Cost analysis for CPT 64590 — Insertion of peripheral or gastric neurostimulator generator
Average Medicare Payment
$4582.52
2023 data
Total Payments (2023)
$66.2M
Services (2023)
12.1K
Price Change (2014–2023)
+39.3%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $3290.34 | $19.1M | 5.3K | — |
| 2015 | $3497.15 | $17.5M | 4.7K | +6.3% |
| 2016 | $3077.14 | $21.5M | 6.2K | -12.0% |
| 2017 | $3481.89 | $25.1M | 6.3K | +13.2% |
| 2018 | $3549.00 | $26.4M | 6.3K | +1.9% |
| 2019 | $3522.78 | $27.4M | 6.6K | -0.7% |
| 2020 | $4346.30 | $34.0M | 6.6K | +23.4% |
| 2021 | $4459.26 | $47.9M | 9.5K | +2.6% |
| 2022 | $4350.04 | $51.0M | 9.8K | -2.4% |
| 2023 | $4582.52 | $66.2M | 12.1K | +5.3% |
The most expensive state pays 106.4x more than the cheapest for this procedure. KY averages $8153.43 vs IN at $76.64.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| KY | $8153.43 | $1.8M | 218 | 6 |
| NE | $7723.75 | $1.4M | 180 | 6 |
| MD | $7705.47 | $3.5M | 451 | 23 |
| CA | $7144.56 | $3.4M | 477 | 26 |
| AZ | $6888.53 | $4.7M | 686 | 25 |
| TX | $6880.26 | $7.5M | 1.1K | 56 |
| FL | $6440.75 | $12.8M | 2.0K | 84 |
| CO | $6130.79 | $2.0M | 324 | 18 |
| MS | $6075.83 | $4.0M | 663 | 20 |
| AR | $5863.75 | $4.3M | 727 | 10 |
| SC | $5745.31 | $1.6M | 270 | 14 |
| IA | $5734.11 | $923.2K | 161 | 11 |
| GA | $4871.85 | $2.2M | 460 | 24 |
| KS | $4833.16 | $971.5K | 201 | 13 |
| IL | $4574.99 | $768.6K | 168 | 11 |
| OK | $4528.48 | $2.2M | 490 | 25 |
| NJ | $4522.76 | $569.9K | 126 | 7 |
| NY | $4492.78 | $948.0K | 211 | 10 |
| MA | $4388.24 | $772.3K | 176 | 9 |
| VA | $4092.49 | $912.6K | 223 | 12 |
| TN | $3838.01 | $1.9M | 491 | 28 |
| MI | $3825.90 | $585.4K | 153 | 9 |
| MO | $3792.49 | $1.1M | 283 | 15 |
| WA | $3744.15 | $711.4K | 190 | 10 |
| PA | $3344.12 | $836.0K | 250 | 15 |
| OH | $3088.69 | $719.7K | 233 | 14 |
| NC | $2910.41 | $625.7K | 215 | 13 |
| SD | $83.42 | $11.3K | 136 | 4 |
| IN | $76.64 | $20.8K | 271 | 9 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Chris Taylor Cosmetics | Ambulatory Surgical Center | AR | $3.7M | 282 | $13044.46 |
| Hayden Surgical Center Llc | Ambulatory Surgical Center | AZ | $2.1M | 142 | $14965.09 |
| Pacific Surgery Center, Llc | Ambulatory Surgical Center | NE | $1.2M | 84 | $14612.69 |
| Aesthetic Plastic Surgery Institute Of Louisville, Llc | Ambulatory Surgical Center | KY | $1.2M | 88 | $13939.32 |
| Upnt Surgery Llc | Ambulatory Surgical Center | TX | $1.1M | 76 | $14762.78 |
| Oxford Urocare Pllc | Ambulatory Surgical Center | MS | $1.1M | 78 | $13791.61 |
| Mae Physicians Surgery Center, Llc | Ambulatory Surgical Center | MS | $1.0M | 73 | $13966.67 |
| Lakewood Ranch Surgical Suites, Llc | Ambulatory Surgical Center | FL | $995.5K | 68 | $14639.74 |
| Advanced Urology Surgery Center | Ambulatory Surgical Center | GA | $906.2K | 63 | $14384.62 |
| Midlantic Urology Surgery Center, Llc | Ambulatory Surgical Center | PA | $819.0K | 54 | $15166.23 |
| Surgery Center Of Naples, Llc | Ambulatory Surgical Center | FL | $771.8K | 55 | $14033.06 |
| Riverwalk Ambulatory Surgery Center Llc | Ambulatory Surgical Center | FL | $762.2K | 53 | $14381.27 |
| Dutchess Ambulatory Surgical Center | Ambulatory Surgical Center | NY | $741.4K | 45 | $16475.45 |
| Physicians Surgical Center Llc | Ambulatory Surgical Center | OK | $709.4K | 51 | $13910.46 |
| North Austin Surgery Center, L.P. | Ambulatory Surgical Center | TX | $665.2K | 45 | $14781.83 |
| Grace Surgery Center Llc | Ambulatory Surgical Center | FL | $652.6K | 46 | $14187.96 |
| Four Peaks Surgery Center, Llc | Ambulatory Surgical Center | AZ | $643.8K | 43 | $14973.09 |
| Trails Edge Surgery Center, Llc | Ambulatory Surgical Center | FL | $620.6K | 43 | $14433.61 |
| Colonial Outpatient Surgery Center, Llc | Ambulatory Surgical Center | FL | $606.6K | 42 | $14441.85 |
| New England Surgery Center Llc | Ambulatory Surgical Center | MA | $579.9K | 33 | $17571.31 |
The data suggests significant pricing inconsistencies for CPT 64590. With a 106.4x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have risen 39.3% since 2014, outpacing inflation and raising questions about whether reimbursement rates reflect actual costs.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.