Use 64561 for percutaneous sacral lead placement; use 64581 when the lead is placed by an open approach.
On this page
CMS RVU26D · Effective 2026-10-01
64561 Sacral nerve lead Medicare reimbursement rates in Rhode Island
Reports percutaneous placement of a sacral nerve stimulation lead, commonly for a sacral neuromodulation trial addressing urinary or bowel dysfunction. Compare 64561 office and facility rates across CMS payment localities in Rhode Island.
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 64561 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$761.34
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$274.15
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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 procedures
About 64561: Percutaneous sacral nerve electrode placement
Reports percutaneous placement of a sacral nerve stimulation lead, commonly for a sacral neuromodulation trial addressing urinary or bowel dysfunction.
The clinician advances an electrode lead through a sacral foramen to stimulate a sacral nerve, commonly the S3 nerve. Urologists, urogynecologists, and other clinicians performing sacral neuromodulation use this approach to assess or treat conditions such as urinary urgency, nonobstructive retention, or fecal incontinence. Placement is generally performed in an operating or procedure room with stimulation used to assess lead position and response.
Choose this code when the sacral lead is placed percutaneously; an open approach is reported differently. The record should identify the sacral target, percutaneous technique, lead placement, and the clinical indication. CMS assigns a 10-day global period, so related postoperative visits during that period are included. For multiple procedures 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%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 64561
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.30 · 24%
- Practice expense (office) RVU16.19 · 73%
- Malpractice RVU0.75 · 3%
41K
Medicare services in 2024 · #861 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.
64561 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
64566 is for posterior tibial nerve stimulation, typically delivered through a tibial-site needle electrode. 64561 places a lead at a sacral nerve.
64555 covers percutaneous electrode placement at a peripheral nerve other than the sacral nerve; sacral nerve placement is reported with 64561.
Compare 64561 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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
$761.34
Facility
$274.15
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64561 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,147
- Code
- 64561
- Physician work
- 5.30
- Practice expense
- 16.19
- Malpractice
- 0.75
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.30 | × 1.019 | 5.4007 |
| Practice expense | 16.19 | × 1.033 | 16.7243 |
| Malpractice | 0.75 | × 0.892 | 0.6690 |
| Total RVUs | 22.7940 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$761.34
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.3 | 1.019 |
| Practice expense | 16.19 | 1.033 |
| Malpractice | 0.75 | 0.892 |
(5.3 × 1.019 + 16.19 × 1.033 + 0.75 × 0.892) × $33.4009 = $761.34
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.3 | 1.019 |
| Practice expense | 2.07 | 1.033 |
| Malpractice | 0.75 | 0.892 |
(5.3 × 1.019 + 2.07 × 1.033 + 0.75 × 0.892) × $33.4009 = $274.15
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
64561 billing questions
How does this differ from 64581?
64561 is for percutaneous sacral lead placement. 64581 describes sacral lead placement through an open approach.
Is the pulse generator included?
No. The pulse generator is a separate service, reported with 64590 when it is implanted or replaced.
What documentation supports 64561?
Document the indication, sacral nerve target, percutaneous placement technique, and lead location or stimulation findings.
How does Medicare handle bilateral reporting?
The CMS rule specifies modifier 50 for a bilateral procedure, with payment at 150%.
Are postoperative visits separately reported during the global period?
Related postoperative visits for 10 days are included in the 10-day global period.
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.
