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Billing code 64774: Neuroma excisionMedicare rate & RVUs

Reports surgical excision of a symptomatic neuroma arising from a cutaneous nerve, such as a painful nerve lesion in a prior incision scar.

CMS RVU26DEffective Oct 1, 2026109 payment localities585 Medicare services in 2024

Medicare pays $411.83 for 64774 nationally in a facility.

Medicare rate · 64774

Neuroma excision

Swap in your local Medicare rate.

Work RVUs
5.66
Total RVUs
12.33
Global days
090

National rate · 2026

$411.83

Facility setting, before claim adjustments.

See every locality for 64774 → · 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 64774 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 64774 covers

This service removes a symptomatic neuroma arising from a cutaneous sensory nerve. A typical situation is a painful nerve-end lesion in a surgical scar or after nerve injury. The surgeon identifies and excises the neuroma; the code is specific to a cutaneous nerve, rather than a digital or major peripheral nerve. Surgeons in specialties such as plastic, orthopedic, or general surgery may perform it in an operating room or another appropriate surgical setting.

Select the code when documentation supports excision of a cutaneous nerve neuroma and identifies the treated nerve and site. Distinguish a neuroma from a cutaneous nerve neurofibroma or neurilemmoma, and from a lesion of a digital or major peripheral nerve. This major surgery code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily restricted, and 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 64774 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

64774 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$371.70
Alaska*Unavailable$500.41
ArizonaUnavailable$400.44
ArkansasUnavailable$366.75
AtlantaUnavailable$423.32
AustinUnavailable$418.30
BakersfieldUnavailable$417.46
Baltimore/Surr. CntysUnavailable$437.64
BeaumontUnavailable$392.54
BrazoriaUnavailable$402.95

64774 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
64774 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 64774 rate is calculated

Each of 64774’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 · 64774

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.66Practice expense 5.48Malpractice 1.19

12.3300 adjusted RVUs×$33.4009 conversion factor=$411.83

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

Payment rules and modifiers for 64774

64774 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64774

Neuroma excision

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)1Not paid (statutory restriction).
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 · 64774

Neuroma excision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

64774 without 51 · national facility

$411.83

Neuroma excision

64774-51 · Second procedure: 50%

$205.92

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

64774 compared with similar codes

Compare codes

64774 vs 64776 vs 64788 vs 64784 vs 64795: national Medicare rates

Swap in your local Medicare rate.

  • 64774
    Neuroma excision · 5.66 wRVU
    —
  • 64776
    Neuroma excision · 5.46 wRVU
    —
  • 64788
    Nerve tumor excision · 5.11 wRVU
    —
  • 64784
    Neuroma excision · 10.35 wRVU
    —
  • 64795
    Nerve biopsy · 2.93 wRVU
    —

How to choose

64776Neuroma excision
64774 is for a cutaneous nerve neuroma; 64776 is for a digital nerve neuroma.
64788Nerve tumor excision
Choose 64774 for a cutaneous nerve neuroma and 64788 for a cutaneous nerve neurofibroma or neurilemmoma.
64784Neuroma excision
64784 concerns a major peripheral nerve neuroma without transposition. 64774 is for a cutaneous nerve neuroma.
64795Nerve biopsy
64795 reports nerve biopsy for diagnostic sampling; 64774 reports excision of a cutaneous nerve neuroma.

Codes related to 64774

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

Codes related to 64774
CodeHow it relatesNational office range
Same family
64776Neuroma excisionExcision of a neuroma involving a digital nerve rather than a cutaneous nerve.No office rate
64782Neuroma excisionNeuroma excision involving a major peripheral nerve, with transposition.No office rate
64784Neuroma excisionNeuroma excision involving a major peripheral nerve, without transposition.No office rate
Used instead
64788Nerve tumor excisionCutaneous nerve lesion excision when the lesion is a neurofibroma or neurilemmoma.No office rate

64774 billing questions

When is 64774 appropriate instead of 64776?

Use 64774 for excision of a cutaneous nerve neuroma. Code 64776 is for a neuroma of a digital nerve.

How does 64774 differ from 64788?

64774 describes excision of a cutaneous nerve neuroma. 64788 is for a cutaneous nerve neurofibroma or neurilemmoma.

What documentation supports reporting 64774?

Document the neuroma diagnosis, the cutaneous nerve and site involved, and the surgical excision performed. The record should distinguish the lesion from a digital or major peripheral nerve lesion.

Should modifier 50 be appended for bilateral lesions?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

How does the global period affect postoperative visits?

The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard reduction.

Can an assistant or co-surgeon be paid for this procedure?

Assistant-at-surgery payment is statutorily restricted. Co-surgeons and team surgery are 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
RVUs for 64774PPRRVU2026_Oct_nonQPP.csv, line 7,229 (RVU26D)

Open CMS sourceHow we calculate rates

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