Billing code 64582: Nerve stimulator implantMedicare rate & RVUs in Washington
Open implantation of a hypoglossal nerve stimulation system for obstructive sleep apnea, including its stimulation array, respiratory sensing lead, and pulse generator.
CMS doesn’t publish an office rate for 64582 in Washington.
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 64582 covers
A surgeon implants a stimulation lead at the hypoglossal nerve, a respiratory sensing lead, and a pulse generator, generally during an operating-room procedure for a patient selected for hypoglossal nerve stimulation to treat obstructive sleep apnea. System testing and programming performed during implantation, and imaging guidance when used, are part of the service. Otolaryngologists and surgeons specializing in sleep-disordered breathing commonly perform the operation.
Report this code for the initial open implantation of the system, not for later revision, replacement, or removal. The operative report should identify the implanted components and document the procedure performed. CMS assigns a 90-day global period, which includes 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 the others at 50%. CMS pays a bilateral procedure reported with modifier 50 at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 64582 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $723.46 |
| Seattle (King Cnty) | Unavailable | $778.92 |
How the 64582 rate is calculated
Each of 64582’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 · 64582
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.65Practice expense 6.00Malpractice 1.99
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64582
64582 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64582
Nerve stimulator implant
| 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| 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 · 64582
Nerve stimulator implant
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
64582 without 50 · national facility
$722.80
Nerve stimulator implant
64582-50 · Bilateral: 150%
$1,084.20
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).
64582 compared with similar codes
Compare codes
64582 vs 64583 vs 64584 vs 64568: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64583Stimulator revision
- Use 64582 for initial open implantation of the hypoglossal nerve stimulation system. Use 64583 when revising or replacing an existing system.
- 64584Stimulator removal
- 64584 describes removal of an existing hypoglossal nerve stimulation system; it is not the initial implantation code.
- 64568Nerve stimulator
- 64568 is an open cranial-nerve neurostimulator implant code for a vagus nerve system. Code 64582 identifies the hypoglossal nerve system used for hypoglossal nerve stimulation.
64582 billing questions
How does this differ from code 64583?
64582 describes the initial open implantation. Code 64583 is for revision or replacement of the hypoglossal nerve stimulation system.
Is the pulse generator separately reported?
The initial implantation service includes the pulse generator along with the nerve stimulation system. Do not separately report a generator implantation code for that same system placement.
What documentation supports the initial implantation?
The operative report should show that the hypoglossal nerve stimulation system was implanted and identify the components placed. It should distinguish initial implantation from revision, replacement, or removal.
What postoperative care is included?
CMS assigns a 90-day global period. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
CMS allows assistant-at-surgery payment only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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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