$1,233.18–$1,370.37
64568 is the open cranial nerve implantation that includes the array and pulse generator; 64567 is the percutaneous cranial nerve electrode-array approach.
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CMS RVU26D · Effective 2026-10-01
64568 Nerve stimulator Medicare reimbursement rates in Oregon
Reports open implantation of a cranial nerve stimulation system, commonly a vagus nerve electrode array and pulse generator for refractory epilepsy. Compare 64568 office and facility rates across CMS payment localities in Oregon.
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 64568 in Oregon?
Oregon 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
$628.20–$667.40
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.
Neurostimulator implantation
About 64568: Open cranial nerve stimulator implantation
Reports open implantation of a cranial nerve stimulation system, commonly a vagus nerve electrode array and pulse generator for refractory epilepsy.
A surgeon implants a stimulation lead on a cranial nerve and places the pulse generator, typically in a subcutaneous chest pocket. Vagus nerve stimulation for medically refractory epilepsy is a common example. The operation generally involves a neck incision to expose the nerve and a separate site for the generator, and is performed in an operating room by a neurosurgeon or another surgeon experienced with the implant.
Report 64568 for the initial open implantation of the cranial nerve electrode array and pulse generator. The operative report should identify the nerve targeted, the open implantation approach, and placement of both the lead and generator. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 64568
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.78 · 44%
- Practice expense (office) RVU7.88 · 40%
- Malpractice RVU3.10 · 16%
210
Medicare services in 2024 · #4280 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.
64568 compared with similar codes
Office rates for Oregon, from the same CMS release.
No office rate
64568 describes initial implantation. Use 64569 for revision or replacement of an existing cranial nerve array and pulse generator.
No office rate
64570 is for removal of a cranial nerve stimulation array and pulse generator, not initial placement.
No office rate
64582 is specific to open implantation of a hypoglossal nerve stimulation system; 64568 covers other cranial nerve stimulation implantation, such as vagus nerve stimulation.
Compare 64568 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
Portland →
Office / nonfacility
Unavailable
Facility
$667.40
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$628.20
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64568 billing questions
When should 64568 be chosen over 64567?
Use 64568 for open implantation of the cranial nerve electrode array and pulse generator. Code 64567 describes a percutaneous cranial nerve electrode-array approach.
Does 64568 include the pulse generator?
Yes. The service covers implantation of both the cranial nerve electrode array and the pulse generator.
How is a revision or replacement reported?
For revision or replacement of an existing cranial nerve stimulation array and pulse generator, compare 64569 rather than reporting the initial-implant code.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures and bilateral services paid?
In the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
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.
7,14764561,,Implant neuroelectrodes,A,,5.30,16.19,,2.07,,0.75,22.24,8.12,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14864566,,Neuroeltrd stim post tibial,A,,0.59,2.85,,0.12,,0.07,3.51,0.78,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,14964567,,Perq elec nrv field stimj cn,A,,1.50,35.45,,0.33,,0.16,37.11,1.99,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15064568,,Opn impltj crnl nrv nea&pg,A,,8.78,7.88,NA,7.88,,3.10,19.76,19.76,0,090,0.11,0.76,0.13,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15164569,,Revise/repl vagus n eltrd,A,,10.73,7.89,NA,7.89,,3.72,22.34,22.34,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15264570,,Remove vagus n eltrd,A,,8.87,10.33,NA,10.33,,3.74,22.94,22.94,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15364575,,Opn impltj nea perph nerve,A,,4.31,3.79,NA,3.79,,0.69,8.79,8.79,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00