No office rate
Choose 64569 for revision or replacement of the vagus nerve electrode array. Choose 64570 when the array and pulse generator are removed.
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CMS RVU26D · Effective 2026-10-01
64570 Vagus stimulator removal Medicare reimbursement rates in Wyoming
Removal of an implanted vagus nerve stimulation electrode array and pulse generator, reported when the complete cranial nerve stimulation system is surgically taken out. Compare 64570 office and facility rates across CMS payment localities in Wyoming.
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 64570 in Wyoming?
Wyoming 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
No supported rate
Facility setting
$733.74
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 surgery
About 64570: Vagus nerve stimulator system removal
Removal of an implanted vagus nerve stimulation electrode array and pulse generator, reported when the complete cranial nerve stimulation system is surgically taken out.
This operation removes the implanted electrode array from the vagus nerve and the associated pulse generator. It is typically performed by a surgeon in a facility setting for a patient with an existing vagus nerve stimulation system, often used to treat epilepsy. Removal may involve dissection of the lead from the nerve and removal of the generator from its implant pocket.
Report the code when both the electrode array and pulse generator are removed; removal is distinct from revising or replacing the array. The operative report should identify the vagus nerve system and document the components taken out. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery, co-surgeon, and team-surgery payment requires supporting documentation as applicable.
CMS billing rules for 64570
- 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 RVU8.87 · 39%
- Practice expense (office) RVU10.33 · 45%
- Malpractice RVU3.74 · 16%
111
Medicare services in 2024 · #4802 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.
64570 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
64568 describes implantation of a cranial nerve stimulation array and pulse generator; 64570 describes removal of the vagus nerve system.
No office rate
64584 concerns removal of a hypoglossal nerve stimulation system. Use 64570 for removal of the vagus nerve system.
Compare 64570 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$733.74
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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 64570 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,152
- Code
- 64570
- Physician work
- 8.87
- Practice expense
- 10.33
- Malpractice
- 3.74
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.87 | × 1.000 | 8.8700 |
| Practice expense | 10.33 | × 1.000 | 10.3300 |
| Malpractice | 3.74 | × 0.740 | 2.7676 |
| Total RVUs | 21.9676 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$733.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.87 | 1 |
| Practice expense | 10.33 | 1 |
| Malpractice | 3.74 | 0.74 |
(8.87 × 1 + 10.33 × 1 + 3.74 × 0.74) × $33.4009 = $733.74
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.
64570 billing questions
How does removal differ from revision or replacement?
Use this code when the vagus nerve electrode array and pulse generator are removed. Revision or replacement of the array is a different service.
Does this code include removal of the pulse generator?
Yes. The service includes removal of the electrode array and its associated pulse generator; document which implanted components were removed.
What documentation supports reporting this code?
The operative report should identify the vagus nerve stimulation system and describe removal of both its electrode array and pulse generator.
How is bilateral removal reported?
For a bilateral procedure, CMS pays this code with modifier 50 at 150%, according to the supplied fee schedule rule.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon or 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.
7,14964567,,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
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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,