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Pain Interventions
Reimbursement
CMS CY2024 Final Rules for Hospital Outpatient, Ambulatory Surgical Center and Physician Payments
New Rates Effective January 1, 2024
Medtronic provides this information for your convenience only. It does not constitute legal advice or a
recommendation regarding clinical practice. Information provided is gathered from third-party sources and is
subject to change without notice due to frequently changing laws, rules and regulations. The provider has the
responsibility to determine medical necessity and to submit appropriate codes and charges for care provided.
Medtronic makes no guarantee that the use of this information will prevent diffserences of opinion or disputes with
Medicare or other payers as to the correct form of billing or the amount that will be paid to providers of service.
Please contact your Medicare contractor, other payers, reimbursement specialists and/or legal counsel for
interpretation of coding, coverage and payment policies. This document provides assistance for FDA approved or
cleared indications. Where reimbursement is sought for use of a product that may be inconsistent with, or not
expressly specied in, the FDA cleared or approved labeling (e.g., instructions for use, operator’s manual or
package insert), consult with your billing advisors or payers on handling such billing issues. Some payers may have
policies that make it inappropriate to submit claims for such items or related service.
Disclaimer
References
1. Medicare Physician Fee Schedule Final Rule; CMS-1770-F. Centers for Medicare & Medicaid Services Page. Office
of the Federal Register website. https://www.cms.gov/les/document/cy2023-physician-fee-schedule-nal-rule-cms-
1770f.pdf. Accessed November 2nd, 2022.
2. Medicare Physician Fee Schedule Final Rule; CMS-1784-F Centers for Medicare & Medicaid Services Page. Office
of the Federal Register website. https://www.federalregister.gov/d/2023-24184. Accessed November 2nd, 2023.
Medicare 2024 Physician Payment Rates
1. Medicare national average payment is determined by multiplying the APC weight by the conversion factor. The nal
conversion factor for 2023 is $85.585 as published in CMS Accessed November 1st, 2022. The conversion factor of
$85.585 assumes that hospitals meet reporting requirements of the Hospital Outpatient Quality Data Reporting
Program. Medicare Program: Hospital Outpatient Prospective Payment System Final Rule; CMS-1772-FC. Office of the
Federal Register website. Centers for Medicare & Medicaid Services Page. https://www.cms.gov/les/document/
cy2023-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center-nal-rule.pdf. Accessed
November 1st, 2022.
2. Medicare national average payment is determined by multiplying the APC weight by the conversion factor. The nal
conversion factor for 2024 is $ $87.382 as published in CMS Accessed November 2nd, 2023 . The conversion factor
of $87.382 assumes that hospitals meet reporting requirements of the Hospital Outpatient Quality Data Reporting
Program. Medicare Program: Hospital Outpatient Prospective Payment System Final Rule; CMS- Office of the Federal
Register website. Centers for Medicare & Medicaid Services Page. https://www.federalregister.gov/d/2023-24293.
Accessed November 2nd, 2023.
1. Medicare Program: Hospital Outpatient Prospective Payment & ASC Payment Systems Final Rule; CMS-1772-FC
Office of the Federal Register website. Centers for Medicare & Medicaid Services Page https://www.cms.gov/les/
document/cy2023-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center-nal-rule.pdf.
Accessed November 1st, 2022.
2. Medicare Program: Hospital Outpatient Prospective Payment & ASC Payment Systems Final Rule; CMS-1786-F .
Office of the Federal Register website. Centers for Medicare & Medicaid Services Page https://
www.federalregister.gov/d/2023-24293. Accessed November 2nd, 2023.
Medicare 2024 Ambulatory Surgical Center Payment Rates
Medicare 2024 Hospital Outpatient Payment Rates
Summary
The Centers for Medicare & Medicaid Services (CMS) provides annual updates to their payment systems for
outpatient, ambulatory surgery centers, and physician services. The information provided in this document provides
therapy specic nal payment rates for CY24 with comparisons to CY24 payment rates.
CPT copyright 2022 American Medical Association. All rights reserved. CPT® is a registered trademark of the
American Medical Association. Applicable FARS/DFARS Restrictions Apply to Government Use. Fee schedules,
relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT,
and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense
medical services. The AMA assumes no liability for data contained or not contained herein
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Hospital Outpatient Rule
Medicare 2024 Hospital Outpatient Payment Rates - Spinal Cord Stimulation
Neurostimulation Therapy (National Average)
PROCEDURE
CPT
FINAL 2023
APC
FINAL 2023
OPPS
PAYMENT
1
FINAL 2024
APC
FINAL 2024 OPPS
PAYMENT
2
$ CHANGE % CHANGE
SINGLE PERC LEAD TRIAL
SCS perc lead implant
63650 5462 $6,604 5462 $6,523
Total
$6,604 $6,523 $ (81) -1%
DUAL PERC LEAD TRIAL
SCS perc lead implant 63650 5462 $6,604 5462 $6,523
SCS perc lead implant 63650
Total $6,604 $6,523 $ (81) -1%
IPG INSERTION OR REPLACEMENT
SCS INS implant (rechargeable
and non-rechargeable)
63685 5465 $29,358 5465 $29,617
Programming, cmplx (rst hour)
95972
Total $29,358 $29,617 $ 259 1%
FULL IMPLANT-SINGLE PERC
SCS INS implant (rechargeable
and non-rechargeable)
63685 5465 $29,358 5465 $29,617
SCS perc lead implant 63650
Programming, cmplx (rst hour)
95972
Total $29,358 $29,617 $ 259 1%
FULL IMPLANT-DUAL PERC
SCS INS implant (rechargeable
and non-rechargeable)
63685 5465 $29,358 5465 $29,617
SCS perc lead implant 63650
SCS perc lead implant 63650
Programming, cmplx (rst hour) 95972
Total $29,358 $29,617 $ 259 1%
SINGLE SURGICAL PADDLE LEAD
SCS lami lead implant
63655 5464 $21,515 5464 $20,865
Total $21,515 $20,865 $ (651) -3%
FULL IMPLANT WITH SURGICAL PADDLE LEAD
SCS INS implant (rechargeable
and non-rechargeable)
63685 5465 $29,358 5465 $29,617
SCS lami lead implant 63655
Programming, cmplx (rst hour) 95972
Total $29,358 $29,617 $ 259 1%
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Medicare 2024 Hospital Outpatient Payment Rates - Targeted Drug Delivery
Targeted Drug Delivery (National Average)
PROCEDURE
CPT
FINAL
2023
APC
FINAL 2023
OPPS
PAYMENT
1
FINAL 2024
APC
FINAL 2024
OPPS
PAYMENT
2
$ CHANGE % CHANGE
TRIAL (SINGLE DAY)
Inject spine l/s (cd) w/o imaging guidance 62322 5443 $852 5443 $869 $17
2%
Inject spine l/s (cd) w/ imaging guidance (i.e.,
uoroscopy or CT)
62323 5442 $644 5442 $660 $15
2%
TRIAL (MULTIPLE DAY)
Inject spine w/cath l/s (cd) w/o imaging
guidance
62326 5443 $852 5443 $869 $17
2%
Inject spine w/cath l/s (cd) w/ imaging
guidance (i.e., uoroscopy of CT)
62323 5442 $644 5442 $660 $15
2%
FULL SYSTEM IMPLANT
Pump implant - programmable 62362 5471 $16,938 5471 $17,010
Catheter implant 62350
Total $16,938 $17,010 $ 72 0.4%
CATHETER IMPLANT
Catheter implant 62350 5432 $6,179 5432 $6,354
Total $6,179 $6,354 $ 175 3%
PUMP INSERT ONLY - IMPLANT & REPLACEMENT
Pump implant - programmable 62362 5471 $16,938 5471 $17,010
Total $16,938 $17,010 $ 72 0.4%
REFILL/PROGRAMMING/ANALYSIS
Analysis w/o reprogramming or rell 62367 5743 $277 5743 $285 $8
3%
Analysis w/ reprogramming 62368 5743 $277 5743 $285 $8
3%
Programming and rell by nurse 62369 5743 $277 5743 $285 $8
3%
Programming and rell by physician 62370 5743 $277 5743 $285
$ 8 3%
CATHETER DYE STUDY
Puncture of reservoir for injection procedure 61070 5442 $644 5442 $660
$ 15 2%
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Medicare 2024 Hospital Outpatient Payment Rates - RF Ablation
RF Ablation (National Average)
PROCEDURE
CPT
FINAL
2023
APC
FINAL 2023
OPPS
PAYMENT
1
FINAL 2024
APC
FINAL 2024
OPPS
PAYMENT
2
$ CHANGE % CHANGE
CERVICAL/THORACIC
Destruction, cervical or thoracic,
paravertebral facet joint nerve(s), single
facet joint
64633 5431 $1,798 5431 $1,842 $44
2%
Destruction, cervical or thoracic,
paravertebral facet joint nerve(s), each
additional
64634 N/A N/A N/A N/A NA
N/A
LUMBAR/SACRAL
Destruction, lumbar or sacral, paravertebral
facet joint nerve(s), single facet joint
64635 5431 $1,798 5431 $1,842 $44
2%
Destruction, lumbar or sacral, paravertebral
facet joint nerve(s), each additional
64636 N/A N/A N/A N/A NA
NA
PERIPHERAL/GENICULAR/SI JOINT
Destruction by neurolytic agent, other
peripheral nerve or branch
64640 5443 $852 5443 $869 $17
2%
Unlisted procedure, nervous system 64999 5441 $272 5441 $282 $11
4%
Genicular nerve branch destruction by
neurolytic agent, including imaging
guidance
64624 5431 $1,798 5431 $1,842 $44
2%
Radiofrequency ablation of nerves
innervating the SI joint, with imaging
guidance
64625 5431 $1,798 5431 $1,842 $44
2%
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Medicare 2024 Hospital Outpatient Payment Rates - Interventional
Interventional (National Average)
PROCEDURE
CPT
FINAL
2023
APC
FINAL 2023
OPPS
PAYMENT
1
FINAL 2024
APC
FINAL 2024
OPPS
PAYMENT
2
$ CHANGE % CHANGE
OSTEOCOOL / VERTEBROPLASTY (VP) / KYPHOPLASTY (BKP)
Vertebroplasty (VP) 22510/ 22511 5113 $2,977 5113 $3,087 $111
4%
Kyphoplasty (BKP) 22513/ 22514 5114 $6,615 5114 $6,823 $209
3%
OsteoCool RF Ablation 20982 5114 $6,615 5115 $12,553 $5,938
90%
Combined VP lumbosacral +
RF
22511 + 20982 5115 $13,048 5115 $12,553 ($495)
-4%
Combined VP Cervicothorac-
ic + RF
22510 + 20982 5114 $6,615 5115 $12,553 $5,938
90%
Combined BKP lumbar + RF 22514 + 20982 5115 $13,048 5115 $12,553 ($495)
-4%
Multi-Level BKP
22513/ 22514
+ 22515
5115 $13,048 5115 $12,553 ($495)
-4%
Multi-Level VP
22510/22511 +
22512
5114 $6,615 5114 $6,823 $209
3%
Combined BKP thoracic + RF 22513 + 20982 5115 $13,048 5115 $12,553 ($495)
-4%
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Ambulatory Surgical Center Rule
Medicare 2024 Ambulatory Surgical Center Payment Rates
SCS, TDD, RF Ablation, and Interventional (National Average)
SCS
PROCEDURE
HCPCS
CODE
2023 ASC FINAL
PAYMENT
1
2024 ASC FINAL
PAYMENT
2
$ CHANGE % CHANGE
SCS perc lead implant 63650 $4,913 $4,952 $ 39 1%
SCS lami lead implant 63655 $17,950 $17,993 $ 44 0.2%
SCS INS implant (rechargeable & non
-rechargeable)
63685 $24,716 $25,298
$ 581 2%
TDD (PAIN & ITB)
PROCEDURE
HCPCS
CODE
2023 ASC FINAL
PAYMENT
1
2024 ASC FINAL
PAYMENT
2
$ CHANGE % CHANGE
Inject spine l/s (cd) w/o imaging guid-
ance
62322 $444 $473 $ 29 7%
Inject spine l/s (cd) w/ imaging guid-
ance (i.e., uoroscopy or CT)
62323 $336 $359 $ 23 7%
Inject spine w/cath l/s (cd) w/o imag-
ing guidance
62326 $444 $473 $ 29 7%
Inject spine w/cath l/s (cd) w/ imaging
guidance (i.e., uoroscopy of CT)
62327 $444 $473 $ 29 7%
Catheter implant 62350 $3,561 $4,266
$ 705 20%
Pump implant - programmable 62362 $14,147 $14,047
$(100) -1%
Analysis w/o reprogramming or rell 62367 $14 $14
$ 0.20 1%
Analysis w/ reprogramming 62368 $19 $19
$ 0.48 3%
Programming and rell by nurse 62369 $66 $66
$ 0 0%
Programming and rell by physician 62370 $59 $58
$(1) -1%
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Medicare 2024 Ambulatory Surgical Center Payment Rates
SCS, TDD, RF Ablation and Interventional (National Average) cont.
RF ABLATION, PAIN
PROCEDURE
HCPCS
CODE
2023 ASC
FINAL
PAYMENT
1
2024 ASC FINAL
PAYMENT
2
$ CHANGE % CHANGE
Destruction, cervical or thoracic,
paravertebral facet joint nerve(s), single
facet joint
64633 $854 $898 $ 44 5%
Destruction, cervical or thoracic,
paravertebral facet joint nerve(s), each
additional
64634 N/A N/A N/A N/A
Destruction, lumbar or sacral,
paravertebral facet joint nerve(s), single
facet joint
64635 $854 $898 $ 44 5%
Destruction, lumbar or sacral,
paravertebral facet joint nerve(s), each
additional
64636 N/A N/A N/A N/A
Destruction by neurolytic agent, other
peripheral nerve or branch
64640 $172 $173 $ 1 0.4%
Genicular nerve branch destruction by
neurolytic agent, including imaging
guidance
64624 $854 $898 $ 44 5%
Radiofrequency ablation of nerves
innervating the SI joint, with imaging
guidance
64625 $854 $898 $ 44 5%
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Medicare 2024 Ambulatory Surgical Center Payment Rates
SCS, TDD, RF Ablation and Interventional (National Average) cont.
INTERVENTIONAL
OSTEOCOOL RF BONE ABLATION
PROCEDURE
HCPCS
CODE
2023 ASC
FINAL
PAYMENT
1
2024 ASC
FINAL
PAYMENT
2
$ CHANGE % CHANGE
Bone Ablation Therapy 20982 $4,009 $6,501 $ 2,492 62%
OsteoCool RF + Single Level Vertebroplasty (VP)
Bone Ablation Therapy 20982 $4,009 $6,501
Single Level VP; cervicothoracic / lumbosacral
22510 /
22511
$707 $759
Total $4,716 $7,260 $2,544 54%
OsteoCool RF + Single Level Kyphoplasty (BKP)
Bone Ablation Therapy 20982 $4,009 $6,501
Single Level BKP; thoracic /lumbar
22513 /
22514
$1,569 $1,697
Total $5,578 $8,197 $2,619 47%
OsteoCool RF+ Multi-level Vertebroplasty (VP)
Bone Ablation Therapy 20982 $4,009 $6,501
Multi-level VP
C7504 /
C7505
$1,569 $1,697
Total $5,578 $8,197 $2,619 47%
Osteo Cool RF + Multi-level Kyphoplasty (BKP)
Bone Ablation Therapy 20982 $2,004 $3,250
Multi-level BKP
C7507 /
C7508
$6,435 $6,501
Total $8,439 $9,751 $1,312 16%
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VERTEBROPLASTY (VP)
PROCEDURE
HCPCS
CODE
2023 ASC
FINAL
PAYMENT
1
2024 ASC
FINAL
PAYMENT
2
$ CHANGE % CHANGE
Perc vertebroplasty; cervicothoracic 22510 $1,415 $1,519 $ 104 7%
Perc vertebroplasty; lumbosacral 22511 $1,415 $1,519 $ 104 7%
Perc vertebroplasty; cervicothoracic or lumbosacral
each addtl
22512 N/A N/A N/A N/A
Multi-level VP cervicothoracic (Perq cvt&ls inj vert bodies)
C7504 $3,138 $3,393 $ 255 8%
Multi-level VP lumbosacral (Perq ls&cvt inj vert bodies)
C7505 $3,138 $3,393 $ 255 8%
KYPHOPLASTY (BKP) /VERTEBRAL AUGMENTATION
PROCEDURE
HCPCS
CODE
2023 ASC
FINAL
PAYMENT
1
2024 ASC
FINAL
PAYMENT
2
$ CHANGE % CHANGE
Percutaneous vertebral augmentation;thoracic 22513 $3,138 $3,393 $ 255 8%
Percutaneous vertebral augmentation; lumbar 22514 $3,138 $3,393 $ 255 8%
Percutaneous vertebral augmentation; thoracic or
lumbar
22515 N/A N/A N/A N/A
Multi-level BKP thoracic (Perq thor&lumb vert aug)
C7507 $6,435 $6,501 $ 66 1%
Multi-level BKP lumbar (Perq lumb&thor vert aug)
C7508 $6,435 $6,501 $ 66 1%
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Medicare Physician Fee Schedule (MPFS)
Medicare 2024 Physician Payment Rates
Spinal Cord Stimulation (National Average)
SCS OFFICE FACILITY
DESCRIPTION CPT
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
SCS perc lead
implant
63650 $2,341 $2,236
($105) -4% $416 $407 ($9) -2%
SCS lami lead
implant
63655 N/A N/A
N/A N/A $858 $838 ($20) -2%
Remove perc lead 63661 $696 $675
($21) -3% $332 $326 ($6) -2%
Remove lami lead 63662 N/A N/A N/A N/A $868 $851 ($17) -2%
Revise/replace
perc lead
63663 $916 $889
($27) -3% $454 $444 ($10) -2%
Revise/replace
lami lead
63664 N/A N/A
N/A N/A $905 $886 ($19) -2%
SCS INS implant
(rechargeable &
non-
rechargeable)
63685 N/A N/A
N/A N/A $367 $337 ($30) -8%
SCS INS removal 63688 N/A N/A
N/A N/A $380 $298 ($82) -22%
Analysis 95970 $19 $18
($1) -5% $19 $18 ($1) -5%
Simple
Programming
95971 $48 $47
($1) -2% $39 $38 ($1) -3%
Programming,
cmplx (rst hour)
95972 $57 $56
($1) -2% $41 $39 ($2) -5%
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Medicare 2024 Physician Payment Rates
Targeted Drug Delivery (National Average)
TARGETED DRUG
DELIVERY (PAIN AND ITB) OFFICE FACILITY
DESCRIPTION CPT
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
Inject spine l/s (cd)
w/o imaging
guidance
62322 $140 $133
($7) -5% $81 $77 ($4) -5%
Inject spine l/s (cd)
w/ imaging
guidance (i.e.,
uoroscopy or CT)
62323 $262 $254
($8) -3% $99 $97 ($2) -2%
Inject spine w/cath
l/s (cd) w/o
imaging guidance
62326 $141 $135
($6) -4% $86 $83 ($3) -3%
Inject spine w/cath
l/s (cd) w/ imaging
guidance (i.e.,
uoroscopy of CT)
62327 $273 $268
($5) -2% $106 $105 ($1) -1%
Catheter implant 62350 N/A N/A
N/A N/A $403 $394 ($9) -2%
Remove spinal
canal catheter
62355 N/A N/A
N/A N/A $280 $274 ($6) -2%
Pump implant -
programmable
62362 N/A N/A
N/A N/A $391 $382 ($9) -2%
Pump removal 62365 N/A N/A
N/A N/A $302 $297 ($5) -2%
Analysis w/o
reprogramming or
rell
62367 $32 $31
($1) -3% $25 $24 ($1) -4%
Analysis w/
reprogramming
62368 $44 $44
$0 0% $35 $33 ($2) -6%
Programming and
rell by nurse
62369 $93 $91
($2) -2% $35 $34 ($1) -3%
Programming and
rell by physician
62370 $94 $91
($3) -3% $46 $45 ($1) -2%
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Medicare 2024 Physician Payment Rates
RF Ablation (National Average)
RF ABLATION, PAIN OFFICE FACILITY
DESCRIPTION CPT
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
Destruction,
cervical or
thoracic,
paravertebral
facet joint nerve(s),
single facet joint
64633 $444 $430
($14) -3% $191 $188 ($3) -2%
Destruction,
cervical or
thoracic,
paravertebral
facet joint nerve(s),
each additional
64634 $261 $251
($10) -4% $67 $65 ($2) -3%
Destruction,
lumbar or sacral,
paravertebral
facet joint nerve(s),
single facet joint
64635 $448 $434
($14) -3% $192 $188 ($4) -2%
Destruction,
lumbar or sacral,
paravertebral
facet joint nerve(s),
each additional
64636 $246 $236
($10) -4% $59 $57 ($2) -3%
Destruction by
neurolytic agent,
other peripheral
nerve or
branch
64640 $250 $244
($6) -2% $119 $117 ($2) -2%
Genicular nerve
branch
destruction by
neurolytic agent,
including imaging
guidance
64624 $394 $382
($12) -3% $146 $143 ($3) -2%
Radiofrequency
ablation of nerves
innervating the SI
joint, with imaging
guidance
64625 $479 $465
($14) -3% $195 $191 ($4) -2%
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Medicare 2024 Physician Payment Rates
Interventional (National Average)
INTERVENTIONAL
OSTEOCOOL RF BONE
ABLATION OFFICE FACILITY
DESCRIPTION CPT
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
Bone ablation
therapy
20982 $3,595 $3,369 ($226) -6% $367 $354 ($13) -4%
VERTEBROPLASTY OFFICE FACILITY
DESCRIPTION CPT
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
Perc
vertebroplasty;
cervicothoracic
22510 $1,861 $1,749
($112) -6% $434 $420 ($14) -3%
Perc
vertebroplasty;
lumbosacral
22511 $1,851 $1,747
($104) -6% $408 $395 ($13) -3%
Perc
vertebroplasty;
cervicothoracic
or lumbosacral
each additional
22512 $748 $709
($39) -5% $207 $201 ($6) -3%
KYPHOPLASTY/
VERTEBRAL
AUGMENTATION OFFICE FACILITY
DESCRIPTION CPT
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
2023
FINAL
PAYMENT
1
2024
FINAL
PAYMENT
2
$
CHANGE
%
CHANGE
Percutaneous
vertebral
augmentation;
thoracic
22513 $5,889 $5,510
($379) -6% $513 $498 ($15) -3%
Percutaneous
vertebral
augmentation;
lumbar
22514 $5,861 $5,486
($375) -6% $479 $464 ($15) -3%
Percutaneous
vertebral
augmentation;
thoracic or
lumbar each
additional
22515 $3,025 $2,822
($203) -7% $219 $211 ($8) -4%
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