator placement
Placement or replacement of an implanted spinal neurostimulator generator or receiver in a pocket, commonly paired with epidural stimulation-lead implantation.
This service places or replaces the implanted pulse generator or receiver that powers a spinal cord neurostimulator. The surgeon creates or accesses a pocket, commonly in the flank or buttock, and connects the generator to the stimulation leads. Neurosurgeons and pain physicians commonly perform the procedure in an operating room, including after a successful temporary stimulation trial or when an implanted generator needs replacement.
Report the generator or receiver service for the implanted power unit; lead implantation is a separate service when performed and coded. Operative documentation should identify whether the unit was newly implanted or replaced, the pocket work, and its connection to the stimulation system. Related postoperative visits for 10 days 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% reduction. Modifier 50 is inappropriate for this descriptor and anatomy. Medicare may pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 63685
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.06 · 53%
- Practice expense (office) RVU3.43 · 36%
- Malpractice RVU1.05 · 11%
47.1K
Medicare services in 2024 · #804 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.
63685 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
63655 covers open implantation of spinal stimulation electrodes. It is distinct from placing or replacing the generator or receiver under 63685.
No office rate
63688 describes revision or removal of the implanted generator or receiver; 63685 describes insertion or replacement.
Compare 63685 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$343.94
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$320.30
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63685 billing questions
How is this different from spinal electrode implantation?
This code covers the implanted generator or receiver in its pocket. Codes 63650 and 63655 describe spinal electrode implantation, not the generator.
Can the generator and lead procedures be reported together?
Yes, when both the generator or receiver and spinal electrodes are implanted during the encounter, report the applicable code for each service, subject to applicable edits.
When should 63688 be considered instead?
Use 63685 for insertion or replacement of the generator or receiver. Code 63688 describes revision or removal of that implanted component.
Should modifier 50 be appended for a generator on each side?
No. CMS identifies modifier 50 as inappropriate for this descriptor and anatomy; report the generator service without bilateral reporting.
What documentation supports reporting this code?
Document whether the generator or receiver was newly placed or replaced, the pocket procedure, and its connection to the spinal stimulation system.
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.
7,08063662,,Remove spine eltrd plate,A,,10.73,10.84,NA,10.84,,3.87,25.44,25.44,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08163663,,Revise spine eltrd perq aray,A,,7.56,19.90,,3.62,,1.08,28.54,12.26,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08263664,,Revise spine eltrd plate,A,,11.23,11.20,NA,11.20,,4.11,26.54,26.54,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08363685,,Ins/rplc spi npg/rcvr pocket,A,,5.06,3.43,NA,3.43,,1.05,9.54,9.54,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08463688,,Rev/rmv imp sp npg/r dtch cn,A,,4.24,3.85,NA,3.85,,1.06,9.15,9.15,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08563700,,Repair of spinal herniation,A,,17.03,15.40,NA,15.40,,7.19,39.62,39.62,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08663702,,Repair of spinal herniation,A,,18.92,16.06,NA,16.06,,7.98,42.96,42.96,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00