CPT code 64787: Nerve-end implantation, into muscle or bone2026 Medicare rate & RVUs in Texas
Reports placement of a divided nerve end into nearby muscle or bone as an additional step during qualifying surgery, often to manage a neuroma.
CMS doesn’t publish an office rate for 64787 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 64787 covers
The surgeon places a divided nerve end into muscle or bone, commonly when treating a symptomatic neuroma or managing a nerve stump during another nerve procedure. The operative report should identify the nerve and site, describe the implantation and its destination, and document the related primary procedure. This work is typically performed in an operating room by a surgeon treating peripheral nerve conditions.
Code 64787 is an add-on, not a stand-alone service: report it only with an eligible primary procedure. CMS pays it within the primary procedure’s global period, so it is not separately paid as a service outside that period. The documentation should distinguish the nerve-end implantation from the primary excision or other nerve work. Identify the primary code and explain why the nerve end was implanted rather than simply documenting nerve division or removal.
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 64787 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 | $203.44 |
| Beaumont, TX | Unavailable | $198.45 |
| Brazoria, TX | Unavailable | $199.00 |
| Dallas, TX | Unavailable | $201.29 |
| Fort Worth, TX | Unavailable | $201.22 |
| Galveston, TX | Unavailable | $200.28 |
| Houston, TX | Unavailable | $214.01 |
| Rest of Texas | Unavailable | $199.32 |
How the 64787 rate is calculated
Each of 64787’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 · 64787
RVUs × geographic indexes × conversion factor
Work4.18
4.18 RVUs× 1.000 GPCI
Practice expense1.17
1.17 RVUs× 1.000 GPCI
Malpractice0.75
0.75 RVUs× 1.000 GPCI
Adjusted RVUs
6.1000
Conversion factor
$33.4009
Medicare rate
$203.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64787
The CMS indicators that decide how 64787 is paid alongside other services.
CMS payment indicators · 64787
Nerve-end implantation, into muscle or bone
| 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) | 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. |
64787 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64774Neuroma excisionCutaneous nerve, surgically treated
- 64774 reports excision of a surgically identifiable cutaneous nerve neuroma. Use 64787 only for the additional placement of a nerve end into muscle or bone with an eligible primary procedure.
- 64776Neuroma excisionDigital nerve, hand or foot
- 64776 addresses excision of a digital nerve neuroma. It describes the primary excision, while 64787 describes additional implantation of the nerve end.
- 64786Neuroma excisionSciatic nerve
- 64786 reports sciatic nerve neuroma excision. It is a primary procedure; 64787 identifies the additional nerve-end implantation when performed.
64787 billing questions
Can 64787 be reported by itself?
No. It is an add-on code and must be reported with an eligible primary procedure.
Is nerve-end implantation included in the neuroma excision?
The implantation is additional work when the nerve end is placed into muscle or bone. Document that step separately from the neuroma excision or other primary nerve procedure.
What should the operative report document?
Name the nerve and operative site, describe the placement of its end, identify whether it was implanted into muscle or bone, and state the related primary procedure.
How does the global-period payment rule affect 64787?
CMS pays this add-on within the primary procedure’s global period. It is not paid as a separate service outside that period.
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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