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Billing code 64897: Nerve graftMedicare rate & RVUs

Reports placement of a short, multiple-strand nerve graft to bridge a peripheral nerve defect in an arm or leg, outside the hand or foot.

CMS RVU26DEffective Oct 1, 2026109 payment localities22 Medicare services in 2024

Medicare pays $1,141.64 for 64897 nationally in a facility.

Medicare rate · 64897

Nerve graft

Swap in your local Medicare rate.

Work RVUs
18.9
Total RVUs
34.18
Global days
090

National rate · 2026

$1,141.64

Facility setting, before claim adjustments.

See every locality for 64897 → · 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 64897 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 64897 covers

A surgeon uses multiple strands of nerve graft to bridge a defect in a peripheral nerve in the arm or leg. This may follow traumatic nerve injury or removal of damaged nerve tissue when the remaining ends cannot be joined directly. Peripheral nerve, hand, plastic, orthopedic, or neurosurgeons may perform the reconstruction, typically in a hospital or ambulatory surgical setting. The graft length for this code is under 4 cm; hand and foot sites have separate codes in this family.

Choose the code based on the recipient site, number of graft strands, and graft length. The operative report should identify the arm or leg nerve reconstructed, document use of multiple strands, and support a graft length under 4 cm. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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 64897 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

64897 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,036.36
Alaska*Unavailable$1,421.44
ArizonaUnavailable$1,110.65
ArkansasUnavailable$1,023.49
AtlantaUnavailable$1,176.54
AustinUnavailable$1,149.41
BakersfieldUnavailable$1,137.24
Baltimore/Surr. CntysUnavailable$1,211.02
BeaumontUnavailable$1,098.26
BrazoriaUnavailable$1,113.77

64897 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.

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
64897 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 64897 rate is calculated

Each of 64897’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 · 64897

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 18.90Practice expense 11.26Malpractice 4.02

34.1800 adjusted RVUs×$33.4009 conversion factor=$1,141.64

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

Payment rules and modifiers for 64897

64897 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 64897

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)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 · 64897

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

64897 without 51 · national facility

$1,141.64

Nerve graft

64897-51 · Second procedure: 50%

$570.82

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

64897 compared with similar codes

Compare codes

64897 vs 64898 vs 64892 vs 64895 vs 64893: national Medicare rates

Swap in your local Medicare rate.

  • 64897
    Nerve graft · 18.9 wRVU
    —
  • 64898
    Nerve graft · 20.45 wRVU
    —
  • 64892
    Nerve graft · 15.35 wRVU
    —
  • 64895
    Nerve graft · 19.88 wRVU
    —
  • 64893
    Nerve graft · 16.45 wRVU
    —

How to choose

64898Nerve graft
Both describe multiple-strand grafting in an arm or leg; select 64898 when the graft length is over 4 cm rather than under 4 cm.
64892Nerve graft
This code covers a single-strand graft in an arm or leg under 4 cm. Use 64897 when multiple strands are used.
64895Nerve graft
Both describe multiple-strand grafts under 4 cm, but 64895 is for a hand or foot site; 64897 is for an arm or leg site.
64893Nerve graft
This code is for a single-strand graft in an arm or leg over 4 cm; 64897 is for multiple strands under 4 cm.

Codes related to 64897

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

Codes related to 64897
CodeHow it relatesNational office range
Same family
64898Nerve graftMultiple-strand graft for an arm or leg when the graft length is over 4 cm.No office rate
64892Nerve graftSingle-strand graft for an arm or leg under 4 cm.No office rate
64893Nerve graftSingle-strand graft for an arm or leg over 4 cm.No office rate
64895Nerve graftMultiple-strand graft under 4 cm for a hand or foot site.No office rate
64896Nerve graftMultiple-strand graft over 4 cm for a hand or foot site.No office rate
64890Nerve graftSingle-strand graft under 4 cm for a hand or foot site.No office rate

64897 billing questions

How does this differ from a single-strand nerve graft code?

This code is for multiple graft strands in an arm or leg, with graft length under 4 cm. A single-strand graft uses a different code in the same family.

When should the longer-length sibling be used?

Use the longer-length code when the documented graft length is over 4 cm. The operative report should support the length used to select the code.

Should modifier 50 be appended for grafts on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used for bilateral reporting.

What documentation supports reporting multiple strands?

The operative report should describe the nerve and arm or leg site reconstructed, the use of multiple graft strands, and a graft length under 4 cm.

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

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

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.

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 64897PPRRVU2026_Oct_nonQPP.csv, line 7,277 (RVU26D)

Open CMS sourceHow we calculate rates

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