2025 CPT code 64595

Revision or removal of a peripheral, sacral, or gastric neurostimulator pulse generator or receiver with a detachable connection to the electrode array.

Follow the most current CPT guidelines for neurostimulator procedures. Ensure proper documentation to support medical necessity and the level of service performed.

Modifiers may be applicable depending on the specific circumstances of the procedure, including multiple procedures (51), reduced services (52), discontinued procedure (53), and others. Consult your payer's guidelines for specific modifier application.

Medical necessity for revision or removal is determined by the patient's symptoms (e.g., pain, infection, device malfunction, lead migration) and the need to either correct the issues with an existing system or to discontinue an ineffective treatment.Documentation should show that less invasive options were tried or deemed inappropriate.

The physician's responsibilities include preparing the patient, making incisions, disconnecting leads (if removing the device), adjusting or repositioning the device (if revision), performing test stimulations to confirm correct placement and system functionality, securing the generator/receiver, and closing the incision. The physician may use imaging guidance during the procedure.

IMPORTANT For revision or removal of a percutaneous electrode array with an integrated neurostimulator, use code 64598.Codes 64553, 64555, and 64561 may be used for temporary and permanent placement of percutaneous electrode arrays.For insertion or replacement of the pulse generator or receiver, see 64590.

In simple words: This code covers fixing or removing a device implanted to help manage pain or other issues with nerves in the body.The device has separate parts that need to be connected, and the procedure involves creating a space under the skin for it.

This CPT code encompasses the revision or removal of a peripheral, sacral, or gastric neurostimulator pulse generator or receiver.The procedure involves a system with a detachable connection between the electrode array and the pulse generator/receiver, necessitating surgical creation of a pocket for placement.Revision may include addressing initial placement issues, while removal involves disconnecting leads from the electrode array and extracting the device.Test stimulations may be performed to confirm functionality. The procedure concludes with securing the generator/receiver in the pocket and incision closure.

Example 1: A patient with chronic back pain from a herniated disc undergoes revision of their existing peripheral nerve stimulator. The generator needs to be repositioned due to migration. The physician performs the revision, including repositioning and confirming functionality through test stimulation., A patient experiences complications from a previously implanted sacral neurostimulator for bladder dysfunction.The device is malfunctioning, causing discomfort. The physician removes the entire system, disconnecting the leads and removing both the generator and electrode array., A patient with gastric dysmotility has a gastric neurostimulator system that needs to be removed due to the device’s failure. The physician removes the neurostimulator and electrode array.

Detailed operative report including the type of neurostimulator (peripheral, sacral, or gastric), type of revision (if applicable), details of lead disconnections (if removal), placement verification method(s), test stimulations performed, and images of the procedure (fluoroscopy, etc.). Preoperative and postoperative diagnostic imaging may also be required. Patient history, including reason for procedure, should be thoroughly documented. Documentation should include medical necessity for the procedure based on the patient's clinical presentation, response to conservative treatment, and prognosis.

** This code specifically addresses systems with a detachable connection.Integrated systems use different codes (e.g., 64596, 64598).Always refer to the latest CPT codebook and payer-specific guidelines for the most accurate coding practices.

  • Revenue Code: P6C (Minor Procedures - Other)
  • RVU: The provided data mentions relative value units of 3.79, but lacks further detail on payment rates or conversion factors.Consult the current Medicare Physician Fee Schedule or other relevant payer fee schedules for the most up-to-date information.
  • Global Days : The provided information does not specify the global surgical period for this code.Refer to the most current guidelines from your payer for this information.
  • Payment Status: Active
  • Modifier TC rule: The provided information does not specify whether a Technical Component (TC) modifier is applicable.Refer to the most up-to-date guidance from your payer and/or NCCI edits.
  • Fee Schedule : The provided data mentions a fee of $358 in one source, but note that fee schedules are subject to constant change.Consult the most current payer fee schedule for definitive pricing information.
  • Specialties:Neurosurgery, Pain Management, Urology (for sacral neuromodulation), Gastroenterology (for gastric neuromodulation)
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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