Billing code 64561: Sacral nerve leadMedicare rate & RVUs in Washington
Reports percutaneous placement of a sacral nerve stimulation lead, commonly for a sacral neuromodulation trial addressing urinary or bowel dysfunction.
Medicare pays $767.81–$869.86 for 64561 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 64561 covers
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.
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.
Where 64561 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $767.81 | $271.19 |
| Seattle (King Cnty) | $869.86 | $291.18 |
How the 64561 rate is calculated
Each of 64561’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 · 64561
RVUs × geographic indexes × conversion factor
Work5.30
5.30 RVUs× 1.000 GPCI
Practice expense16.19
16.19 RVUs× 1.000 GPCI
Malpractice0.75
0.75 RVUs× 1.000 GPCI
Adjusted RVUs
22.2400
Conversion factor
$33.4009
Medicare rate
$742.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64561
64561 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64561
Sacral nerve lead
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 64561
Sacral nerve lead
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 50 · payment effect
With and without the modifier
64561 without 50 · national office
$742.84
Sacral nerve lead
64561-50 · Bilateral: 150%
$1,114.26
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).
64561 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64581Sacral nerve lead
- Use 64561 for percutaneous sacral lead placement; use 64581 when the lead is placed by an open approach.
- 64566Tibial nerve stimulation
- 64566 is for posterior tibial nerve stimulation, typically delivered through a tibial-site needle electrode. 64561 places a lead at a sacral nerve.
- 64555Nerve stimulation
- 64555 covers percutaneous electrode placement at a peripheral nerve other than the sacral nerve; sacral nerve placement is reported with 64561.
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 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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