{
    "code": "63685",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/63685/2019/A",
    "release_specific_url": "https://localishealth.com/cpt/63685/2019/A",
    "description": "Implantation or replacement of the battery-powered pulse generator that drives a spinal cord stimulator. The generator is placed in a pocket under the skin, usually in the upper buttock or flank, and connected to leads already positioned near the spinal cord; it sends mild electrical pulses that change how pain signals reach the brain. This is the power source part of the system, distinct from the codes covering placement of the leads themselves, and it covers both a first-time implant and swapping out a depleted or failed unit.",
    "answer": {
        "question": "How much did Medicare pay for CPT 63685 in Q1 2019?",
        "text": "Medicare paid $374.81 for CPT 63685 in the office (non-facility) setting and $374.81 in a facility under the Q1 2019 Physician Fee Schedule, effective January 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.6% decrease from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2019,
        "quarter": "A",
        "label": "Q1 2019",
        "effective": "January 1 – March 31, 2019",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 374.81,
        "facility": 374.81,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 5.19,
        "practice_expense_non_facility": 4.15,
        "practice_expense_facility": 4.15,
        "malpractice": 1.06
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0391,
    "source": {
        "label": "Physician relative value file (Q1 2019)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19a.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2019/A",
        "file": "PPRRVU19_V1213.csv",
        "row": 11161,
        "sha256": "027b1b615e25a1c68ccff88175acf40056bc59d858295f8e37b0c5a88a2e7d35"
    },
    "modified_at": "2026-08-04T03:08:45+00:00"
}