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Billing code 64876: Nerve repairMedicare rate & RVUs

Add-on work for a nerve repair that requires shortening a bone to bring the nerve ends together for reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $168.01 for 64876 nationally in a facility.

Medicare rate · 64876

Nerve repair

Work RVUs
3.29
Total RVUs
5.03
Global days
ZZZ

National rate · 2026

$168.01

Facility setting, before claim adjustments.

See every locality for 64876 →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 64876 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 64876 covers

This add-on captures bone shortening performed as part of a nerve repair when reducing the distance between the nerve ends is needed to complete the reconstruction. It is relevant to operative repair of an injured peripheral nerve when the surgeon documents that bone shortening was part of the approach to the nerve repair. The work is performed by the surgeon during the operative encounter, not as a standalone bone procedure.

Report 64876 only with an eligible primary procedure; it is not reported by itself. The operative report should identify the nerve repair, the bone shortened, and why shortening was needed to accomplish the repair. CMS treats payment for this add-on as part of the primary procedure's global period. The supplied CMS facts do not identify the eligible primary codes, so confirm that the selected primary procedure permits this add-on before billing.

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 64876 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

64876 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$153.62
Alaska*Unavailable$214.88
ArizonaUnavailable$163.60
ArkansasUnavailable$151.88
AtlantaUnavailable$173.53
AustinUnavailable$167.63
BakersfieldUnavailable$164.45
Baltimore/Surr. CntysUnavailable$177.79
BeaumontUnavailable$163.21
BrazoriaUnavailable$163.50

64876 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
64876 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 64876 rate is calculated

Each of 64876’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 · 64876

RVUs × geographic indexes × conversion factor

Work3.29

3.29 RVUs× 1.000 GPCI

Practice expense1.05

1.05 RVUs× 1.000 GPCI

Malpractice0.69

0.69 RVUs× 1.000 GPCI

Adjusted RVUs

5.0300

Conversion factor

$33.4009

Medicare rate

$168.01

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 64876

The CMS indicators that decide how 64876 is paid alongside other services.

CMS payment indicators · 64876

Nerve repair

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

64876 without 80 · national facility

$168.01

Nerve repair

64876-80 · Assistant: 16%

$26.88

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

64876 compared with similar codes

Compare codes · National

4 codes, side by side

  • 64876

    Nerve repair3.29 wRVU

    Not priced

  • 64874

    Nerve repair2.91 wRVU

    Not priced

  • 64872

    Nerve repair1.94 wRVU

    Not priced

  • 64890

    Nerve graft15.83 wRVU

    Not priced

How to choose

64874Nerve repair
64874 describes nerve repair and revision add-on work. Use 64876 for documented bone shortening performed to facilitate the nerve repair.
64872Nerve repair
64872 concerns subsequent or delayed nerve repair. 64876 identifies bone-shortening work associated with a nerve repair.
64890Nerve graft
64890 describes a single-strand nerve graft in the hand or foot. 64876 describes bone shortening in connection with nerve repair, not graft placement.

Codes related to 64876

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

Codes related to 64876
CodeHow it relatesNational office range
Add-on codes
64856Brachial plexus repairMajor peripheral nerve repair code that may serve as the primary procedure when eligible.No office rate
Same family
64857Nerve repairNearby major peripheral nerve repair code; distinguish by the nerve and operative service documented.No office rate
64858Nerve repairNerve repair code for the sciatic nerve, rather than bone-shortening add-on work.No office rate
64874Nerve repairRelated nerve repair add-on for revision work; it describes a different operative service.No office rate
Used instead
64872Nerve repairFor a subsequent or delayed nerve repair, rather than bone shortening performed with a repair.No office rate
64890Nerve graftNerve graft code for a single strand in the hand or foot, rather than bone shortening.No office rate

64876 billing questions

When should 64876 be considered instead of a nerve graft code?

Consider 64876 when bone shortening is performed to facilitate the nerve repair. Nerve graft codes describe grafting work, not bone shortening.

Can 64876 be billed by itself?

No. CMS identifies it as an add-on code that must be billed with an eligible primary procedure.

What should the operative note document?

Document the nerve repaired, the bone shortened, and the reason shortening was necessary to accomplish the nerve repair.

How does the global period affect payment?

Payment for 64876 is within the global period of the primary procedure with which it is billed.

Is bone shortening alone enough to report 64876?

No. The code represents bone-shortening work in connection with a nerve repair and must accompany an eligible primary procedure.

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 64876PPRRVU2026_Oct_nonQPP.csv, line 7,268 (RVU26D)

Open CMS sourceHow we calculate rates

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