How much does Medicare pay for CPT 64566?

Medicare allowed an average of $111.18 per service and paid $85.35 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $448.83, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64566?

Insertion of lower leg neurostimulator electrode. It was billed 97,198 times to 18,982 Medicare beneficiaries by 846 providers in 2024.

Does 64566 pay differently in an office than a hospital?

Yes. The allowed amount averaged $114.95 in an office setting and $26.89 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 64566 most?

Urology, with 40,237 services from 358 clinicians. Next are Nurse Practitioner, Physician Assistant, Obstetrics & Gynecology.

CPT 64566

Insertion of lower leg neurostimulator electrode

$111.18Medicare-allowed amount per service, averaged across 97,198 services

Providers submitted

$448.83

Asking price, not received

Medicare allowed

$111.18

The fee schedule figure

Medicare paid

$85.35

Balance is patient coinsurance

Providers submitted an average of $448.83 for this code and Medicare allowed $111.18 — 4.0× 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 $85.35 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $114.95
Hospital / facility: $26.89

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 93,037 services were billed in an office setting and 4,161 in a facility.

Services: 97,198
Beneficiaries: 18,982
Providers billing it: 846
Total allowed: $10,806,474

What Medicare pays for CPT 64566

Across 97,198 services billed by 846 providers to 18,982 beneficiaries, Medicare allowed an average of $111.18 per service. That is 5.1 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 64566

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	40,237	8,118	$124.41	358
Nurse Practitioner	24,117	4,343	$90.05	203
Physician Assistant	15,366	3,332	$94.22	152
Obstetrics & Gynecology	14,675	2,719	$123.01	112
Undefined Physician type	1,116	209	$139.32	7
Gynecological Oncology	373	37	$145.74	1
Internal Medicine	257	65	$127.07	3
Physical Medicine and Rehabilitation	217	39	$91.35	2
Family Practice	198	26	$153.35	1
Endocrinology	177	23	$136.58	1
General Surgery	129	11	$123.03	1
Pediatric Medicine	123	14	$129.98	1
Geriatric Medicine	106	12	$132.18	1
Neurology	74	11	$124.06	1
Radiation Oncology	18	11	$122.43	1

64566 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
California	34,864	$120.95	$78.41	207
New York	11,044	$127.59	$82.21	49
Florida	6,524	$110.70	$83.41	63
Arizona	5,604	$104.38	$80.20	63
Pennsylvania	3,948	$100.88	$77.11	33
Texas	3,714	$97.68	$74.24	34
Illinois	2,599	$99.40	$73.65	21
Washington	2,139	$99.16	$71.24	27
Massachusetts	2,117	$117.35	$81.21	24
Michigan	1,905	$71.44	$53.43	29
New Jersey	1,806	$114.77	$78.48	21
Georgia	1,681	$104.49	$80.37	21
Virginia	1,610	$94.61	$68.48	21
Colorado	1,492	$107.75	$78.50	24
Nevada	1,355	$108.20	$81.61	16
Maryland	1,127	$113.18	$81.25	15
North Carolina	1,085	$92.07	$74.24	11
Connecticut	997	$100.86	$70.64	12
Utah	962	$87.55	$71.06	13
Ohio	884	$101.65	$82.57	13
South Carolina	824	$100.22	$83.23	12
Oregon	810	$107.13	$79.39	16
New Hampshire	794	$107.68	$78.04	8
Delaware	680	$96.31	$70.55	8
Indiana	673	$90.82	$74.34	8
Oklahoma	662	$101.95	$86.45	15
Iowa	620	$78.80	$65.03	7
New Mexico	491	$25.86	$19.08	4
Missouri	479	$108.89	$84.01	8
Kentucky	475	$89.34	$74.29	5
Tennessee	402	$102.71	$81.69	5
Minnesota	368	$116.03	$84.47	5
District of Columbia	350	$135.14	$89.05	5
Idaho	299	$77.31	$55.92	3
Kansas	293	$59.62	$47.96	3
Alaska	270	$111.10	$75.51	4
North Dakota	230	$77.35	$57.93	2
Montana	193	$25.01	$18.88	1
Nebraska	184	$104.19	$79.02	2
Louisiana	161	$97.32	$75.74	2
Mississippi	140	$106.61	$88.71	1
Hawaii	113	$114.54	$87.75	1
Wisconsin	112	$102.86	$83.80	2
Maine	62	$24.99	$19.29	1
Rhode Island	56	$131.72	$91.34	1

Related codes

64561Insertion of sacral nerve neurostimulator electrode array$2661.59
64590Insertion or replacement of peripheral$7256.19
64555Insertion of peripheral nerve neurostimulator electrode through skin$2824.92
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.