Billing code 64898: Nerve graftMedicare rate & RVUs

Medicare pays $1,236.50 for 64898 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 64898 covers

This procedure bridges a peripheral nerve defect in an arm or leg with multiple strands of graft arranged as cables. It may be used after traumatic nerve injury or when a segment must be removed and direct repair would not close the gap without tension. Peripheral nerve, hand, plastic, orthopedic, or neurosurgeons may perform it in an operating room. The operative report should identify the recipient nerve and extremity, explain the need for graft reconstruction, and document the number of strands and graft length.

Select this code when the graft uses multiple strands and its length is over 4 cm; the site must be an arm or leg rather than the hand, foot, head, or neck. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and 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 64898 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

64898 rates by state

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

How the 64898 rate is calculated

Each of 64898’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.

Payment rules and modifiers for 64898

64898 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

64898 compared with similar codes

How to choose

64897Nerve graft

Both cover multiple-strand grafting in an arm or leg. The length distinction is the key: 64897 is for under 4 cm, while 64898 is for over 4 cm.

64893Nerve graft

This code is for a single-strand graft over 4 cm in an arm or leg. Report 64898 when multiple strands are used.

64896Nerve graft

This is the multiple-strand, over-4-cm counterpart for a hand or foot nerve; 64898 is for an arm or leg nerve.

64886Nerve graft

Both describe multiple-strand grafts over 4 cm, but 64886 is for the head or neck rather than an arm or leg.

Codes related to 64898

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

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

Open CMS sourceHow we calculate rates