CPT code 64856: Brachial plexus repair, repair or transposition2026 Medicare rate & RVUs in Utah

In Utah, Medicare pays $888.93 for 64856 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 64856 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

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.

How Utah compares for 64856

Across 109 of 109 payment localities, the facility rate for 64856 runs from $819.19 in Arkansas to $1,133.16 in Alaska. Utah pays $888.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

64856 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 64856 in every payment locality

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.

Payment rules and modifiers for 64856

64856 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 64856

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 64856 has changed in Utah

Price 64856 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

• Alpine
• Alta
• Altamont
• Alton
• Amalga
• American Fork
• Aneth
• Annabella

Browse all communities in Utah

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

Open CMS sourceHow we calculate rates