CPT code 64778: Digital neuroma excision, each additional nerve2026 Medicare rate & RVUs in New Mexico
Reports excision of a neuroma from an additional digital nerve in the hand or foot during the same session as the primary nerve procedure.
In New Mexico, Medicare pays $156.59 for 64778 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 64778 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 64778 covers
This add-on represents excision of a neuroma from an additional digital nerve in a finger or toe. A hand, orthopedic, plastic, or podiatric surgeon may perform the work in an operating room when a patient has painful neuromas involving more than one digital nerve, such as after nerve injury or prior surgery. The surgeon identifies and removes the additional affected nerve lesion as part of the operative treatment.
Report 64778 only with the primary digital nerve neuroma excision code, 64776, for an additional nerve treated during the same operative session. The operative note should identify the hand or foot, the distinct digital nerves treated, and the neuroma excised at each site. CMS classifies 64778 as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period.
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.
How New Mexico compares for 64778
Across 109 of 109 payment localities, the facility rate for 64778 runs from $138.83 in Wisconsin to $198.09 in Alaska. New Mexico pays $156.59. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$156.59
- Los Angeles, CA · California$157.88+$1.29
- Washington, DC area · District of Columbia$168.63+$12.04
- Miami, FL · Florida$188.99+$32.40
- Chicago, IL · Illinois$183.53+$26.94
- Manhattan, NY · New York$179.23+$22.64
- Alaska · Alaska$198.09+$41.50
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $141.65 |
| ArkansasArkansas | — | $140.04 |
| ArizonaArizona | — | $150.90 |
| Bakersfield, CACalifornia | — | $151.66 |
| Chico, CACalifornia | — | $149.89 |
| El Centro, CACalifornia | — | $150.00 |
| Fresno, CACalifornia | — | $149.89 |
| Hanford, CACalifornia | — | $149.89 |
| Madera, CACalifornia | — | $149.89 |
| Merced, CACalifornia | — | $149.89 |
| Modesto, CACalifornia | — | $149.89 |
| Napa, CACalifornia | — | $161.14 |
| Oxnard, CACalifornia | — | $155.65 |
| Redding, CACalifornia | — | $149.89 |
| Rest of CaliforniaCalifornia | — | $149.89 |
| Riverside, CACalifornia | — | $156.77 |
| Sacramento, CACalifornia | — | $153.99 |
| Salinas, CACalifornia | — | $153.35 |
| San Diego, CACalifornia | — | $154.58 |
| Marin County, CACalifornia | — | $166.31 |
| San Francisco, CACalifornia | — | $165.59 |
| San Benito County, CACalifornia | — | $170.51 |
| Santa Clara County, CACalifornia | — | $167.54 |
| San Luis Obispo, CACalifornia | — | $151.29 |
| Santa Cruz, CACalifornia | — | $154.15 |
| Santa Maria, CACalifornia | — | $153.27 |
| Santa Rosa, CACalifornia | — | $155.48 |
| Stockton, CACalifornia | — | $149.89 |
| Vallejo, CACalifornia | — | $160.09 |
| Visalia, CACalifornia | — | $149.89 |
| Yuba City, CACalifornia | — | $149.89 |
| ColoradoColorado | — | $153.59 |
| ConnecticutConnecticut | — | $163.99 |
| DelawareDelaware | — | $152.94 |
| Fort Lauderdale, FLFlorida | — | $172.67 |
| Rest of FloridaFlorida | — | $164.31 |
| Atlanta, GAGeorgia | — | $160.10 |
| Rest of GeorgiaGeorgia | — | $155.59 |
| Hawaii, Guam, HIHawaii | — | $150.42 |
| IowaIowa | — | $139.34 |
| IdahoIdaho | — | $141.12 |
| East St. Louis, ILIllinois | — | $174.06 |
| Rest of IllinoisIllinois | — | $164.20 |
| Suburban Chicago, ILIllinois | — | $173.07 |
| IndianaIndiana | — | $141.63 |
| KansasKansas | — | $141.27 |
| KentuckyKentucky | — | $149.57 |
| New Orleans, LALouisiana | — | $155.98 |
| Rest of LouisianaLouisiana | — | $150.36 |
| Metropolitan Boston, MAMassachusetts | — | $163.06 |
| Rest of MassachusettsMassachusetts | — | $153.98 |
| Baltimore area, MDMaryland | — | $164.03 |
| Rest of MarylandMaryland | — | $154.63 |
| Rest of MaineMaine | — | $144.31 |
| Southern Maine, MEMaine | — | $146.80 |
| Detroit, MIMichigan | — | $168.51 |
| Rest of MichiganMichigan | — | $154.92 |
| MinnesotaMinnesota | — | $140.87 |
| Metropolitan Kansas City, MOMissouri | — | $152.51 |
| Metropolitan St. Louis, MOMissouri | — | $153.47 |
| Rest of MissouriMissouri | — | $149.95 |
| MississippiMississippi | — | $144.90 |
| MontanaMontana | — | $154.94 |
| North CarolinaNorth Carolina | — | $145.09 |
| North DakotaNorth Dakota | — | $142.28 |
| NebraskaNebraska | — | $139.19 |
| New HampshireNew Hampshire | — | $153.64 |
| Northern New JerseyNew Jersey | — | $167.99 |
| Rest of New JerseyNew Jersey | — | $164.08 |
| NevadaNevada | — | $151.44 |
| NYC suburbs and Long Island, NYNew York | — | $185.90 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $167.10 |
| Queens, NYNew York | — | $176.80 |
| Rest of New YorkNew York | — | $147.01 |
| OhioOhio | — | $152.33 |
| OklahomaOklahoma | — | $146.75 |
| Portland, OROregon | — | $154.72 |
| Rest of OregonOregon | — | $148.50 |
| Metropolitan Philadelphia, PAPennsylvania | — | $162.26 |
| Rest of PennsylvaniaPennsylvania | — | $151.15 |
| Puerto RicoPuerto Rico | — | $155.02 |
| Rhode IslandRhode Island | — | $155.66 |
| South CarolinaSouth Carolina | — | $149.31 |
| South DakotaSouth Dakota | — | $140.79 |
| TennesseeTennessee | — | $142.13 |
| Austin, TXTexas | — | $154.62 |
| Beaumont, TXTexas | — | $150.55 |
| Brazoria, TXTexas | — | $150.80 |
| Dallas, TXTexas | — | $152.73 |
| Fort Worth, TXTexas | — | $152.68 |
| Galveston, TXTexas | — | $151.89 |
| Houston, TXTexas | — | $163.60 |
| Rest of TexasTexas | — | $151.25 |
| UtahUtah | — | $150.86 |
| VirginiaVirginia | — | $148.14 |
| Virgin Islands, VIUnited States Virgin Islands | — | $155.02 |
| VermontVermont | — | $144.10 |
| Rest of WashingtonWashington | — | $152.90 |
| King County, WAWashington | — | $163.48 |
| WisconsinWisconsin | — | $138.83 |
| West VirginiaWest Virginia | — | $159.95 |
| WyomingWyoming | — | $149.42 |
64778 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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 64778 rate is calculated
Each of 64778’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 · 64778
RVUs × geographic indexes × conversion factor
Work3.03
3.03 RVUs× 1.000 GPCI
Practice expense0.97
0.97 RVUs× 1.000 GPCI
Malpractice0.64
0.64 RVUs× 1.000 GPCI
Adjusted RVUs
4.6400
Conversion factor
$33.4009
Medicare rate
$154.98
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,231
- Code
- 64778
- Physician work
- 3.03
- Practice expense
- 0.97
- Malpractice
- 0.64
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.03 | × 1.000 | 3.0300 |
| Practice expense | 0.97 | × 0.917 | 0.8895 |
| Malpractice | 0.64 | × 1.201 | 0.7686 |
| Total RVUs | 4.6881 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$156.59
Facility: (3.03 × 1 + 0.97 × 0.917 + 0.64 × 1.201) × $33.4009 = $156.59
Payment rules and modifiers for 64778
The CMS indicators that decide how 64778 is paid alongside other services.
CMS payment indicators · 64778
Digital neuroma excision, each additional nerve
| 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. |
How 64778 has changed in New Mexico
64778 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $156.59 | RVU26D |
| 2026-07-01 | Not available in this setting | $156.59 | RVU26C |
| 2026-04-01 | Not available in this setting | $156.59 | RVU26B |
| 2026-01-01 | Not available in this setting | $156.59 | RVU26A |
| 2025-10-01 | Not available in this setting | $172.65 | RVU25D |
| 2025-07-01 | Not available in this setting | $172.65 | RVU25C |
| 2025-04-01 | Not available in this setting | $172.65 | RVU25B |
| 2025-01-01 | Not available in this setting | $172.65 | RVU25A |
| 2024-10-01 | Not available in this setting | $176.85 | RVU24D |
| 2024-07-01 | Not available in this setting | $176.85 | RVU24C |
| 2024-04-01 | Not available in this setting | $176.85 | RVU24B |
| 2024-03-09 | Not available in this setting | $176.85 | RVU24AR |
| 2024-01-01 | Not available in this setting | $173.97 | RVU24A |
| 2023-10-01 | Not available in this setting | $179.95 | RVU23D |
| 2023-07-01 | Not available in this setting | $179.95 | RVU23C |
| 2023-04-01 | Not available in this setting | $179.95 | RVU23B |
| 2023-01-01 | Not available in this setting | $179.95 | RVU23A |
| 2022-10-01 | Not available in this setting | $182.13 | RVU22D |
| 2022-07-01 | Not available in this setting | $182.13 | RVU22C |
| 2022-04-01 | Not available in this setting | $182.13 | RVU22B |
| 2022-01-01 | Not available in this setting | $182.13 | RVU22A |
| 2021-10-01 | Not available in this setting | $184.17 | RVU21D |
| 2021-07-01 | Not available in this setting | $184.17 | RVU21C |
| 2021-04-01 | Not available in this setting | $184.17 | RVU21B |
| 2021-01-01 | Not available in this setting | $184.17 | RVU21A |
| 2020-10-01 | Not available in this setting | $190.37 | RVU20D |
| 2020-07-01 | Not available in this setting | $190.37 | RVU20C |
| 2020-04-01 | Not available in this setting | $190.37 | RVU20B |
| 2020-01-01 | Not available in this setting | $190.37 | RVU20A |
| 2019-10-01 | Not available in this setting | $192.17 | RVU19D |
| 2019-07-01 | Not available in this setting | $192.17 | RVU19C |
| 2019-04-01 | Not available in this setting | $192.17 | RVU19B |
| 2019-01-01 | Not available in this setting | $192.17 | RVU19A |
| 2018-10-01 | Not available in this setting | $192.29 | RVU18D |
| 2018-07-01 | Not available in this setting | $192.29 | RVU18C |
| 2018-04-01 | Not available in this setting | $192.29 | RVU18B |
| 2018-01-01 | Not available in this setting | $192.29 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $146.11 | RVU17D |
| 2017-07-01 | Not available in this setting | $146.11 | RVU17C |
| 2017-04-01 | Not available in this setting | $146.11 | RVU17B |
| 2017-01-01 | Not available in this setting | $146.11 | RVU17A |
| 2016-10-01 | Not available in this setting | $146.99 | RVU16D |
| 2016-07-01 | Not available in this setting | $146.99 | RVU16C |
| 2016-04-01 | Not available in this setting | $146.99 | RVU16B |
| 2016-01-01 | Not available in this setting | $146.99 | RVU16A |
| 2015-10-01 | Not available in this setting | $146.45 | RVU15D |
| 2015-07-01 | Not available in this setting | $146.45 | RVU15C |
| 2015-04-01 | Not available in this setting | $145.72 | RVU15B |
| 2015-01-01 | Not available in this setting | $145.72 | RVU15A |
| 2014-10-01 | Not available in this setting | $158.82 | RVU14D |
| 2014-07-01 | Not available in this setting | $158.82 | RVU14C |
| 2014-04-01 | Not available in this setting | $158.82 | RVU14B |
| 2014-01-01 | Not available in this setting | $158.82 | RVU14A |
| 2013-10-01 | Not available in this setting | $151.44 | RVU13D |
| 2013-07-01 | Not available in this setting | $151.44 | RVU13C |
| 2013-04-01 | Not available in this setting | $151.44 | RVU13B |
| 2013-01-01 | Not available in this setting | $151.44 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
64778 billing questions
When should 64778 be reported instead of 64776?
Use 64776 for the primary digital nerve neuroma excision. Report 64778 for each additional digital nerve neuroma excised in the same session.
Can 64778 be billed by itself?
No. It is an add-on code and must be reported with the primary digital nerve procedure, 64776.
What should the operative note document?
Document the treated hand or foot, identify each distinct digital nerve, and describe the neuroma excised from the additional nerve.
How many units should be reported?
Report the add-on for each additional digital nerve neuroma excised beyond the primary nerve treated under 64776. The record should support each separately treated nerve.
How does the global period affect 64778?
CMS pays this add-on within the global period of its primary procedure. It is not reported as a standalone service.
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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