$343.26
Choose 64590 for generator or receiver insertion or replacement. Choose 64595 for revision or removal of that unit.
On this page
CMS RVU26D · Effective 2026-10-01
64590 Neurostimulator generator Medicare reimbursement rates in Wyoming
Reports placement or replacement of an implanted pulse generator or receiver for peripheral, sacral, or gastric neurostimulation, including connection to an electrode array. Compare 64590 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 64590 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
$421.86
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$260.53
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 procedures
About 64590: Peripheral neurostimulator generator insertion or replacement
Reports placement or replacement of an implanted pulse generator or receiver for peripheral, sacral, or gastric neurostimulation, including connection to an electrode array.
This service places or replaces the implanted power unit that drives a peripheral, sacral, or gastric neurostimulator. The surgeon or other qualified proceduralist typically creates or reopens a pocket, positions the generator or receiver, and connects it to the implanted electrode array. Examples include generator replacement for a patient receiving sacral neuromodulation for urinary or bowel symptoms, or for gastric stimulation for gastroparesis. The work is commonly performed in an operating room or procedure facility; the generator procedure is distinct from placing or revising the nerve electrode.
Report this code when the implanted generator or receiver is inserted or replaced, not for lead work alone. The operative report should identify the device, the reason for insertion or replacement, the pocket and connection work, and any electrode-array procedure performed. Medicare includes related postoperative visits for 10 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted.
CMS billing rules for 64590
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.97 · 39%
- Practice expense (office) RVU7.12 · 56%
- Malpractice RVU0.73 · 6%
26.7K
Medicare services in 2024 · #1019 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.
64590 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$249.32
64585 addresses revision or removal of a peripheral neurostimulator electrode array. It does not represent work on the generator or receiver.
No office rate
64581 reports open implantation of a sacral nerve electrode array. Use 64590 for the implanted generator or receiver, which may be placed during the same encounter.
Compare 64590 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
$421.86
Facility
$260.53
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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 64590 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,160
- Code
- 64590
- Physician work
- 4.97
- Practice expense
- 7.12
- Malpractice
- 0.73
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.97 | × 1.000 | 4.9700 |
| Practice expense | 7.12 | × 1.000 | 7.1200 |
| Malpractice | 0.73 | × 0.740 | 0.5402 |
| Total RVUs | 12.6302 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$421.86
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.97 | 1 |
| Practice expense | 7.12 | 1 |
| Malpractice | 0.73 | 0.74 |
(4.97 × 1 + 7.12 × 1 + 0.73 × 0.74) × $33.4009 = $421.86
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.97 | 1 |
| Practice expense | 2.29 | 1 |
| Malpractice | 0.73 | 0.74 |
(4.97 × 1 + 2.29 × 1 + 0.73 × 0.74) × $33.4009 = $260.53
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.
64590 billing questions
How is this different from 64595?
64590 is for inserting or replacing the generator or receiver. Use 64595 when the generator or receiver is revised or removed without insertion or replacement.
Does this code include placement of the electrode array?
No. This code represents generator or receiver work; electrode-array placement, revision, or removal is a separate service when performed and supported by the operative documentation.
Can it be reported with a sacral electrode-array code?
It may be reported with 64561 or 64581 when the electrode array and implanted generator are placed during the same permanent implantation encounter. The record should describe both services.
What documentation supports generator replacement?
Document the existing device and its indication, why replacement was performed, the generator or receiver work, and its connection to the electrode array.
Should modifier 50 be used for bilateral treatment?
No. Modifier 50 is inappropriate for this generator or receiver service.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in the service.
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.
7,15764583,,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
7,16064590,,Ins/rpl prph sac/gstr npg/r,A,,4.97,7.12,,2.29,,0.73,12.82,7.99,0,010,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16164595,,Rev/rmv prph sac/gstr npg/r,A,,3.70,6.17,,2.03,,0.55,10.42,6.28,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16264596,,Ins/rplcmt prq eltrd ra pn 1,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,16364597,,Ins/rplcm prq eltrd ra pn ea,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,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.,,,,,,