CPT code 64856: Brachial plexus repair, repair or transposition2026 Medicare rate & RVUs in Missouri
Report this service for operative repair or transposition of a brachial plexus nerve, such as reconstruction after a traumatic plexus injury.
CMS doesn’t publish an office rate for 64856 in Missouri.
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 64856 covers
This service covers operative repair or transposition of a brachial plexus nerve. It is commonly performed by a neurosurgeon, plastic surgeon, or orthopedic surgeon with peripheral nerve expertise in a hospital operating room. A typical clinical setting is reconstruction of a traumatic brachial plexus injury when the surgeon repairs or repositions the involved nerve structures.
Choose the code based on the documented anatomy and work performed, not simply the diagnosis of plexus injury. The operative report should identify the brachial plexus structures treated and describe the repair or transposition. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this descriptor and anatomy. Medicare does not pay an assistant at surgery for this service; co-surgeons require supporting documentation, and team surgery is 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 64856 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $897.77 |
| Metropolitan St. Louis, MO | Unavailable | $904.74 |
| Rest of Missouri | Unavailable | $873.32 |
How the 64856 rate is calculated
Each of 64856’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 · 64856
RVUs × geographic indexes × conversion factor
Work14.69
14.69 RVUs× 1.000 GPCI
Practice expense9.37
9.37 RVUs× 1.000 GPCI
Malpractice3.47
3.47 RVUs× 1.000 GPCI
Adjusted RVUs
27.5300
Conversion factor
$33.4009
Medicare rate
$919.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64856
64856 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64856
Brachial plexus repair, repair or transposition
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 64856
Brachial plexus repair, repair or transposition
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
64856 without 51 · national facility
$919.53
Brachial plexus repair, repair or transposition
64856-51 · Second procedure: 50%
$459.77
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%).
64856 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64857Nerve repairArm or leg, no transposition
- 64856 addresses the brachial plexus. Code 64857 is for a major peripheral nerve in the arm or leg, excluding the sciatic nerve.
- 64858Nerve repairSciatic nerve
- Choose 64856 for brachial plexus repair or transposition; 64858 is specific to repair of the sciatic nerve.
- 64831Digital nerve repairHand or foot
- 64831 is for repair of one digital nerve in the hand or foot. It is not the code for a brachial plexus injury.
64856 billing questions
How does this differ from 64857?
Use 64856 for brachial plexus repair or transposition. Code 64857 describes repair of a major peripheral nerve in the arm or leg, excluding the sciatic nerve.
Is this code reported for a digital nerve repair?
No. Code 64856 is for the brachial plexus; a digital nerve repair is represented by 64831 for one digital nerve.
What documentation supports 64856?
The operative report should identify the brachial plexus anatomy treated and describe the repair or transposition performed. A diagnosis of plexus injury alone does not establish the service.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period for this major surgery.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
Should modifier 50 be used for bilateral treatment?
Modifier 50 is inappropriate for this code's descriptor and anatomy.
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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