How much does Medicare pay for CPT 64590?

Medicare allowed an average of $7256.19 per service and paid $5780.80 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $20,529, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 64590?

Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver. It was billed 12,311 times to 12,074 Medicare beneficiaries by 576 providers in 2024.

Does 64590 pay differently in an office than a hospital?

Yes. The allowed amount averaged $194.16 in an office setting and $7296.57 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 64590 most?

Ambulatory Surgical Center, with 4,991 services from 185 clinicians. Next are Urology, Obstetrics & Gynecology, General Surgery.

CPT 64590

Insertion or replacement of peripheral, sacral, or gastric neurostimulator generator or receiver

$7256.19Medicare-allowed amount per service, averaged across 12,311 services

Providers submitted

$20,529

Asking price, not received

Medicare allowed

$7256.19

The fee schedule figure

Medicare paid

$5780.80

Balance is patient coinsurance

Providers submitted an average of $20,529 for this code and Medicare allowed $7256.19 — 2.8× 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 $5780.80 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $194.16
Hospital / facility: $7296.57

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 70 services were billed in an office setting and 12,241 in a facility.

Services: 12,311
Beneficiaries: 12,074
Providers billing it: 576
Total allowed: $89,330,955

What Medicare pays for CPT 64590

Across 12,311 services billed by 576 providers to 12,074 beneficiaries, Medicare allowed an average of $7256.19 per service. 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 64590

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	4,991	4,893	$17,649	185
Urology	4,284	4,230	$172.20	243
Obstetrics & Gynecology	1,951	1,917	$167.90	94
General Surgery	192	172	$204.13	10
Pain Management	159	156	$152.06	11
Interventional Pain Management	127	121	$156.52	8
Anesthesiology	121	120	$145.14	3
Sports Medicine	105	96	$147.44	1
Physical Medicine and Rehabilitation	79	79	$158.82	6
Colorectal Surgery (Proctology)	79	79	$180.74	6
Undefined Physician type	74	72	$170.84	2
Orthopedic Surgery	43	43	$153.36	3
Neurology	42	33	$147.02	1
Thoracic Surgery	32	32	$152.72	1
Podiatry	18	18	$142.52	1

64590 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
Florida	2,279	$8492.62	$7325.25	91
Texas	1,106	$8761.38	$7281.22	56
Arkansas	913	$7719.04	$6978.02	20
Mississippi	686	$7483.80	$6720.14	19
Arizona	614	$8870.09	$7257.20	23
Tennessee	513	$5902.34	$5167.86	26
Maryland	439	$8949.98	$7344.70	21
Georgia	426	$7648.05	$6205.88	22
California	345	$10,251	$7263.08	21
South Carolina	335	$6067.83	$5243.69	18
New York	333	$5343.18	$3859.42	17
Oklahoma	312	$6547.52	$5616.54	19
Ohio	298	$4367.21	$3613.77	20
Colorado	297	$8548.82	$6882.98	18
Missouri	282	$5133.12	$4336.78	14
Indiana	279	$1738.25	$1419.97	10
Kentucky	262	$9291.04	$8000.84	9
Pennsylvania	240	$7490.28	$6097.05	13
Nebraska	232	$9653.15	$7957.33	11
Virginia	218	$5551.99	$4618.19	12
Kansas	189	$4242.94	$3660.02	12
Massachusetts	181	$4927.70	$3479.78	9
North Carolina	155	$3027.84	$2638.74	11
Alabama	154	$6321.73	$5919.98	7
Michigan	150	$5802.94	$4861.09	10
Illinois	148	$6799.97	$5446.01	9
New Jersey	137	$6918.05	$5203.12	8
Washington	131	$7278.64	$5199.16	10
South Dakota	106	$168.17	$141.06	4
Nevada	81	$7051.03	$5818.81	4
Minnesota	80	$6402.45	$5406.12	5
Louisiana	57	$5184.88	$4535.10	4
Iowa	50	$5289.24	$4583.42	3
North Dakota	43	$174.15	$143.48	3
Wisconsin	41	$7402.86	$6331.09	3
Rhode Island	34	$11,061	$8804.16	2
Oregon	30	$245.12	$195.12	2
Connecticut	28	$220.24	$158.75	2
West Virginia	26	$179.43	$149.74	2
Maine	23	$186.41	$148.71	2
Utah	17	$17,949	$14,881	1
New Hampshire	17	$139.94	$116.69	1
Delaware	13	$165.66	$132.22	1
Montana	11	$197.84	$139.33	1

Related codes

64566Insertion of lower leg neurostimulator electrode$111.18
64561Insertion of sacral nerve neurostimulator electrode array$2661.59
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.