CPT code 64727: Internal neurolysis, microscope-assisted nerve dissection2026 Medicare rate & RVUs in Texas
Reports microscope-assisted dissection within a peripheral nerve to free internal fascicles from scar or adhesions during a neuroplasty procedure.
CMS doesn’t publish an office rate for 64727 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 64727 covers
The surgeon uses an operating microscope to separate nerve fascicles from internal scar or adhesions as part of peripheral nerve surgery. This is an intraoperative maneuver performed by surgeons treating peripheral nerve injury or entrapment, commonly in a hospital operating room or ambulatory surgery center. It describes dissection within the nerve, not simply exposing the nerve or freeing it from tissue around its outer surface.
Report 64727 only with a qualifying primary neuroplasty procedure; it is an add-on and is paid within that primary procedure’s global period. The operative report should identify the nerve and site, describe the internal fascicular dissection, and support use of the operating microscope. Do not use it for external neurolysis or decompression alone. The primary procedure accounts for the operative service to which this additional work is attached.
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 64727 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $146.23 |
| Beaumont, TX | Unavailable | $141.16 |
| Brazoria, TX | Unavailable | $143.54 |
| Dallas, TX | Unavailable | $144.49 |
| Fort Worth, TX | Unavailable | $144.25 |
| Galveston, TX | Unavailable | $144.03 |
| Houston, TX | Unavailable | $148.78 |
| Rest of Texas | Unavailable | $142.31 |
How the 64727 rate is calculated
Each of 64727’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 · 64727
RVUs × geographic indexes × conversion factor
Work3.02
3.02 RVUs× 1.000 GPCI
Practice expense1.06
1.06 RVUs× 1.000 GPCI
Malpractice0.26
0.26 RVUs× 1.000 GPCI
Adjusted RVUs
4.3400
Conversion factor
$33.4009
Medicare rate
$144.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64727
The CMS indicators that decide how 64727 is paid alongside other services.
CMS payment indicators · 64727
Internal neurolysis, microscope-assisted nerve dissection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
64727 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64708Nerve neuroplastyMajor arm or leg nerve
- 64708 reports the primary neuroplasty of a major arm or leg nerve. Add 64727 only when the surgeon also performs microscope-assisted internal fascicular dissection.
- 64722Nerve decompressionUnspecified nerve
- 64722 describes decompression of an unspecified nerve. It does not represent the additional internal fascicular dissection reported by 64727.
- 64721Carpal tunnel releaseMedian nerve at carpal tunnel
- 64721 is the median nerve procedure at the carpal tunnel. Code 64727 is an add-on for internal neurolysis performed with a qualifying neuroplasty.
64727 billing questions
Can 64727 be reported by itself?
No. It is an add-on code and must be reported with a qualifying primary neuroplasty procedure.
Does microscope use alone support 64727?
No. The operative work must include internal dissection of nerve fascicles, not merely microscope use or exposure of the nerve.
Is external neurolysis enough to report this code?
No. Freeing a nerve from surrounding tissue without intraneural fascicular dissection does not describe internal neurolysis.
What documentation supports 64727?
Document the nerve and operative site, the internal fascicular dissection performed, and use of an operating microscope, along with the primary neuroplasty.
How does the global period affect this add-on?
CMS pays 64727 within the global period of the primary procedure with which it is reported.
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
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