CPT code 64896: Nerve graft, multiple strands, over 4 cm2026 Medicare rate & RVUs in Michigan
Reports reconstruction of a hand or foot nerve gap with a multiple-strand graft when the graft length exceeds 4 cm.
CMS doesn’t publish an office rate for 64896 in Michigan.
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 64896 covers
This code describes microsurgical reconstruction of a nerve in the hand or foot using a graft arranged in multiple strands to bridge a defect longer than 4 cm. It is typically performed by a hand, plastic, orthopedic, or peripheral nerve surgeon in an operating room. The operative report should identify the treated nerve and anatomical site, explain the graft reconstruction, and document the graft length and multiple-strand configuration.
Select this code based on the graft configuration, anatomical region, and documented length. The 90-day global period includes 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. Modifier 50 is inappropriate for this descriptor. 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 64896 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | $1,376.09 |
| Rest of Michigan | Unavailable | $1,269.48 |
How the 64896 rate is calculated
Each of 64896’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 · 64896
RVUs × geographic indexes × conversion factor
Work21.41
21.41 RVUs× 1.000 GPCI
Practice expense12.54
12.54 RVUs× 1.000 GPCI
Malpractice4.56
4.56 RVUs× 1.000 GPCI
Adjusted RVUs
38.5100
Conversion factor
$33.4009
Medicare rate
$1,286.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64896
64896 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64896
Nerve graft, multiple strands, 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) | 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 · 64896
Nerve graft, multiple strands, 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
64896 without 51 · national facility
$1,286.27
Nerve graft, multiple strands, over 4 cm
64896-51 · Second procedure: 50%
$643.14
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%).
64896 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64895Nerve graftMultiple strands, hand or foot, under 4 cm
- Both codes describe multiple-strand grafting in the hand or foot; 64895 is for the shorter graft-length category, while 64896 is for a graft longer than 4 cm.
- 64891Nerve graftHand or foot, over 4 cm
- 64891 describes a single-strand hand or foot graft over 4 cm. Use 64896 when the graft is multiple-strand.
- 64898Nerve graftMultiple strands, arm or leg, over 4 cm
- 64898 describes a multiple-strand graft over 4 cm in an arm or leg; 64896 is specific to the hand or foot.
64896 billing questions
How is this code distinguished from 64895?
Both describe multiple-strand grafting in the hand or foot. Use 64896 when the documented graft length is more than 4 cm; 64895 is the shorter-length sibling.
When would a single-strand graft code be more appropriate?
Choose the single-strand hand or foot code when the reconstruction uses one strand rather than multiple strands. Length determines which code within that single-strand pair applies.
What documentation supports reporting 64896?
Document the hand or foot nerve treated, the graft reconstruction, its multiple-strand configuration, and a graft length greater than 4 cm.
Can modifier 50 be used for bilateral grafting?
No. CMS identifies bilateral adjustment as inappropriate for this code's descriptor or anatomy.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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