CPT code 64891: Nerve graft, hand or foot, over 4 cm2026 Medicare rate & RVUs in Wisconsin
Reports microsurgical placement of one nerve-graft strand longer than 4 cm to bridge a nerve gap in the hand or foot.
In Wisconsin, Medicare pays $942.42 for 64891 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 64891 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 64891 covers
A surgeon uses this service to bridge a peripheral nerve gap in the hand or foot when the nerve ends cannot be brought together for direct repair. The graft restores continuity across the defect, such as after traumatic nerve loss or excision of a damaged nerve segment. Hand, plastic, orthopedic, and peripheral nerve surgeons commonly perform the procedure in an operating room using microsurgical technique. The code specifies one graft strand and a graft length exceeding 4 cm at a hand or foot site.
Choose the code from the operative report’s documented anatomic site, number of strands, and graft length; distinguish it from shorter grafts and grafts for other body regions. Documentation should identify the injured or resected nerve, the gap bridged, the graft configuration, and its length. The service 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 other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are 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 Wisconsin compares for 64891
Across 109 of 109 payment localities, the facility rate for 64891 runs from $932.23 in Arkansas to $1,292.28 in Alaska. Wisconsin pays $942.42. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Wisconsin · this page$942.42
- Los Angeles, CA · California$1,088.40+$145.98
- Washington, DC area · District of Columbia$1,148.11+$205.69
- Miami, FL · Florida$1,239.69+$297.27
- Chicago, IL · Illinois$1,202.65+$260.23
- Manhattan, NY · New York$1,205.12+$262.70
- Alaska · Alaska$1,292.28+$349.86
Other areas in Wisconsin first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $944.06 |
| ArkansasArkansas | — | $932.23 |
| ArizonaArizona | — | $1,012.40 |
| Bakersfield, CACalifornia | — | $1,038.45 |
| Chico, CACalifornia | — | $1,028.52 |
| El Centro, CACalifornia | — | $1,029.12 |
| Fresno, CACalifornia | — | $1,028.52 |
| Hanford, CACalifornia | — | $1,028.52 |
| Madera, CACalifornia | — | $1,028.52 |
| Merced, CACalifornia | — | $1,028.52 |
| Modesto, CACalifornia | — | $1,028.52 |
| Napa, CACalifornia | — | $1,129.96 |
| Oxnard, CACalifornia | — | $1,075.76 |
| Redding, CACalifornia | — | $1,028.52 |
| Rest of CaliforniaCalifornia | — | $1,028.52 |
| Riverside, CACalifornia | — | $1,067.30 |
| Sacramento, CACalifornia | — | $1,063.04 |
| Salinas, CACalifornia | — | $1,058.80 |
| San Diego, CACalifornia | — | $1,072.09 |
| Marin County, CACalifornia | — | $1,174.80 |
| San Francisco, CACalifornia | — | $1,170.70 |
| San Benito County, CACalifornia | — | $1,203.92 |
| Santa Clara County, CACalifornia | — | $1,187.16 |
| San Luis Obispo, CACalifornia | — | $1,043.78 |
| Santa Cruz, CACalifornia | — | $1,073.03 |
| Santa Maria, CACalifornia | — | $1,059.59 |
| Santa Rosa, CACalifornia | — | $1,082.73 |
| Stockton, CACalifornia | — | $1,028.52 |
| Vallejo, CACalifornia | — | $1,124.05 |
| Visalia, CACalifornia | — | $1,028.52 |
| Yuba City, CACalifornia | — | $1,028.52 |
| ColoradoColorado | — | $1,043.87 |
| ConnecticutConnecticut | — | $1,104.74 |
| DelawareDelaware | — | $1,027.16 |
| Fort Lauderdale, FLFlorida | — | $1,142.81 |
| Rest of FloridaFlorida | — | $1,085.80 |
| Atlanta, GAGeorgia | — | $1,072.38 |
| Rest of GeorgiaGeorgia | — | $1,025.58 |
| Hawaii, Guam, HIHawaii | — | $1,038.65 |
| IowaIowa | — | $937.88 |
| IdahoIdaho | — | $948.82 |
| East St. Louis, ILIllinois | — | $1,134.63 |
| Rest of IllinoisIllinois | — | $1,077.77 |
| Suburban Chicago, ILIllinois | — | $1,147.40 |
| IndianaIndiana | — | $952.88 |
| KansasKansas | — | $946.88 |
| KentuckyKentucky | — | $991.11 |
| New Orleans, LALouisiana | — | $1,036.22 |
| Rest of LouisianaLouisiana | — | $994.88 |
| Metropolitan Boston, MAMassachusetts | — | $1,119.56 |
| Rest of MassachusettsMassachusetts | — | $1,044.15 |
| Baltimore area, MDMaryland | — | $1,104.31 |
| Rest of MarylandMaryland | — | $1,040.80 |
| Rest of MaineMaine | — | $966.79 |
| Southern Maine, MEMaine | — | $993.08 |
| Detroit, MIMichigan | — | $1,111.06 |
| Rest of MichiganMichigan | — | $1,025.44 |
| MinnesotaMinnesota | — | $966.18 |
| Metropolitan Kansas City, MOMissouri | — | $1,016.34 |
| Metropolitan St. Louis, MOMissouri | — | $1,023.97 |
| Rest of MissouriMissouri | — | $988.64 |
| MississippiMississippi | — | $959.95 |
| MontanaMontana | — | $1,040.53 |
| North CarolinaNorth Carolina | — | $973.46 |
| North DakotaNorth Dakota | — | $969.15 |
| NebraskaNebraska | — | $938.43 |
| New HampshireNew Hampshire | — | $1,040.26 |
| Northern New JerseyNew Jersey | — | $1,141.38 |
| Rest of New JerseyNew Jersey | — | $1,107.74 |
| New MexicoNew Mexico | — | $1,035.54 |
| NevadaNevada | — | $1,020.99 |
| NYC suburbs and Long Island, NYNew York | — | $1,247.38 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,125.25 |
| Queens, NYNew York | — | $1,194.86 |
| Rest of New YorkNew York | — | $987.21 |
| OhioOhio | — | $1,010.85 |
| OklahomaOklahoma | — | $975.89 |
| Portland, OROregon | — | $1,058.36 |
| Rest of OregonOregon | — | $1,003.54 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,088.77 |
| Rest of PennsylvaniaPennsylvania | — | $1,005.03 |
| Puerto RicoPuerto Rico | — | $1,042.87 |
| Rhode IslandRhode Island | — | $1,050.20 |
| South CarolinaSouth Carolina | — | $995.70 |
| South DakotaSouth Dakota | — | $960.71 |
| TennesseeTennessee | — | $952.64 |
| Austin, TXTexas | — | $1,048.75 |
| Beaumont, TXTexas | — | $1,000.26 |
| Brazoria, TXTexas | — | $1,015.57 |
| Dallas, TXTexas | — | $1,027.32 |
| Fort Worth, TXTexas | — | $1,025.33 |
| Galveston, TXTexas | — | $1,022.07 |
| Houston, TXTexas | — | $1,088.14 |
| Rest of TexasTexas | — | $1,010.97 |
| UtahUtah | — | $1,007.17 |
| VirginiaVirginia | — | $999.29 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,042.87 |
| VermontVermont | — | $977.66 |
| Rest of WashingtonWashington | — | $1,038.12 |
| King County, WAWashington | — | $1,127.56 |
| West VirginiaWest Virginia | — | $1,046.23 |
| WyomingWyoming | — | $1,009.42 |
64891 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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 64891 rate is calculated
Each of 64891’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 · 64891
RVUs × geographic indexes × conversion factor
Work16.92
16.92 RVUs× 1.000 GPCI
Practice expense10.63
10.63 RVUs× 1.000 GPCI
Malpractice3.61
3.61 RVUs× 1.000 GPCI
Adjusted RVUs
31.1600
Conversion factor
$33.4009
Medicare rate
$1,040.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Wisconsin inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,272
- Code
- 64891
- Physician work
- 16.92
- Practice expense
- 10.63
- Malpractice
- 3.61
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.92 | × 1.000 | 16.9200 |
| Practice expense | 10.63 | × 0.958 | 10.1835 |
| Malpractice | 3.61 | × 0.308 | 1.1119 |
| Total RVUs | 28.2154 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$942.42
Facility: (16.92 × 1 + 10.63 × 0.958 + 3.61 × 0.308) × $33.4009 = $942.42
Payment rules and modifiers for 64891
64891 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64891
Nerve graft, hand or foot, over 4 cm
| 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) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 64891
Nerve graft, hand or foot, over 4 cm
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
64891 without 51 · national facility
$1,040.77
Nerve graft, hand or foot, over 4 cm
64891-51 · Second procedure: 50%
$520.39
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%).
How 64891 has changed in Wisconsin
64891 · 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 | $942.42 | RVU26D |
| 2026-07-01 | Not available in this setting | $942.42 | RVU26C |
| 2026-04-01 | Not available in this setting | $942.42 | RVU26B |
| 2026-01-01 | Not available in this setting | $942.42 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,028.78 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,028.78 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,028.78 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,028.78 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,049.70 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,049.70 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,049.70 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,049.70 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,032.57 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,058.39 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,058.39 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,058.39 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,058.39 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,063.16 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,063.16 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,063.16 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,063.16 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,069.09 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,069.09 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,069.09 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,069.09 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,092.19 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,092.19 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,092.19 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,092.19 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,095.74 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,095.74 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,093.87 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,093.87 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,094.73 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,094.73 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,094.73 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,094.73 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,119.97 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,119.97 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,119.97 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,119.97 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,135.48 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,135.48 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,135.48 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,135.48 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,138.90 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,138.90 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,133.23 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,133.23 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,141.69 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,141.69 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,141.69 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,141.69 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,122.83 | RVU13D |
| 2013-07-01 | Not available in this setting | Rate data unavailable | RVU13C |
| 2013-04-01 | Not available in this setting | Rate data unavailable | RVU13B |
| 2013-01-01 | Not available in this setting | Rate data unavailable | RVU13AR |
Where the Wisconsin rate applies
Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.
- Abbotsford
- Abrams
- Adams
- Adell
- Albany
- Algoma
- Allens Grove
- Allenton
64891 billing questions
How is this code distinguished from 64890?
Both describe a single-strand graft for a hand or foot nerve. Select this code when the graft length exceeds 4 cm; 64890 is for a graft up to 4 cm.
When should 64893 be considered instead?
64893 describes a single-strand graft longer than 4 cm for an arm or leg nerve. This code is for a hand or foot site.
What operative details support code selection?
Document the nerve and operative site, the nerve gap being bridged, the use of one graft strand, and graft length exceeding 4 cm.
Can modifier 50 be used for grafting both sides?
CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate under the descriptor and anatomy. Document the treated site or sites.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be allowed. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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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