Billing code 64786: Neuroma excisionMedicare rate & RVUs

Medicare pays $951.26 for 64786 nationally in a facility.

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

What 64786 covers

This code describes surgery to remove a neuroma involving the sciatic nerve. A neuroma may develop after nerve injury or a prior operation and cause persistent pain or sensitivity. The procedure is typically performed by a peripheral nerve, neurosurgical, or orthopedic surgeon in an operating-room setting, with exposure of the sciatic nerve and excision of the lesion. The code is specific to the sciatic nerve; the operative report should identify the nerve and describe the lesion removed.

Select this code when the operative service is excision of a sciatic nerve neuroma, rather than excision of a neuroma on another nerve or removal of a different nerve lesion. Documentation should support the diagnosis, sciatic nerve involvement, and work performed. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 reports bilateral surgery and is paid at 150%. Assistant-at-surgery payment may be made; 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 64786 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

64786 rates by state

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

How the 64786 rate is calculated

Each of 64786’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.

Payment rules and modifiers for 64786

64786 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

64786 compared with similar codes

How to choose

64784Neuroma excision

Use 64786 for a sciatic nerve neuroma; use 64784 when the neuroma involves another major peripheral nerve.

64790Nerve tumor removal

64786 describes neuroma excision. Code 64790 is for excision of a neurofibroma or neurilemmoma involving a major peripheral nerve.

64787Nerve-end implantation

64786 removes the sciatic nerve neuroma. Code 64787 describes implantation of a nerve end into bone or muscle, which is a distinct operative service.

Codes related to 64786

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

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

Open CMS sourceHow we calculate rates