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Billing code 64718: Ulnar nerve surgeryMedicare rate & RVUs

Reports surgical freeing or repositioning of the ulnar nerve at the elbow, commonly for cubital tunnel symptoms or nerve irritation.

CMS RVU26DEffective Oct 1, 2026109 payment localities39.6K Medicare services in 2024

Medicare pays $575.16 for 64718 nationally in a facility.

Medicare rate · 64718

Ulnar nerve surgery

Work RVUs
7.08
Total RVUs
17.22
Global days
090

National rate · 2026

$575.16

Facility setting, before claim adjustments.

See every locality for 64718 →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.

On this page 10 sections
  1. Medicare rate
  2. What 64718 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 64718 covers

This operation addresses the ulnar nerve where it passes the elbow, often for cubital tunnel syndrome or nerve compression, tethering, or irritation. The surgeon frees the nerve from constricting tissue and may move it to a new position when the clinical findings call for transposition. Orthopedic, hand, plastic, or neurosurgeons commonly perform the procedure in an operating room, usually in a facility setting.

Report the code when the operative work involves the ulnar nerve at the elbow; a transposition is not required in every case. The operative report should identify the nerve and elbow site, the condition treated, and the release or repositioning performed. This major surgery has a 90-day global period that includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; 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.

Where 64718 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

64718 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$518.07
Alaska*Unavailable$690.87
ArizonaUnavailable$559.27
ArkansasUnavailable$510.98
AtlantaUnavailable$590.13
AustinUnavailable$587.06
BakersfieldUnavailable$588.91
Baltimore/Surr. CntysUnavailable$611.50
BeaumontUnavailable$545.59
BrazoriaUnavailable$563.93

64718 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
64718 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 64718 rate is calculated

Each of 64718’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 · 64718

RVUs × geographic indexes × conversion factor

Work7.08

7.08 RVUs× 1.000 GPCI

Practice expense8.71

8.71 RVUs× 1.000 GPCI

Malpractice1.43

1.43 RVUs× 1.000 GPCI

Adjusted RVUs

17.2200

Conversion factor

$33.4009

Medicare rate

$575.16

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

Payment rules and modifiers for 64718

64718 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64718

Ulnar nerve surgery

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
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 · 64718

Ulnar nerve surgery

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 50 · payment effect

With and without the modifier

64718 without 50 · national facility

$575.16

Ulnar nerve surgery

64718-50 · Bilateral: 150%

$862.74

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

64718 compared with similar codes

Compare codes · National

5 codes, side by side

  • 64718

    Ulnar nerve surgery7.08 wRVU

    Not priced

  • 64719

    Ulnar nerve surgery4.85 wRVU

    Not priced

  • 64708

    Nerve neuroplasty6.2 wRVU

    Not priced

  • 64721

    Carpal tunnel release4.85 wRVU

    $482.64

  • 64727

    Internal neurolysis3.02 wRVU

    Not priced

How to choose

64719Ulnar nerve surgery
Choose 64718 for the ulnar nerve at the elbow; 64719 identifies work on that nerve at the wrist.
64708Nerve neuroplasty
64718 specifically identifies the ulnar nerve at the elbow. Consider 64708 for a major peripheral nerve procedure that does not fit a more specific site-and-nerve code.
64721Carpal tunnel release
64721 is median nerve surgery for carpal tunnel at the wrist. It does not describe ulnar nerve surgery at the elbow.
64727Internal neurolysis
64727 describes internal neurolysis requiring an operating microscope, not the primary ulnar nerve elbow procedure.

Codes related to 64718

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

Codes related to 64718
CodeHow it relatesNational office range
Same family
64719Ulnar nerve surgeryUlnar nerve procedure at the wrist rather than the elbow.No office rate
64713Nerve revisionRelated revision code for peripheral nerve work in the arm.No office rate
Used instead
64708Nerve neuroplastyBroader major peripheral nerve procedure when a more specific elbow code is not appropriate.No office rate
Add-on codes
64727Internal neurolysisAdd-on code for separately performed internal neurolysis requiring an operating microscope.No office rate

64718 billing questions

Does the nerve have to be transposed?

No. The code covers freeing the ulnar nerve at the elbow, with transposition performed when indicated. The operative report should make clear which work was done.

How is this different from 64719?

This code is for ulnar nerve surgery at the elbow. Code 64719 concerns the ulnar nerve at the wrist.

Can the surgeon report 64727 with this procedure?

Code 64727 may be relevant when internal neurolysis requiring an operating microscope is separately performed and documented in addition to the primary nerve procedure.

How is bilateral surgery paid?

CMS pays bilateral reporting with modifier 50 at 150%. The operative documentation should support treatment of both elbows.

What happens when other procedures are performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 64718PPRRVU2026_Oct_nonQPP.csv, line 7,208 (RVU26D)

Open CMS sourceHow we calculate rates

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