No office rate
Use 64582 for initial open implantation of the hypoglossal nerve stimulation system. Use 64583 when revising or replacing an existing system.
On this page
CMS RVU26D · Effective 2026-10-01
64582 Nerve stimulator implant Medicare reimbursement rates in Wyoming
Open implantation of a hypoglossal nerve stimulation system for obstructive sleep apnea, including its stimulation array, respiratory sensing lead, and pulse generator. Compare 64582 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 64582 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
$705.51
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 64582: Open hypoglossal nerve stimulator implantation
Open implantation of a hypoglossal nerve stimulation system for obstructive sleep apnea, including its stimulation array, respiratory sensing lead, and pulse generator.
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.
CMS billing rules for 64582
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.65 · 63%
- Practice expense (office) RVU6.00 · 28%
- Malpractice RVU1.99 · 9%
6.8K
Medicare services in 2024 · #1678 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.
64582 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
64584 describes removal of an existing hypoglossal nerve stimulation system; it is not the initial implantation code.
No office rate
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.
Compare 64582 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
$705.51
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 64582 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,156
- Code
- 64582
- Physician work
- 13.65
- Practice expense
- 6.00
- Malpractice
- 1.99
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.65 | × 1.000 | 13.6500 |
| Practice expense | 6.00 | × 1.000 | 6.0000 |
| Malpractice | 1.99 | × 0.740 | 1.4726 |
| Total RVUs | 21.1226 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$705.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.65 | 1 |
| Practice expense | 6 | 1 |
| Malpractice | 1.99 | 0.74 |
(13.65 × 1 + 6 × 1 + 1.99 × 0.74) × $33.4009 = $705.51
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.
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 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.
7,15364575,,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
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
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.,,,,,,