CPT 63685 Surgery - Nervous

How Much Does Ins/rplc Spi Npg/rcvr Pocket Cost?

Also known as: Ins/rplc spi npg/rcvr pocket (CPT 63685)

Implantation of a permanent spinal cord stimulator.

The total estimated cost of Ins/rplc Spi Npg/rcvr Pocket (CPT 63685) is $1,071 to $2,008, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $319.

Total Estimated Cost of Care

$1,071 — $2,008

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$319
Hospital Facility Fee
$956
Anesthesia (est.)
$64
Important: The physician fee of $319 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$319
Physician component only — CMS PFS 2026

Patient Guide: Ins/rplc Spi Npg/rcvr Pocket

What you need to know before your appointment

What to Expect

Under anesthesia, permanent leads are placed in the epidural space and connected to a pulse generator implanted under the skin (usually in the buttock or abdomen).

How Long Does It Take?

1-2 hours

Common Reasons Doctors Order This

Chronic pain confirmed responsive during stimulator trial, failed back surgery syndrome, complex regional pain syndrome, neuropathy

How to Prepare

Fast before surgery. Avoid MRIs (depending on device type). Carry device identification card. The device can be adjusted wirelessly.

Procedures Commonly Done Together

These procedures are frequently performed alongside Ins/rplc spi npg/rcvr pocket

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How to Reduce Your Cost for Ins/rplc spi npg/rcvr pocket

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

5.06
Work RVU
3.43
Practice Expense RVU
1.05
Malpractice RVU
9.54
Total RVU

Payment = Total RVU (9.54) x CF ($33.40) = $319

Frequently Asked Questions

How much does Ins/rplc spi npg/rcvr pocket cost?

The Medicare facility rate for Ins/rplc spi npg/rcvr pocket is $319. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Ins/rplc spi npg/rcvr pocket cost without insurance?

Without insurance, the cost of Ins/rplc spi npg/rcvr pocket can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Ins/rplc spi npg/rcvr pocket?

Most commercial health insurance plans and Medicare cover Ins/rplc spi npg/rcvr pocket when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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