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CPT code 64719: Ulnar nerve surgery, at wrist2026 Medicare rate & RVUs

Surgical freeing or repositioning of the ulnar nerve at the wrist is reported for compression or tethering in the Guyon canal region.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.1K Medicare services in 2024

Medicare pays $387.78 for 64719 nationally in a facility.

Medicare rate · 64719

Ulnar nerve surgery, at wrist

Office or facility?

Work RVUs
4.85
Total RVUs
11.61
Global days
090

National rate · 2026

$387.78

Facility setting, before claim adjustments.

See every locality for 64719 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 64719 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 64719 covers

This operation frees the ulnar nerve from constricting tissue or repositions it at the wrist. It is commonly performed for ulnar nerve compression in or near Guyon canal, which may cause symptoms in the ring and small fingers or weakness in the hand. Hand, orthopedic, plastic, or neurosurgeons may perform it in a hospital or ambulatory surgery setting. The wrist location distinguishes it from surgery on the ulnar nerve at the elbow.

Report the service when the operative note supports surgical treatment of the ulnar nerve at the wrist, such as release of compression or nerve repositioning; a diagnosis of ulnar neuropathy alone does not establish the procedure. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 64719 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

64719 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$349.65
AlaskaUnavailable$466.98
ArizonaUnavailable$377.16
ArkansasUnavailable$344.92
Atlanta, GAUnavailable$397.82
Austin, TXUnavailable$395.69
Bakersfield, CAUnavailable$396.92
Baltimore area, MDUnavailable$412.12
Beaumont, TXUnavailable$368.07
Brazoria, TXUnavailable$380.28

64719 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
64719 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 64719 rate is calculated

Each of 64719’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 64719

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.85

4.85 RVUs× 1.000 GPCI

Practice expense5.80

5.80 RVUs× 1.000 GPCI

Malpractice0.96

0.96 RVUs× 1.000 GPCI

Adjusted RVUs

11.6100

Conversion factor

$33.4009

Medicare rate

$387.78

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 64719

64719 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64719

Ulnar nerve surgery, at wrist

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 64719

Ulnar nerve surgery, at wrist

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

64719 without 50 · national facility

$387.78

Ulnar nerve surgery, at wrist

64719-50 · Bilateral: 150%

$581.67

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

64719 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 64719

    Ulnar nerve surgery, at wrist4.85 wRVU

    Not priced

  • 64718

    Ulnar nerve surgery, at the elbow7.08 wRVU

    Not priced

  • 64721

    Carpal tunnel release, median nerve at carpal tunnel4.85 wRVU

    $482.64

  • 64704

    Nerve neuroplasty, hand or foot nerve4.57 wRVU

    Not priced

How to choose

64718Ulnar nerve surgeryAt the elbow
The key distinction is the operative site: this code is for the ulnar nerve at the wrist; 64718 is for the ulnar nerve at the elbow.
64721Carpal tunnel releaseMedian nerve at carpal tunnel
64721 addresses median nerve decompression for carpal tunnel syndrome. This code addresses the ulnar nerve at the wrist, including compression near Guyon canal.
64704Nerve neuroplastyHand or foot nerve
Use 64704 for neuroplasty or repositioning of another nerve in the hand or foot. This code is specific to the ulnar nerve at the wrist.

Codes related to 64719

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 64719
CodeHow it relatesNational office range
Used instead
64718Ulnar nerve surgery, at the elbowTreats the ulnar nerve at the elbow rather than at the wrist.No office rate
64704Nerve neuroplasty, hand or foot nerveApplies to neuroplasty or repositioning of another nerve in the hand or foot.No office rate
64708Nerve neuroplasty, major arm or leg nerveApplies to neuroplasty or repositioning of a major peripheral nerve in the arm or leg.No office rate
Often billed with
64721Carpal tunnel release, median nerve at carpal tunnelMay be reported for separately performed median nerve decompression at the wrist.$426.06–$612.23

64719 billing questions

When should this code be selected instead of 64718?

Use this code for surgery on the ulnar nerve at the wrist, typically in the Guyon canal region. Code 64718 is for the ulnar nerve at the elbow.

Can this be reported with carpal tunnel surgery?

Yes, when the surgeon also performs a separately documented median nerve decompression at the wrist. The operative note should identify the distinct nerve and procedure treated.

How is bilateral wrist surgery reported?

For bilateral procedures, report modifier 50. CMS pays the bilateral procedure at 150%.

Does the global period include routine postoperative visits?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

What documentation supports reporting this procedure?

Document the wrist-level ulnar nerve condition and the operative work performed, including the site and whether the nerve was freed from compression or repositioned.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 64719PPRRVU2026_Oct_nonQPP.csv, line 7,209 (RVU26D)

Open CMS sourceHow we calculate rates

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