Billing code 64595: Generator revisionMedicare rate & RVUs in Ohio
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.
Medicare pays $330.26 for 64595 in the office in Ohio (Ohio). Which amount applies depends on the service address.
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 64595 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $330.26 | $204.01 |
How the 64595 rate is calculated
Each of 64595’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 · 64595
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.70Practice expense 6.17Malpractice 0.55
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64595
64595 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64595
Generator revision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 64595
Generator revision
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
64595 without 51 · national office
$348.04
Generator revision
64595-51 · Second procedure: 50%
$174.02
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
64595 compared with similar codes
Compare codes
64595 vs 64590 vs 64585 vs 64561: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64590Neurostimulator generator
- Use 64590 for insertion or replacement of the generator or receiver; use 64595 for its revision or removal.
- 64585Lead revision/removal
- 64585 addresses revision or removal of a peripheral neurostimulator electrode array. 64595 addresses the generator or receiver in a sacral or gastric system.
- 64561Sacral nerve lead
- 64561 covers percutaneous implantation of a sacral nerve electrode array. It is not the code for revising or removing the system generator.
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 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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