CPT code 64857: Nerve repair, arm or leg, no transposition2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 64857 in California.

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

What 64857 covers

A surgeon uses this code for direct suture repair of a major peripheral nerve in an arm or leg, such as after a traumatic transection. The repair does not include transposition, and the code excludes the sciatic nerve. These procedures are typically performed in an operating room by a surgeon with peripheral nerve expertise, often using magnification to align and join the nerve ends. It is not the code for repair of a small digital nerve in a finger or toe.

The operative report should identify the nerve and site, describe the injury and direct repair, and make clear that transposition was not performed. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral adjustment is inappropriate for this code. Assistant-at-surgery payment may be available; co-surgeon payment requires 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 64857 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 64857 rate is calculated

Each of 64857’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 64857

64857 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

64857 compared with similar codes

How to choose

64856Brachial plexus repairRepair or transposition

Choose 64857 when the major arm or leg nerve is repaired without transposition; 64856 describes repair that includes transposition.

64858Nerve repairSciatic nerve

64858 is for sciatic nerve repair. 64857 is for a major peripheral nerve in an arm or leg other than the sciatic nerve.

64831Digital nerve repairHand or foot

64831 applies to repair of a digital nerve. 64857 is for a major peripheral nerve in an arm or leg, not a small finger or toe nerve.

Codes related to 64857

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

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