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CPT code 64892: Nerve graft, single strand, arm or leg, under 4 cm2026 Medicare rate & RVUs

Reports a single-strand nerve graft under 4 cm used to bridge a nerve defect in an arm or leg when direct repair is not feasible.

CMS RVU26DEffective Oct 1, 2026109 payment localities19 Medicare services in 2024

Medicare pays $954.93 for 64892 nationally in a facility.

Medicare rate · 64892

Nerve graft, single strand, arm or leg, under 4 cm

Office or facility?

Work RVUs
15.35
Total RVUs
28.59
Global days
090

National rate · 2026

$954.93

Facility setting, before claim adjustments.

See every locality for 64892 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 64892 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 64892 covers

The surgeon bridges a gap in an arm or leg nerve by placing a single strand of nerve graft between the nerve ends. The service includes obtaining the graft. It is used when injury, resection, or another defect leaves insufficient nerve length for direct repair. Peripheral nerve, hand, plastic, orthopedic, and neurosurgeons may perform the procedure in an operating room, commonly in a hospital setting.

Select this code when the graft is a single strand, the treated nerve is in an arm or leg, and the graft length is under 4 cm. The operative report should identify the nerve and site, graft strand count and length, and why bridging was needed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; an assistant may be paid, 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 64892 pays more and less

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

109 of 109 payment localities

64892 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$866.01
AlaskaUnavailable$1,184.06
ArizonaUnavailable$928.92
ArkansasUnavailable$855.12
Atlanta, GAUnavailable$983.69
Austin, TXUnavailable$962.88
Bakersfield, CAUnavailable$954.10
Baltimore area, MDUnavailable$1,013.28
Beaumont, TXUnavailable$917.20
Brazoria, TXUnavailable$932.08

64892 rates by state

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

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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
64892 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 64892 rate is calculated

Each of 64892’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 · 64892

RVUs × geographic indexes × conversion factor

Office or facility?

Work15.35

15.35 RVUs× 1.000 GPCI

Practice expense9.98

9.98 RVUs× 1.000 GPCI

Malpractice3.26

3.26 RVUs× 1.000 GPCI

Adjusted RVUs

28.5900

Conversion factor

$33.4009

Medicare rate

$954.93

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 64892

64892 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64892

Nerve graft, single strand, arm or leg, under 4 cm

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 64892

Nerve graft, single strand, arm or leg, under 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

64892 without 51 · national facility

$954.93

Nerve graft, single strand, arm or leg, under 4 cm

64892-51 · Second procedure: 50%

$477.47

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%).

When to use modifier 51

64892 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 64892

    Nerve graft, single strand, arm or leg, under 4 cm15.35 wRVU

    Not priced

  • 64893

    Nerve graft, single strand, arm or leg, over 4 cm16.45 wRVU

    Not priced

  • 64897

    Nerve graft, multiple strands, under 4 cm18.9 wRVU

    Not priced

  • 64890

    Nerve graft, single strand, under 4 cm15.83 wRVU

    Not priced

  • 64857

    Nerve repair, arm or leg, no transposition15.42 wRVU

    Not priced

How to choose

64893Nerve graftSingle strand, arm or leg, over 4 cm
Both are single-strand grafts for an arm or leg nerve; the graft length separates them. This code is for under 4 cm, while 64893 is for over 4 cm.
64897Nerve graftMultiple strands, under 4 cm
Both cover an arm or leg graft under 4 cm, but 64897 is for multiple strands rather than a single strand.
64890Nerve graftSingle strand, under 4 cm
This code is for an arm or leg nerve; 64890 is for a hand or foot nerve. Both describe a single-strand graft under 4 cm.
64857Nerve repairArm or leg, no transposition
64857 describes nerve repair rather than an interposed graft. Choose the graft code when a nerve defect requires bridging with a graft.

Codes related to 64892

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

Codes related to 64892
CodeHow it relatesNational office range
Same family
64893Nerve graft, single strand, arm or leg, over 4 cmSingle-strand graft for an arm or leg nerve when the graft is over 4 cm.No office rate
64897Nerve graft, multiple strands, under 4 cmMultiple-strand graft for an arm or leg nerve under 4 cm.No office rate
64890Nerve graft, single strand, under 4 cmSingle-strand graft under 4 cm for a hand or foot nerve.No office rate
Used instead
64857Nerve repair, arm or leg, no transpositionNerve repair may be used when the nerve ends can be repaired without an interposed graft.No office rate

64892 billing questions

How is this code distinguished from 64893?

Both describe a single-strand graft for an arm or leg nerve. Use 64892 for a graft under 4 cm and 64893 for a graft over 4 cm.

When would 64897 be more appropriate?

64897 describes a multiple-strand graft for an arm or leg under 4 cm. This code is for a single strand.

Is obtaining the donor graft separately reportable?

Obtaining the graft is included in this service; do not separately report the graft-harvesting work as part of the same graft service.

Can modifier 50 be used for bilateral grafting?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

What documentation supports this code?

Document the arm or leg nerve treated, the nerve defect requiring a graft, the single-strand configuration, and graft length under 4 cm.

How does the 90-day global period affect follow-up billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global 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

Show the CMS file lines behind this rate
RVUs for 64892PPRRVU2026_Oct_nonQPP.csv, line 7,273 (RVU26D)

Open CMS sourceHow we calculate rates

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