CPT code 64590 describes the surgical insertion or replacement of an implantable pulse generator or receiver for peripheral, sacral, or gastric neurostimulation systems that require a surgically created pocket and a connection to an electrode array. This code captures a high-complexity implant procedure used in neuromodulation therapies for pain management, sacral modulation for bladder and bowel dysfunction, and gastric stimulation for select motility disorders. Nationally, the code is important for tracking utilization of advanced implantable neuromodulation procedures and for aligning surgical billing with device implantation protocols.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks for common payer coverage approaches, summaries of clinical context for when implantation or replacement is billed, and notes on coding scope and service setting. The publication outlines typical sites of service and the procedural intent captured by the code, and it highlights areas where payer policies commonly address medical necessity, prior authorization, and device replacement timing. Data not available in the input is noted where applicable.