2025 CPT code 64561
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System Surgery Feed
Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed.
Modifiers may be applicable to this code depending on the specific circumstances of the procedure. Consult modifier guidelines for appropriate usage.
Medical necessity for this procedure must be established by documenting the patient's chronic pain condition, failed conservative treatments, and the rationale for sacral nerve stimulation as a treatment option.
The physician prepares and anesthetizes the patient, then uses imaging guidance to locate the sacral nerves and place the neurostimulator electrodes transforaminally. The electrodes are placed near the sacral nerves, with minimal skin penetration (less than half an inch). The physician also stimulates the nerves to ensure proper placement and function, aiming to reduce pain along the nerve path.
In simple words: The doctor inserts tiny wires (electrodes) near your sacral nerves in your lower back to help reduce pain. The procedure is minimally invasive, meaning it's done through the skin with small incisions. The doctor uses imaging technology to guide the placement of the electrodes. These electrodes are part of a system that uses electrical impulses to stimulate the nerves and help control pain.
Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed. This code represents the placement of a neurostimulator electrode array near the sacral nerves using a percutaneous, transforaminal approach, which involves inserting the electrodes through the foramen (opening) in the sacral spine where the nerve roots exit. Image guidance, such as fluoroscopy, is included if performed. This procedure aims to stimulate the nerves to reduce pain sensation.
Example 1: A patient with chronic lower back pain unresponsive to conservative treatment undergoes percutaneous implantation of a neurostimulator electrode array in the sacral nerves under fluoroscopic guidance. The transforaminal approach is used to access the target nerves. Code 64561 is reported., A patient with persistent buttock pain is recommended for a trial of sacral nerve stimulation. The physician performs percutaneous placement of the electrode array near the sacral nerves for the trial period, using image guidance. Code 64561 is reported. If the trial is successful and the leads are left in for permanent implantation, 64561 is reported again with the insertion of the pulse generator 64590., A patient with complex regional pain syndrome affecting the lower extremities is evaluated for sacral neuromodulation. The physician inserts the neurostimulator electrodes near the sacral nerves using percutaneous transforaminal placement. Intraoperative fluoroscopy is used to confirm correct placement. Code 64561 is reported.
Documentation should include details of the patient's condition, the medical necessity of the procedure, the type of imaging guidance used (if any), the location of electrode placement (sacral nerve), the transforaminal approach used, and any intraoperative findings.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Specialties:Pain Management, Neurosurgery, Neurology
- Place of Service:Ambulatory Surgical Center, Hospital - Outpatient, Office