How much does Medicare pay for CPT 64555?

Medicare allowed an average of $2824.92 per service and paid $2249.40 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $11,637, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64555?

Insertion of peripheral nerve neurostimulator electrode through skin. It was billed 11,454 times to 5,652 Medicare beneficiaries by 268 providers in 2024.

Does 64555 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1522.65 in an office setting and $2999.36 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 64555 most?

Ambulatory Surgical Center, with 5,163 services from 106 clinicians. Next are Pain Management, Anesthesiology, Interventional Pain Management.

CPT 64555

Insertion of peripheral nerve neurostimulator electrode through skin

$2824.92Medicare-allowed amount per service, averaged across 11,454 services

Providers submitted

$11,637

Asking price, not received

Medicare allowed

$2824.92

The fee schedule figure

Medicare paid

$2249.40

Balance is patient coinsurance

Providers submitted an average of $11,637 for this code and Medicare allowed $2824.92 — 4.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $2249.40 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1522.65
Hospital / facility: $2999.36

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 1,353 services were billed in an office setting and 10,101 in a facility.

Services: 11,454
Beneficiaries: 5,652
Providers billing it: 268
Total allowed: $32,356,634

What Medicare pays for CPT 64555

Across 11,454 services billed by 268 providers to 5,652 beneficiaries, Medicare allowed an average of $2824.92 per service. That is 2.0 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 64555

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	5,163	2,236	$5619.00	106
Pain Management	2,049	1,020	$387.14	56
Anesthesiology	1,301	679	$373.36	36
Interventional Pain Management	871	445	$558.23	24
Physical Medicine and Rehabilitation	827	462	$493.62	24
Sports Medicine	266	235	$1265.77	1
Orthopedic Surgery	184	93	$738.51	4
Neurology	164	57	$249.62	2
Podiatry	128	76	$1160.27	5
Preventive Medicine	124	58	$273.72	2
Endocrinology	115	115	$1838.97	2
Family Practice	102	61	$252.74	2
Nurse Practitioner	80	59	$1775.92	1
Neurosurgery	49	26	$826.31	1
Diagnostic Radiology	18	17	$1858.04	1

64555 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	2,232	$3015.95	$2466.16	45
California	1,985	$3590.77	$2314.43	37
Florida	1,278	$2808.63	$2401.82	21
Arizona	667	$3207.10	$2675.13	12
New York	405	$3063.06	$2277.81	12
Illinois	403	$2001.80	$1542.69	11
Wisconsin	372	$2106.02	$1678.05	10
Indiana	357	$3287.01	$2676.96	6
South Carolina	332	$2773.02	$2314.05	9
Tennessee	314	$2190.39	$1966.52	8
Oklahoma	289	$2351.54	$1961.47	9
Georgia	271	$2678.96	$2186.91	9
North Carolina	269	$1716.06	$1393.97	13
Ohio	268	$824.15	$641.38	5
Pennsylvania	211	$2841.09	$2293.19	4
Kansas	180	$2346.81	$1923.71	4
Maryland	179	$3068.02	$2439.88	5
Massachusetts	136	$1141.32	$854.39	6
Washington	125	$3947.78	$2879.02	3
New Jersey	123	$2432.32	$1760.99	4
Nebraska	110	$4707.40	$3828.74	3
Oregon	103	$4471.45	$3325.60	4
Missouri	95	$584.19	$459.83	4
Colorado	83	$2273.93	$1796.52	3
Iowa	75	$231.48	$168.53	1
Rhode Island	68	$3352.27	$2664.94	2
Idaho	66	$279.84	$241.74	2
Connecticut	65	$335.15	$244.52	2
Utah	63	$3420.81	$2810.32	2
Nevada	58	$5904.51	$4402.20	1
Kentucky	53	$3817.13	$3226.78	2
Virginia	48	$1873.58	$1657.97	2
Louisiana	48	$292.22	$236.41	2
Minnesota	47	$270.87	$199.32	2
Arkansas	32	$268.58	$232.25	1
Michigan	27	$5594.28	$4402.21	1
New Hampshire	17	$261.28	$204.00	1

Related codes

64566Insertion of lower leg neurostimulator electrode$111.18
64561Insertion of sacral nerve neurostimulator electrode array$2661.59
64590Insertion or replacement of peripheral$7256.19
64582Insertion of hypoglossal nerve neurostimulator electrode and generator$1710.79
64520Injection of anesthetic agent into middle or lower spine sympathetic n$263.66
64510Injection of anesthetic agent into sympathetic nerve bundle$184.69

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.