No office rate
Choose 64582 for initial implantation of a hypoglossal stimulation system. Choose 64583 when an existing array and pulse generator are revised or replaced.
On this page
CMS RVU26D · Effective 2026-10-01
64583 Stimulator revision Medicare reimbursement rates in Pennsylvania
Revision or replacement of an implanted hypoglossal nerve stimulation array and pulse generator, generally performed to address a problem with an existing system. Compare 64583 office and facility rates across CMS payment localities in Pennsylvania.
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 64583 in Pennsylvania?
Pennsylvania 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
$724.66–$775.32
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 surgery
About 64583: Hypoglossal stimulator system revision or replacement
Revision or replacement of an implanted hypoglossal nerve stimulation array and pulse generator, generally performed to address a problem with an existing system.
This operating-room service revises or replaces an implanted hypoglossal nerve stimulation array and pulse generator. It is typically performed by an otolaryngologist or another surgeon experienced with hypoglossal nerve stimulation for obstructive sleep apnea. The work concerns an existing system, rather than the initial implantation used to treat a patient with sleep-disordered breathing.
Report 64583 when the operative work revises or replaces the hypoglossal array and pulse generator; document the existing device, the reason for the procedure, and the components addressed. The code has a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed 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, co-surgeon, and team-surgery payment requires supporting documentation; an assistant also requires documentation of medical necessity.
CMS billing rules for 64583
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU14.14 · 63%
- Practice expense (office) RVU6.11 · 27%
- Malpractice RVU2.06 · 9%
97
Medicare services in 2024 · #4913 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.
64583 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
64584 describes removal of the hypoglossal array and pulse generator; 64583 describes revision or replacement of those system components.
$407.36–$445.64
64590 addresses insertion or replacement of a pulse generator for specified peripheral or gastric neurostimulator systems. 64583 is specific to revision or replacement of the hypoglossal array and generator.
Compare 64583 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 Philadelphia →
Office / nonfacility
Unavailable
Facility
$775.32
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$724.66
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64583 billing questions
How is 64583 different from 64582?
64583 is for revision or replacement of an existing hypoglossal stimulation array and pulse generator. 64582 is for initial implantation of the system.
When is 64584 reported instead?
64584 describes removal of the hypoglossal nerve stimulation array and pulse generator. Use 64583 when the operative service is revision or replacement rather than removal.
Does 64583 cover both the array and pulse generator?
The code describes revision or replacement of the hypoglossal array and pulse generator. Document which components were addressed; do not treat the code as a separate charge for each component.
What documentation supports 64583?
The operative report should identify the existing hypoglossal system, the reason for revision or replacement, and the work performed on the array and pulse generator.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and 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 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.
7,15464580,,Opn impltj nea neuromuscular,A,,4.09,4.24,NA,4.24,,1.10,9.43,9.43,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15564581,,Opn impltj nea sacral nerve,A,,11.90,3.97,NA,3.97,,1.73,17.60,17.60,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15664582,,Opn mpltj hpglsl nstm ary pg,A,,13.65,6.00,NA,6.00,,1.99,21.64,21.64,0,090,0.11,0.76,0.13,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15764583,,Rev/rplct hpglsl nstm ary pg,A,,14.14,6.11,NA,6.11,,2.06,22.31,22.31,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15864584,,Rmvl hpglsl nstim ary pg,A,,11.70,5.51,NA,5.51,,1.70,18.91,18.91,0,090,0.11,0.76,0.13,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,15964585,,Rev/rmv perph nstim eltrd ra,A,,2.06,5.19,,1.72,,0.29,7.54,4.07,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16064590,,Ins/rpl prph sac/gstr npg/r,A,,4.97,7.12,,2.29,,0.73,12.82,7.99,0,010,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00