Billing code 64790: Nerve tumor removalMedicare rate & RVUs

Reports surgical removal of a neurofibroma or schwannoma involving a major peripheral nerve other than the sciatic nerve.

CMS RVU26DEffective Oct 1, 2026109 payment localities369 Medicare services in 2024

Medicare pays $803.96 for 64790 nationally in a facility.

Medicare rate · 64790

Nerve tumor removal

Swap in your local Medicare rate.

Work RVUs
11.8
Total RVUs
24.07
Global days
090

National rate · 2026

$803.96

Facility setting, before claim adjustments.

See every locality for 64790 → · 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 64790 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 64790 covers

This code describes operative removal of a neurofibroma or schwannoma arising from a major peripheral nerve, excluding the sciatic nerve. A peripheral nerve, neurosurgical, or orthopedic surgeon typically exposes the involved nerve and removes the tumor, taking care to distinguish the mass from functioning nerve fascicles. The service may occur in a hospital or other surgical setting; the code is not for a superficial cutaneous nerve lesion or an ordinary traumatic neuroma.

Select the code based on the operative findings, the involved nerve, and the extent of tumor removal. Documentation should identify the nerve and lesion, describe the excision, and support that the lesion is a nerve sheath tumor rather than a neuroma. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery and co-surgeon payment require supporting documentation; 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 64790 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

64790 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$720.63
Alaska*Unavailable$974.27
ArizonaUnavailable$779.52
ArkansasUnavailable$710.44
AtlantaUnavailable$830.92
AustinUnavailable$810.65
BakersfieldUnavailable$800.20
Baltimore/Surr. CntysUnavailable$857.22
BeaumontUnavailable$769.05
BrazoriaUnavailable$781.51

64790 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.

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64790 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 64790 rate is calculated

Each of 64790’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 · 64790

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.80Practice expense 9.16Malpractice 3.11

24.0700 adjusted RVUs×$33.4009 conversion factor=$803.96

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

Payment rules and modifiers for 64790

64790 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64790

Nerve tumor removal

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)0Not paid without supporting documentation.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 64790

Nerve tumor removal

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

64790 without 51 · national facility

$803.96

Nerve tumor removal

64790-51 · Second procedure: 50%

$401.98

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

64790 compared with similar codes

Compare codes

64790 vs 64784 vs 64792 vs 64788 vs 64795: national Medicare rates

Swap in your local Medicare rate.

  • 64790
    Nerve tumor removal · 11.8 wRVU
    —
  • 64784
    Neuroma excision · 10.35 wRVU
    —
  • 64792
    Neuroma excision · 15.46 wRVU
    —
  • 64788
    Nerve tumor excision · 5.11 wRVU
    —
  • 64795
    Nerve biopsy · 2.93 wRVU
    —

How to choose

64784Neuroma excision
Choose 64784 for a neuroma of a major peripheral nerve other than the sciatic nerve. Choose 64790 for removal of a neurofibroma or schwannoma in that nerve.
64792Neuroma excision
This code applies to nerve sheath tumor removal that is not described as extensive. Code 64792 represents the extensive form, including peripheral nerve involvement.
64788Nerve tumor excision
Code 64788 is for a cutaneous nerve lesion. This code applies when the tumor involves a major peripheral nerve.
64795Nerve biopsy
Code 64795 represents biopsy of a nerve for diagnostic tissue sampling. This code is for operative removal of a nerve sheath tumor.

64790 billing questions

How is this different from code 64784?

This code is for a neurofibroma or schwannoma involving a major peripheral nerve other than the sciatic nerve. Code 64784 describes removal of a neuroma from a major peripheral nerve.

When would code 64792 be more appropriate?

Use 64792 when the neurofibroma or schwannoma removal is extensive, including peripheral nerve involvement. The operative report should support the extent that distinguishes it from this code.

Can modifier 50 be used for bilateral lesions?

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

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care. Those services are not separately reported as routine care within the global period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction, with payment at 50%.

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 64790PPRRVU2026_Oct_nonQPP.csv, line 7,238 (RVU26D)

Open CMS sourceHow we calculate rates

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