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Billing code 64890: Nerve graftMedicare rate & RVUs

Reports reconstruction of a hand or foot nerve gap with a single-strand graft measuring less than 4 cm, including harvesting the graft.

CMS RVU26DEffective Oct 1, 2026109 payment localities73 Medicare services in 2024

Medicare pays $979.65 for 64890 nationally in a facility.

Medicare rate · 64890

Nerve graft

Swap in your local Medicare rate.

Work RVUs
15.83
Total RVUs
29.33
Global days
090

National rate · 2026

$979.65

Facility setting, before claim adjustments.

See every locality for 64890 → · 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 64890 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 64890 covers

This service bridges a short defect in a nerve in the hand or foot using one graft strand. It may be performed when an injury or surgical removal leaves a gap that prevents direct nerve repair without tension. A surgeon places the graft between the nerve ends to support continuity and later nerve regeneration. The operative work includes harvesting the graft. Peripheral nerve, hand, plastic, and orthopedic surgeons may perform the procedure, generally in an operating room setting.

Report this code when the operative documentation supports the hand or foot location, a single graft strand, and a graft length under 4 cm. The note should identify the nerve treated, the defect and graft length, the number of strands, and the graft placement; graft harvesting is part of the service. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. 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 64890 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

64890 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$888.50
Alaska*Unavailable$1,215.47
ArizonaUnavailable$952.95
ArkansasUnavailable$877.35
AtlantaUnavailable$1,009.27
AustinUnavailable$987.50
BakersfieldUnavailable$978.16
Baltimore/Surr. CntysUnavailable$1,039.48
BeaumontUnavailable$941.20
BrazoriaUnavailable$956.07

64890 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
64890 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 64890 rate is calculated

Each of 64890’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 · 64890

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.83Practice expense 10.13Malpractice 3.37

29.3300 adjusted RVUs×$33.4009 conversion factor=$979.65

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

Payment rules and modifiers for 64890

64890 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64890

Nerve graft

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)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 · 64890

Nerve graft

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

64890 without 51 · national facility

$979.65

Nerve graft

64890-51 · Second procedure: 50%

$489.83

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

64890 compared with similar codes

Compare codes

64890 vs 64891 vs 64895 vs 64892: national Medicare rates

Swap in your local Medicare rate.

  • 64890
    Nerve graft · 15.83 wRVU
    —
  • 64891
    Nerve graft · 16.92 wRVU
    —
  • 64895
    Nerve graft · 19.88 wRVU
    —
  • 64892
    Nerve graft · 15.35 wRVU
    —

How to choose

64891Nerve graft
Use 64891 for a single-strand hand or foot nerve graft over 4 cm; this code is for a graft under 4 cm.
64895Nerve graft
64895 is for a multiple-strand graft under 4 cm in the hand or foot. This code describes one strand.
64892Nerve graft
64892 covers a single-strand graft under 4 cm for an arm or leg nerve. This code is specific to the hand or foot.

Codes related to 64890

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

Codes related to 64890
CodeHow it relatesNational office range
Same family
64891Nerve graftSingle-strand hand or foot nerve graft over 4 cm.No office rate
64895Nerve graftMultiple-strand hand or foot nerve graft under 4 cm.No office rate
64896Nerve graftMultiple-strand hand or foot nerve graft over 4 cm.No office rate
64892Nerve graftSingle-strand graft under 4 cm for an arm or leg nerve.No office rate

64890 billing questions

How is this code distinguished from 64891?

Both describe a single-strand graft for a hand or foot nerve. Use 64890 for a graft under 4 cm and 64891 for a graft over 4 cm.

When is 64895 a better fit?

64895 describes a multiple-strand graft for a hand or foot nerve under 4 cm. This code is for one strand.

Can the graft harvest be billed separately?

Graft harvesting is included in this service. Document the harvest and graft placement in the operative report.

What documentation supports the code?

Record the hand or foot nerve treated, the nerve defect, graft length, and use of a single strand. The operative note should describe placement of the graft between the nerve ends.

Can modifier 50 be used for grafts on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

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

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

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 64890PPRRVU2026_Oct_nonQPP.csv, line 7,271 (RVU26D)

Open CMS sourceHow we calculate rates

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