Summary & Overview
CPT 64575: Open Peripheral Nerve Neurostimulator Electrode Implantation
CPT code 64575 denotes the open surgical implantation of a peripheral nerve neurostimulator electrode array used to treat chronic pain when sacral nerves are not involved. This code captures a targeted neuromodulation approach distinct from percutaneous lead placement and is relevant to surgical and pain-management practices nationwide. Its use affects facility and professional billing across inpatient and outpatient surgical settings and has implications for coverage, prior authorization, and quality measurement related to chronic pain interventions.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how the code is defined clinically, common billing considerations, and the typical sites of service where the procedure is performed. The publication summarizes benchmarking points, payer coverage patterns where available, and recent policy or coding guidance that can influence claim adjudication. Clinical context clarifies the role of open peripheral nerve neurostimulator implantation within the broader landscape of neuromodulation for chronic pain.
This national-level summary is intended for billing managers, surgical and pain clinicians, and policy analysts seeking a clear description of the code, its clinical application, and the payer landscape relevant to CPT code 64575.
Billing Code Overview
CPT code 64575 describes an open surgical implantation of a peripheral nerve neurostimulator electrode array. The procedure involves a direct, open approach to place an electrode array on a peripheral nerve for the purpose of treating chronic pain. The description specifies that the service is performed on peripheral nerves other than a sacral nerve.
Service type: Surgical implantation procedure for peripheral nerve stimulation
Typical site of service: Hospital operating room or ambulatory surgical center (outpatient surgical setting)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient with long-standing, intractable peripheral neuropathic pain of the left forearm and hand following brachial plexus injury is evaluated after failing conservative care including pharmacotherapy, nerve blocks, and physical therapy. The pain is neuropathic, constant, and function-limiting despite opioids, gabapentinoids, and multiple targeted injections. The interdisciplinary team (pain medicine physician, neurosurgeon, and physical therapist) determines the patient is a candidate for surgical implantation of a peripheral nerve neurostimulator electrode array to provide targeted neuromodulation of the affected peripheral nerve branches.
Preoperative workflow includes informed consent, preoperative imaging (ultrasound or MRI as indicated), medication reconciliation, and baseline pain/function scoring. In the operating room under appropriate anesthesia and monitoring, the surgeon performs an open approach to expose the targeted peripheral nerve, places and secures the neurostimulator electrode array adjacent to the nerve, verifies electrode position and stimulation parameters intraoperatively (nerve stimulation testing), and closes the wound. Postoperative care includes recovery monitoring, wound checks, device programming in follow-up, and rehabilitation as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work, time, or complexity substantially exceeds typical for (support with documentation). |