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Billing code 64840: Leg nerve repairMedicare rate & RVUs

Repair of a major peripheral nerve in the leg, reported for operative treatment of nerve injury rather than repair of a smaller distal nerve.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $884.79 for 64840 nationally in a facility.

Medicare rate · 64840

Leg nerve repair

Swap in your local Medicare rate.

Work RVUs
13.67
Total RVUs
26.49
Global days
090

National rate · 2026

$884.79

Facility setting, before claim adjustments.

See every locality for 64840 → · 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 64840 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 64840 covers

This service covers operative repair of a major peripheral nerve in the leg, such as repair after a traumatic laceration or transection. It is typically performed by a surgeon with peripheral nerve, orthopedic, plastic, or neurosurgical expertise in an operating room. The operative report should identify the injured nerve and leg location, describe the injury and repair performed, and distinguish the service from treatment of a smaller nerve in the hand or foot or repair of the sciatic nerve.

Report the code supported by the nerve treated and the operative service; document the findings and repair technique. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of 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% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 64840 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

64840 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$801.23
Alaska*Unavailable$1,090.96
ArizonaUnavailable$860.53
ArkansasUnavailable$790.98
AtlantaUnavailable$910.99
AustinUnavailable$893.82
BakersfieldUnavailable$887.24
Baltimore/Surr. CntysUnavailable$939.29
BeaumontUnavailable$848.10
BrazoriaUnavailable$864.08

64840 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
64840 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 64840 rate is calculated

Each of 64840’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 · 64840

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.67Practice expense 9.91Malpractice 2.91

26.4900 adjusted RVUs×$33.4009 conversion factor=$884.79

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

Payment rules and modifiers for 64840

64840 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64840

Leg nerve repair

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)2Paid.
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 · 64840

Leg nerve repair

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 50 · payment effect

With and without the modifier

64840 without 50 · national facility

$884.79

Leg nerve repair

64840-50 · Bilateral: 150%

$1,327.19

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

64840 compared with similar codes

Compare codes

64840 vs 64857 vs 64858 vs 64834: national Medicare rates

Swap in your local Medicare rate.

  • 64840
    Leg nerve repair · 13.67 wRVU
    —
  • 64857
    Nerve repair · 15.42 wRVU
    —
  • 64858
    Nerve repair · 17.37 wRVU
    —
  • 64834
    Nerve repair · 10.54 wRVU
    —

How to choose

64857Nerve repair
64857 covers major peripheral nerve repair in the arm or leg, excluding the sciatic nerve, without transposition. Choose based on the applicable code description and documented operation.
64858Nerve repair
64858 is specific to repair of the sciatic nerve; this code applies to a major peripheral nerve repair in the leg other than that nerve.
64834Nerve repair
64834 describes repair of a nerve in the hand or foot, except a digital nerve. This code concerns a major peripheral nerve in the leg.

Codes related to 64840

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

Codes related to 64840
CodeHow it relatesNational office range
Same family
64857Nerve repairRelated major peripheral nerve repair code covering the arm or leg, except the sciatic nerve.No office rate
64834Nerve repairRepair code for a nerve in the hand or foot, except a digital nerve.No office rate
64831Digital nerve repairRepair code specifically for a digital nerve of the hand or foot.No office rate
Used instead
64858Nerve repairUse for repair of the sciatic nerve rather than another major peripheral nerve in the leg.No office rate

64840 billing questions

How is this different from repair of a hand or foot nerve?

This code is for a major peripheral nerve in the leg. Codes such as 64834 address a nerve in the hand or foot, except a digital nerve.

When would the sciatic nerve repair code be considered instead?

Use the sciatic nerve repair code, 64858, when the operative repair is of the sciatic nerve. Code selection depends on the nerve actually repaired.

What documentation supports reporting this service?

Document the nerve and leg location, the nature of the injury, operative findings, and the repair performed. The record should support repair of a major peripheral nerve rather than a smaller distal nerve.

How does the 90-day global period affect related care?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period for this major surgery.

How are bilateral and same-session procedures handled?

Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted under the CMS rules 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 64840PPRRVU2026_Oct_nonQPP.csv, line 7,255 (RVU26D)

Open CMS sourceHow we calculate rates

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