CPT code 64776: Neuroma excision, digital nerve, hand or foot2026 Medicare rate & RVUs in Texas
Reports surgical excision of a neuroma involving a digital nerve in the hand or foot, typically to treat persistent focal nerve pain.
CMS doesn’t publish an office rate for 64776 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 64776 covers
A surgeon excises a neuroma arising from a digital nerve in a finger or toe, commonly to address persistent, localized pain after nerve injury or prior surgery. The procedure may be performed by a hand, orthopedic, plastic, or foot surgeon in an operating room or ambulatory surgery setting. The operative record should identify the affected digit and nerve and describe the neuroma and its excision.
Choose this code for a digital nerve neuroma, rather than a lesion of a cutaneous or larger peripheral nerve. If additional digital nerves are excised in the same operative session, the separate add-on code is available for each additional nerve. Medicare assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 64776 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 | $380.70 |
| Beaumont, TX | Unavailable | $357.72 |
| Brazoria, TX | Unavailable | $367.74 |
| Dallas, TX | Unavailable | $371.10 |
| Fort Worth, TX | Unavailable | $369.88 |
| Galveston, TX | Unavailable | $369.52 |
| Houston, TX | Unavailable | $386.18 |
| Rest of Texas | Unavailable | $363.23 |
How the 64776 rate is calculated
Each of 64776’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 · 64776
RVUs × geographic indexes × conversion factor
Work5.46
5.46 RVUs× 1.000 GPCI
Practice expense4.84
4.84 RVUs× 1.000 GPCI
Malpractice0.91
0.91 RVUs× 1.000 GPCI
Adjusted RVUs
11.2100
Conversion factor
$33.4009
Medicare rate
$374.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64776
64776 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64776
Neuroma excision, digital nerve, hand or foot
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 64776
Neuroma excision, digital nerve, hand or foot
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
64776 without 51 · national facility
$374.42
Neuroma excision, digital nerve, hand or foot
64776-51 · Second procedure: 50%
$187.21
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
64776 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64774Neuroma excisionCutaneous nerve, surgically treated
- This code is for a digital nerve in the hand or foot. Code 64774 applies to a neuroma of a surgically identifiable cutaneous nerve.
- 64778Digital neuroma excisionEach additional nerve
- Code 64776 reports the primary digital nerve neuroma excision; 64778 is the add-on for each additional digital nerve excised.
- 64782Neuroma excisionMajor arm or leg nerve
- Use 64782 for a neuroma involving a major peripheral nerve, rather than a digital nerve in a finger or toe.
64776 billing questions
When should this code be selected instead of a cutaneous nerve neuroma code?
Use this code when the excised neuroma involves a digital nerve in the hand or foot. A neuroma of a surgically identifiable cutaneous nerve is represented by a different code.
How is excision of another digital nerve reported?
Code 64778 is the add-on for each additional digital nerve excised. The operative documentation should identify the additional nerve or digit treated.
Can modifier 50 be used when neuromas are excised on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the procedures according to the nerves and services documented, subject to applicable claim instructions.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is an assistant surgeon payable?
Assistant-at-surgery payment is available only when medical necessity is documented. CMS does not permit co-surgeon or team-surgery payment for this code.
How does Medicare handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
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
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