Billing code 64658: Lead removalMedicare rate & RVUs in Ohio
Removal of the implanted lead from a battery-powered neuromodulation system when the lead is taken out and the pulse generator is not removed.
CMS doesn’t publish an office rate for 64658 in Ohio.
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 64658 covers
This code represents surgical removal of the implanted lead from a battery-powered neuromodulation system, without removal of the pulse generator. For sacral neuromodulation, the lead is placed near the sacral nerves; urologists, urogynecologists, and colorectal surgeons may perform removal when a device is no longer needed, has malfunctioned, or requires a different treatment plan. The operative report should identify the lead removed and the generator’s status.
Report this code when the work is removal of the lead only; removal of the whole system or generator alone corresponds to a different code in the family. Documentation should support the operative work, device components addressed, and laterality when relevant. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery, co-surgeon, and team-surgery payment require the specified supporting documentation.
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.
64658 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $467.76 |
How the 64658 rate is calculated
Each of 64658’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 · 64658
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.95Practice expense 3.03Malpractice 2.27
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64658
64658 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64658
Lead 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 · 64658
Lead 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
64658 without 50 · national facility
$475.96
Lead removal
64658-50 · Bilateral: 150%
$713.94
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).
64658 compared with similar codes
Compare codes
64658 vs 64657 vs 64659 vs 64655: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64657System removal
- Choose 64658 when only the lead is removed and the generator remains; 64657 represents removal of the complete system.
- 64659Generator removal
- 64659 is for removal of the pulse generator alone. This code is for removal of the lead alone.
- 64655BAT lead revision
- 64655 represents lead revision or replacement. Use 64658 when the lead is removed without revision or replacement.
64658 billing questions
How is this different from removal of the entire system?
Use this code when the lead is removed but the pulse generator remains. Removal of both components is represented by the total-system removal code, 64657.
How is this different from generator-only removal?
This code covers removal of the lead, not the pulse generator. Generator-only removal is reported with 64659.
Can this code describe lead revision or replacement?
No. This code represents lead removal only; revision or replacement of the lead is represented by 64655.
What should the operative report document?
Document the neuromodulation system, the lead removed, whether the pulse generator was retained, and the work performed. Include laterality when relevant.
How does Medicare handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. The code has a 90-day global period.
What documentation is needed for an assistant or co-surgeon?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment require supporting documentation.
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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