CPT 64656: Revision/Replacement of BAT Pulse Generator

Medicare pays $429 on average nationally for this procedure.

CPT code 64656 describes revision or replacement of only the pulse generator of a baroreflex activation therapy (BAT) system, including intraoperative interrogation and programming; service type: device revision/replacement procedure, typical site of service: hospital operating room or outpatient surgical center.

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CPT 64656: Revision/Replacement of BAT Pulse Generator

Medicare pays $429 on average nationally for this procedure.

Customize your policy alerts

Sign up for cpt 64656 policy alerts

Get alerted when payer policies referencing 64656 are released or updated.

Monitor payer policy activity

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Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with resistant hypertension and symptomatic orthostatic intolerance previously implanted with a baroreflex activation therapy (BAT) system presents with progressive battery depletion or device malfunction. The patient is evaluated in the outpatient electrophysiology or vascular neuromodulation clinic; device interrogation confirms reduced battery capacity or hardware fault limited to the implanted pulse generator. The clinical workflow includes preoperative evaluation (history, medication review, focused cardiac and neurologic exam), device interrogation and programming in clinic, informed consent, perioperative antibiotics, scheduling for replacement of the pulse generator only, operating room or procedure suite admission, general or monitored anesthesia care, intraoperative removal of the old pulse generator, placement and connection of the new pulse generator to existing leads, intraoperative interrogation and programming of the system to confirm appropriate lead function and therapy parameters, wound closure, and short post-anesthesia recovery with device checks prior to discharge. Typical sites of service are the hospital outpatient department, ambulatory surgery center, or specialized electrophysiology procedure suite. The payer mix for such procedures commonly includes Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33249`	Removal and replacement of permanent pacemaker pulse generator with existing leads; single lead system	Analogous generator replacement workflow when pacemaker systems require generator exchange; similar intraoperative interrogation and programming steps
`64585`	Percutaneous implantation of neurostimulator electrode array; peripheral nerve (e.g., occipital)	Represents implantation of neurostimulation leads; relates conceptually to neuromodulation device procedures though different anatomic target
`95970`	Electronic analysis of implanted neurostimulator pulse generator system, with reprogramming, with simple or complex analysis	Used for device interrogation and reprogramming services in follow-up or during procedures; mirrors intraoperative interrogation and programming elements
`93660`	Comprehensive electrophysiologic evaluation including insertion and repositioning of temporary pacemaker wires	Represents intraoperative electrophysiology testing and lead function assessment practices relevant to BAT device verification
`99231`	Subsequent hospital care, per day, for evaluation and management	May be billed for postoperative inpatient follow-up evaluation when documented separately from the procedure

Related Modifiers

5 rows

Modifier	Description	When to Use
24	Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…	- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
57	CPT® modifier -57 (“Decision for Surgery”) is appended to an Evaluation and Management (E/M) service when that encounter results in the initial decision to perform a major surgery (a procedure with a…	- Use modifier 57 when an E/M service provided by the same provider (or same tax ID) on the day of or the day before a major surgical procedure (90‑day global period) results in the initial decision…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
207ZI0100X	Immunopathology Physician	A pathologist who specializes in the diagnosis of immunologic diseases.
213EP1101X	Primary Podiatric Medicine Podiatrist	Podiatric Medicine & Surgery Service Providers · Podiatrist
261QE0002X	Emergency Care Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
207ZP0104X	Chemical Pathology Physician	A chemical pathologist has expertise in the biochemistry of the human body as it applies to the understanding of the cause and progress of disease. Th…

Related ICD-10-CM Codes

29 rows

ICD-10-CM Code	Description
E11.9	Type 2 diabetes mellitus without complications
E78.5	Hyperlipidemia, unspecified
F05	Delirium due to known physiological condition
F41.9	Anxiety disorder, unspecified
G45.0	Vertebro-basilar artery syndrome
G45.1	Carotid artery syndrome (hemispheric)
G45.8	Other transient cerebral ischemic attacks and related syndromes
G45.9	Transient cerebral ischemic attack, unspecified
I10	Essential (primary) hypertension
I11.9	Hypertensive heart disease without heart failure

Showing 1–10 of 29

Related Payer Policy Updates

Specialty: Anesthesiology1 / 3

10 rows

Policy	Payer	Effective Date
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Elective Inpatient Services (for Idaho Only)	UnitedHealthcare	2026-06-01
Sites of Service	priority health	2026-06-01
Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Services	univerahealthcare	2026-05-21
Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_Blocks	Cigna	2026-05-15
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01

CPT 64650: Chemical Injection for Axillary Hyperhidrosis

CPT-64653-CHEMICAL-INJECTION-ECCRINE-GLANDS-NON-AXILLARY-HYPERHIDROSIS

CPT 64653: Chemical Sympathectomy for Hyperhidrosis (Non-Axillary)

CPT-64654-BAROREFLEX-ACTIVATION-THERAPY-IMPLANTATION

CPT 64654: Baroreflex Activation Therapy (BAT) System Implantation

CPT-64657-BAT-SYSTEM-EXPLANTATION-LEAD-AND-PULSE-GENERATOR-REMOVAL

CPT 64657: Baroreflex Activation Therapy System Removal

CPT-64658-BAROREFLEX-ACTIVATION-THERAPY-LEAD-REMOVAL

CPT 64658: Removal of Baroreflex Activation Therapy Lead

CPT-64659-PULSE-GENERATOR-REMOVAL-BAROREFLEX-ACTIVATION-THERAPY

CPT 64659: Removal of Pulse Generator for Baroreflex Activation Therapy

CPT-64680-CELIAC-PLEXUS-NEUROLYTIC-INJECTION

CPT 64680: Celiac Plexus Neurolysis/Destruction

CPT-64681-SUPERIOR-HYPOGASTRIC-PLEXUS-NEUROLYSIS-PELVIC-PAIN

CPT 64681: Superior Hypogastric Plexus Neurolysis

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`33249`	Removal and replacement of permanent pacemaker pulse generator with existing leads; single lead system	Analogous generator replacement workflow when pacemaker systems require generator exchange; similar intraoperative interrogation and programming steps
`64585`	Percutaneous implantation of neurostimulator electrode array; peripheral nerve (e.g., occipital)	Represents implantation of neurostimulation leads; relates conceptually to neuromodulation device procedures though different anatomic target
`95970`	Electronic analysis of implanted neurostimulator pulse generator system, with reprogramming, with simple or complex analysis	Used for device interrogation and reprogramming services in follow-up or during procedures; mirrors intraoperative interrogation and programming elements
`93660`	Comprehensive electrophysiologic evaluation including insertion and repositioning of temporary pacemaker wires	Represents intraoperative electrophysiology testing and lead function assessment practices relevant to BAT device verification
`99231`	Subsequent hospital care, per day, for evaluation and management	May be billed for postoperative inpatient follow-up evaluation when documented separately from the procedure

Related Modifiers

5 rows

Modifier	Description	When to Use
24	Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…	- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
57	CPT® modifier -57 (“Decision for Surgery”) is appended to an Evaluation and Management (E/M) service when that encounter results in the initial decision to perform a major surgery (a procedure with a…	- Use modifier 57 when an E/M service provided by the same provider (or same tax ID) on the day of or the day before a major surgical procedure (90‑day global period) results in the initial decision…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
207ZI0100X	Immunopathology Physician	A pathologist who specializes in the diagnosis of immunologic diseases.
213EP1101X	Primary Podiatric Medicine Podiatrist	Podiatric Medicine & Surgery Service Providers · Podiatrist
261QE0002X	Emergency Care Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
207ZP0104X	Chemical Pathology Physician	A chemical pathologist has expertise in the biochemistry of the human body as it applies to the understanding of the cause and progress of disease. Th…

Related ICD-10-CM Codes

29 rows

ICD-10-CM Code	Description
E11.9	Type 2 diabetes mellitus without complications
E78.5	Hyperlipidemia, unspecified
F05	Delirium due to known physiological condition
F41.9	Anxiety disorder, unspecified
G45.0	Vertebro-basilar artery syndrome
G45.1	Carotid artery syndrome (hemispheric)
G45.8	Other transient cerebral ischemic attacks and related syndromes
G45.9	Transient cerebral ischemic attack, unspecified
I10	Essential (primary) hypertension
I11.9	Hypertensive heart disease without heart failure

Showing 1–10 of 29

Related Payer Policy Updates

Specialty: Anesthesiology1 / 3

10 rows

Policy	Payer	Effective Date
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders	Premera Bluecross	2026-07-01
Elective Inpatient Services (for Idaho Only)	UnitedHealthcare	2026-06-01
Sites of Service	priority health	2026-06-01
Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Services	univerahealthcare	2026-05-21
Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_Blocks	Cigna	2026-05-15
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric Disorders	Blue Cross Blue Shield - North Carolina	2026-04-01

CPT 64650: Chemical Injection for Axillary Hyperhidrosis

CPT-64653-CHEMICAL-INJECTION-ECCRINE-GLANDS-NON-AXILLARY-HYPERHIDROSIS

CPT 64653: Chemical Sympathectomy for Hyperhidrosis (Non-Axillary)

CPT-64654-BAROREFLEX-ACTIVATION-THERAPY-IMPLANTATION

CPT 64654: Baroreflex Activation Therapy (BAT) System Implantation

CPT-64657-BAT-SYSTEM-EXPLANTATION-LEAD-AND-PULSE-GENERATOR-REMOVAL

CPT 64657: Baroreflex Activation Therapy System Removal

CPT-64658-BAROREFLEX-ACTIVATION-THERAPY-LEAD-REMOVAL

CPT 64658: Removal of Baroreflex Activation Therapy Lead

CPT-64659-PULSE-GENERATOR-REMOVAL-BAROREFLEX-ACTIVATION-THERAPY

CPT 64659: Removal of Pulse Generator for Baroreflex Activation Therapy

CPT-64680-CELIAC-PLEXUS-NEUROLYTIC-INJECTION

CPT 64680: Celiac Plexus Neurolysis/Destruction

CPT-64681-SUPERIOR-HYPOGASTRIC-PLEXUS-NEUROLYSIS-PELVIC-PAIN

CPT 64681: Superior Hypogastric Plexus Neurolysis

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 64656: Revision/Replacement of BAT Pulse Generator

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OpenPayer

CPT 64656: Revision/Replacement of BAT Pulse Generator

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 64656: Revision/Replacement of BAT Pulse Generator

Sign up for cpt 64656 policy alerts

CPT 64656: Revision/Replacement of BAT Pulse Generator

Sign up for cpt 64656 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What clinical service does CPT 64656 describe?

Where is a CPT 64656 procedure typically performed?

What documentation should be present to support billing CPT 64656?

Which modifiers are commonly relevant when coding CPT 64656?

Are there related CPT codes referenced for similar device or testing services?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What clinical service does CPT 64656 describe?

Where is a CPT 64656 procedure typically performed?

What documentation should be present to support billing CPT 64656?

Which modifiers are commonly relevant when coding CPT 64656?

Are there related CPT codes referenced for similar device or testing services?

References