2025 CPT code 64555
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Nervous System - Neurostimulator Procedures on the Peripheral Nerves Surgery Feed
Percutaneous implantation of a neurostimulator electrode array into a peripheral nerve (excluding the sacral nerve).
Modifiers -51 (multiple procedures), -59 (distinct procedural service), -26 (professional component) and -TC (technical component) may be applicable depending on the circumstances.
Medical necessity for this procedure is generally established by the presence of chronic pain refractory to conservative management.The expected benefits of the procedure should outweigh the risks, as determined by the physician. This includes a failed trial of conservative treatment methods.
The clinical responsibility includes pre-operative evaluation, obtaining informed consent, surgical placement of the electrode array, post-operative monitoring, and management of any complications.This requires a surgeon experienced in neurostimulator implantation.
- Surgery
- Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System
In simple words: This code describes a surgical procedure where thin wires with electrodes are inserted under the skin near a nerve to help control pain.These wires are connected to a small device under the skin that sends electrical signals to the nerve.
This CPT code encompasses the percutaneous implantation of a neurostimulator electrode array targeting a peripheral nerve.The procedure excludes implantation into the sacral nerve.The electrode array may be a single-component implant integrated with the pulse generator, or a multi-component implant with a detachable connection to the pulse generator or receiver.The procedure may involve temporary or permanent placement.
Example 1: A patient with chronic neuropathic pain in their lower extremities undergoes percutaneous implantation of a neurostimulator electrode array near the sciatic nerve.This is a permanent placement., A patient with intractable back pain receives a trial placement of a neurostimulator electrode array near a spinal nerve. After a trial period, the device is removed, and the patient decides against a permanent implant., A patient with trigeminal neuralgia undergoes percutaneous implantation of a neurostimulator electrode array near the trigeminal nerve.This involves placement of multiple leads in the same session.
Detailed medical history, including pain characteristics, prior treatments, and imaging studies showing the target nerve.Pre-operative and post-operative evaluations, operative report with details of the procedure, including the specific nerves targeted, location of electrode array placement, and device settings.Follow-up notes documenting pain relief and any complications.
** Always refer to the most up-to-date CPT codebook and payer guidelines for accurate coding and reimbursement.The use of imaging guidance (e.g., ultrasound) may be reported separately using code 76942. The removal of the electrode array is coded separately.Auricular nerve stimulation is not appropriately coded with 64555.
- Revenue Code: P6C (Minor Procedures - Other)
- RVU: Medicare reimbursement for this code is subject to multiple procedure payment reduction when more than one lead is placed in the same session.The first lead is reimbursed at 100%, while subsequent leads are reimbursed at 50%. Specific RVU values will vary based on location and year.
- Global Days : CPT code 64555 has a 10-day global period. This includes pre-operative visits on the day of surgery, intraoperative services, routine follow-up care during the post-operative global period, and treatment of complications not requiring a return trip to the operating room.
- Payment Status: Active
- Modifier TC rule: Modifier -TC is not typically applicable to this code, as it usually refers to the technical component of a procedure and not the professional component which this code represents.
- Fee Schedule : Historical fee schedules vary widely by payer, location, and year. Consult specific fee schedules for historical data.
- Specialties:Neurosurgery, Pain Management, Neurology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center