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Billing code 64727: Internal neurolysisMedicare rate & RVUs

Reports microscope-assisted dissection within a peripheral nerve to free internal fascicles from scar or adhesions during a neuroplasty procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities11.4K Medicare services in 2024

Medicare pays $144.96 for 64727 nationally in a facility.

Medicare rate · 64727

Internal neurolysis

Swap in your local Medicare rate.

Work RVUs
3.02
Total RVUs
4.34
Global days
ZZZ

National rate · 2026

$144.96

Facility setting, before claim adjustments.

See every locality for 64727 → · 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 64727 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 64727 covers

The surgeon uses an operating microscope to separate nerve fascicles from internal scar or adhesions as part of peripheral nerve surgery. This is an intraoperative maneuver performed by surgeons treating peripheral nerve injury or entrapment, commonly in a hospital operating room or ambulatory surgery center. It describes dissection within the nerve, not simply exposing the nerve or freeing it from tissue around its outer surface.

Report 64727 only with a qualifying primary neuroplasty procedure; it is an add-on and is paid within that primary procedure’s global period. The operative report should identify the nerve and site, describe the internal fascicular dissection, and support use of the operating microscope. Do not use it for external neurolysis or decompression alone. The primary procedure accounts for the operative service to which this additional work is attached.

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 64727 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

64727 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$136.77
Alaska*Unavailable$193.80
ArizonaUnavailable$142.61
ArkansasUnavailable$135.76
AtlantaUnavailable$147.57
AustinUnavailable$146.23
BakersfieldUnavailable$146.88
Baltimore/Surr. CntysUnavailable$151.22
BeaumontUnavailable$141.16
BrazoriaUnavailable$143.54

64727 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
64727 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 64727 rate is calculated

Each of 64727’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 · 64727

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.02Practice expense 1.06Malpractice 0.26

4.3400 adjusted RVUs×$33.4009 conversion factor=$144.96

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 64727

The CMS indicators that decide how 64727 is paid alongside other services.

CMS payment indicators · 64727

Internal neurolysis

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

64727 compared with similar codes

Compare codes

64727 vs 64708 vs 64722 vs 64721: national Medicare rates

Swap in your local Medicare rate.

  • 64727
    Internal neurolysis · 3.02 wRVU
    —
  • 64708
    Nerve neuroplasty · 6.2 wRVU
    —
  • 64722
    Nerve decompression · 4.7 wRVU
    —
  • 64721
    Carpal tunnel release · 4.85 wRVU
    $482.64

How to choose

64708Nerve neuroplasty
64708 reports the primary neuroplasty of a major arm or leg nerve. Add 64727 only when the surgeon also performs microscope-assisted internal fascicular dissection.
64722Nerve decompression
64722 describes decompression of an unspecified nerve. It does not represent the additional internal fascicular dissection reported by 64727.
64721Carpal tunnel release
64721 is the median nerve procedure at the carpal tunnel. Code 64727 is an add-on for internal neurolysis performed with a qualifying neuroplasty.

Codes related to 64727

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

Codes related to 64727
CodeHow it relatesNational office range
Add-on codes
64708Nerve neuroplastyNeuroplasty of a major peripheral nerve in the arm or leg can serve as the primary procedure.No office rate
64712Nerve revisionSciatic nerve neuroplasty may be the primary procedure accompanying internal neurolysis.No office rate
64718Ulnar nerve surgeryUlnar nerve neuroplasty at the elbow is a related primary nerve procedure.No office rate
Used instead
64722Nerve decompressionDescribes nerve decompression rather than microscope-assisted dissection within nerve fascicles.No office rate
64721Carpal tunnel releaseCovers median nerve surgery at the carpal tunnel, not internal neurolysis as a standalone service.$426.06–$612.23

64727 billing questions

Can 64727 be reported by itself?

No. It is an add-on code and must be reported with a qualifying primary neuroplasty procedure.

Does microscope use alone support 64727?

No. The operative work must include internal dissection of nerve fascicles, not merely microscope use or exposure of the nerve.

Is external neurolysis enough to report this code?

No. Freeing a nerve from surrounding tissue without intraneural fascicular dissection does not describe internal neurolysis.

What documentation supports 64727?

Document the nerve and operative site, the internal fascicular dissection performed, and use of an operating microscope, along with the primary neuroplasty.

How does the global period affect this add-on?

CMS pays 64727 within the global period of the primary procedure with which it is reported.

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 64727PPRRVU2026_Oct_nonQPP.csv, line 7,213 (RVU26D)

Open CMS sourceHow we calculate rates

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