# CPT 64590

> Medicare paid $273.90 for CPT 64590 in the office (non-facility) setting and $167.22 in a facility under the Q4 2019 Physician Fee Schedule, effective October 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2019, when it decreased 0.2%.

## What it is

Implantation or replacement of the pulse generator or receiver that powers a peripheral nerve or gastric stimulator, placed in a pocket made under the skin and connected to leads already in position. This is the power-source half of systems such as sacral neuromodulation for bladder control, peripheral nerve stimulation for pain, or gastric stimulation for chronic nausea and vomiting. It is the counterpart to the spinal cord stimulator generator code, which covers devices driving leads near the spinal cord instead.

## Selected release

- Release: Q4 2019 (2019 D)
- Effective: October 1 – December 31, 2019
- Status indicator: A
- Office (non-facility) national allowed amount: $273.90
- Facility national allowed amount: $167.22
- Sequestration: not applied

## RVUs and formula

- Work RVU: 2.45
- Office (non-facility) practice expense RVU: 4.83
- Facility practice expense RVU: 1.87
- Malpractice RVU: 0.32
- Conversion factor: 36.0391
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q4 2019)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19d.zip
- Parsed file: PPRRVU19_OCT.csv, row 11,315
- Canonical page: https://localishealth.com/cpt/64590/2019/A
- Release-specific citation URL: https://localishealth.com/cpt/64590/2019/D
- Last significant update: 2026-08-04T03:09:13+00:00