No office rate
Choose 64857 when the major arm or leg nerve is repaired without transposition; 64856 describes repair that includes transposition.
On this page
CMS RVU26D · Effective 2026-10-01
64857 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$934.69
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Peripheral nerve surgery
About 64857: Major peripheral nerve repair without transposition
Reports direct repair of a major peripheral nerve in an arm or leg, excluding the sciatic nerve, when the repair does not include transposition.
A surgeon uses this code for direct suture repair of a major peripheral nerve in an arm or leg, such as after a traumatic transection. The repair does not include transposition, and the code excludes the sciatic nerve. These procedures are typically performed in an operating room by a surgeon with peripheral nerve expertise, often using magnification to align and join the nerve ends. It is not the code for repair of a small digital nerve in a finger or toe.
The operative report should identify the nerve and site, describe the injury and direct repair, and make clear that transposition was not performed. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral adjustment is inappropriate for this code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 64857
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.42 · 55%
- Practice expense (office) RVU9.62 · 34%
- Malpractice RVU3.25 · 11%
182
Medicare services in 2024 · #4412 by national volume
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.
64857 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
64858 is for sciatic nerve repair. 64857 is for a major peripheral nerve in an arm or leg other than the sciatic nerve.
No office rate
64831 applies to repair of a digital nerve. 64857 is for a major peripheral nerve in an arm or leg, not a small finger or toe nerve.
The same code, a different location
How does El Centro compare?
64857 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 64857
Office
Unavailable
Facility
$934.15
No comparable office rate is available.
Modesto
California · 64857
Office
Unavailable
Facility
$934.15
No comparable office rate is available.
Napa
California · 64857
Office
Unavailable
Facility
$1026.13
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 64857
Office
Unavailable
Facility
$976.89
No comparable office rate is available.
Redding
California · 64857
Office
Unavailable
Facility
$934.15
No comparable office rate is available.
Rest Of California
California · 64857
Office
Unavailable
Facility
$934.15
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 64857
Office
Unavailable
Facility
$969.07
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 64857
Office
Unavailable
Facility
$965.46
No comparable office rate is available.
Salinas
California · 64857
Office
Unavailable
Facility
$961.60
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 64857
Office
Unavailable
Facility
$973.62
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 64857
Office
Unavailable
Facility
$1066.85
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 64857
Office
Unavailable
Facility
$1063.16
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 64857
Office
Unavailable
Facility
$1093.22
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 64857
Office
Unavailable
Facility
$1078.13
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 64857
Office
Unavailable
Facility
$947.96
No comparable office rate is available.
Santa Cruz-Watsonville
California · 64857
Office
Unavailable
Facility
$974.44
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 64857
Office
Unavailable
Facility
$962.30
No comparable office rate is available.
Santa Rosa-Petaluma
California · 64857
Office
Unavailable
Facility
$983.25
No comparable office rate is available.
Stockton
California · 64857
Office
Unavailable
Facility
$934.15
No comparable office rate is available.
Vallejo
California · 64857
Office
Unavailable
Facility
$1020.81
No comparable office rate is available.
Visalia
California · 64857
Office
Unavailable
Facility
$934.15
No comparable office rate is available.
Yuba City
California · 64857
Office
Unavailable
Facility
$934.15
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 64857
Office
Unavailable
Facility
$1042.18
No comparable office rate is available.
Miami
Florida · 64857
Office
Unavailable
Facility
$1124.06
No comparable office rate is available.
Chicago
Illinois · 64857
Office
Unavailable
Facility
$1090.70
No comparable office rate is available.
Manhattan
New York · 64857
Office
Unavailable
Facility
$1093.54
No comparable office rate is available.
Alaska*
Alaska · 64857
Office
Unavailable
Facility
$1174.58
No comparable office rate is available.
Alabama
Alabama · 64857
Office
Unavailable
Facility
$857.63
No comparable office rate is available.
Arkansas
Arkansas · 64857
Office
Unavailable
Facility
$846.96
No comparable office rate is available.
Arizona
Arizona · 64857
Office
Unavailable
Facility
$919.32
No comparable office rate is available.
Colorado
Colorado · 64857
Office
Unavailable
Facility
$947.88
No comparable office rate is available.
Connecticut
Connecticut · 64857
Office
Unavailable
Facility
$1002.75
No comparable office rate is available.
Delaware
Delaware · 64857
Office
Unavailable
Facility
$932.67
No comparable office rate is available.
Fort Lauderdale
Florida · 64857
Office
Unavailable
Facility
$1036.80
No comparable office rate is available.
Rest Of Florida
Florida · 64857
Office
Unavailable
Facility
$985.38
No comparable office rate is available.
Atlanta
Georgia · 64857
Office
Unavailable
Facility
$973.42
No comparable office rate is available.
Rest Of Georgia
Georgia · 64857
Office
Unavailable
Facility
$931.05
No comparable office rate is available.
Hawaii, Guam
Hawaii · 64857
Office
Unavailable
Facility
$943.23
No comparable office rate is available.
Iowa
Iowa · 64857
Office
Unavailable
Facility
$852.14
No comparable office rate is available.
Idaho
Idaho · 64857
Office
Unavailable
Facility
$862.00
No comparable office rate is available.
East St. Louis
Illinois · 64857
Office
Unavailable
Facility
$1029.28
No comparable office rate is available.
Rest Of Illinois
Illinois · 64857
Office
Unavailable
Facility
$978.07
No comparable office rate is available.
Suburban Chicago
Illinois · 64857
Office
Unavailable
Facility
$1041.00
No comparable office rate is available.
Indiana
Indiana · 64857
Office
Unavailable
Facility
$865.66
No comparable office rate is available.
Kansas
Kansas · 64857
Office
Unavailable
Facility
$860.22
No comparable office rate is available.
Kentucky
Kentucky · 64857
Office
Unavailable
Facility
$900.02
No comparable office rate is available.
New Orleans
Louisiana · 64857
Office
Unavailable
Facility
$940.72
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 64857
Office
Unavailable
Facility
$903.40
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 64857
Office
Unavailable
Facility
$1016.42
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 64857
Office
Unavailable
Facility
$948.15
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 64857
Office
Unavailable
Facility
$1002.34
No comparable office rate is available.
Rest Of Maryland
Maryland · 64857
Office
Unavailable
Facility
$945.02
No comparable office rate is available.
Rest Of Maine
Maine · 64857
Office
Unavailable
Facility
$878.17
No comparable office rate is available.
Southern Maine
Maine · 64857
Office
Unavailable
Facility
$901.96
No comparable office rate is available.
Detroit
Michigan · 64857
Office
Unavailable
Facility
$1008.13
No comparable office rate is available.
Rest Of Michigan
Michigan · 64857
Office
Unavailable
Facility
$930.96
No comparable office rate is available.
Minnesota
Minnesota · 64857
Office
Unavailable
Facility
$877.81
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 64857
Office
Unavailable
Facility
$922.81
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 64857
Office
Unavailable
Facility
$929.71
No comparable office rate is available.
Rest Of Missouri
Missouri · 64857
Office
Unavailable
Facility
$897.75
No comparable office rate is available.
Mississippi
Mississippi · 64857
Office
Unavailable
Facility
$871.92
No comparable office rate is available.
Montana**
Montana · 64857
Office
Unavailable
Facility
$944.69
No comparable office rate is available.
North Carolina
North Carolina · 64857
Office
Unavailable
Facility
$884.20
No comparable office rate is available.
North Dakota**
North Dakota · 64857
Office
Unavailable
Facility
$880.43
No comparable office rate is available.
Nebraska
Nebraska · 64857
Office
Unavailable
Facility
$852.65
No comparable office rate is available.
New Hampshire
New Hampshire · 64857
Office
Unavailable
Facility
$944.52
No comparable office rate is available.
Northern Nj
New Jersey · 64857
Office
Unavailable
Facility
$1036.15
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 64857
Office
Unavailable
Facility
$1005.60
No comparable office rate is available.
New Mexico
New Mexico · 64857
Office
Unavailable
Facility
$940.06
No comparable office rate is available.
Nevada**
Nevada · 64857
Office
Unavailable
Facility
$927.10
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 64857
Office
Unavailable
Facility
$1131.63
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 64857
Office
Unavailable
Facility
$1021.41
No comparable office rate is available.
Queens
New York · 64857
Office
Unavailable
Facility
$1084.33
No comparable office rate is available.
Rest Of New York
New York · 64857
Office
Unavailable
Facility
$896.61
No comparable office rate is available.
Ohio
Ohio · 64857
Office
Unavailable
Facility
$917.83
No comparable office rate is available.
Oklahoma
Oklahoma · 64857
Office
Unavailable
Facility
$886.32
No comparable office rate is available.
Portland
Oregon · 64857
Office
Unavailable
Facility
$961.03
No comparable office rate is available.
Rest Of Oregon
Oregon · 64857
Office
Unavailable
Facility
$911.39
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 64857
Office
Unavailable
Facility
$988.31
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 64857
Office
Unavailable
Facility
$912.59
No comparable office rate is available.
Puerto Rico
Puerto Rico · 64857
Office
Unavailable
Facility
$946.82
No comparable office rate is available.
Rhode Island
Rhode Island · 64857
Office
Unavailable
Facility
$953.58
No comparable office rate is available.
South Carolina
South Carolina · 64857
Office
Unavailable
Facility
$904.21
No comparable office rate is available.
South Dakota**
South Dakota · 64857
Office
Unavailable
Facility
$872.83
No comparable office rate is available.
Tennessee
Tennessee · 64857
Office
Unavailable
Facility
$865.41
No comparable office rate is available.
Austin
Texas · 64857
Office
Unavailable
Facility
$952.20
No comparable office rate is available.
Beaumont
Texas · 64857
Office
Unavailable
Facility
$908.29
No comparable office rate is available.
Brazoria
Texas · 64857
Office
Unavailable
Facility
$922.26
No comparable office rate is available.
Dallas
Texas · 64857
Office
Unavailable
Facility
$932.85
No comparable office rate is available.
Fort Worth
Texas · 64857
Office
Unavailable
Facility
$931.05
No comparable office rate is available.
Galveston
Texas · 64857
Office
Unavailable
Facility
$928.11
No comparable office rate is available.
Houston
Texas · 64857
Office
Unavailable
Facility
$987.60
No comparable office rate is available.
Rest Of Texas
Texas · 64857
Office
Unavailable
Facility
$917.99
No comparable office rate is available.
Utah
Utah · 64857
Office
Unavailable
Facility
$914.56
No comparable office rate is available.
Virginia
Virginia · 64857
Office
Unavailable
Facility
$907.53
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 64857
Office
Unavailable
Facility
$946.82
No comparable office rate is available.
Vermont
Vermont · 64857
Office
Unavailable
Facility
$888.07
No comparable office rate is available.
Rest Of Washington
Washington · 64857
Office
Unavailable
Facility
$942.69
No comparable office rate is available.
Seattle (King Cnty)
Washington · 64857
Office
Unavailable
Facility
$1023.74
No comparable office rate is available.
Wisconsin
Wisconsin · 64857
Office
Unavailable
Facility
$856.30
No comparable office rate is available.
West Virginia
West Virginia · 64857
Office
Unavailable
Facility
$949.61
No comparable office rate is available.
Wyoming**
Wyoming · 64857
Office
Unavailable
Facility
$916.69
No comparable office rate is available.
See how rates vary across the country
64857 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 64857 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1028.16
$934.69 × 110% = $1028.16
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64857 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
7,257
- Code
- 64857
- Physician work
- 15.42
- Practice expense
- 9.62
- Malpractice
- 3.25
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.42 | × 1.017 | 15.6821 |
| Practice expense | 9.62 | × 1.096 | 10.5435 |
| Malpractice | 3.25 | × 0.541 | 1.7583 |
| Total RVUs | 27.9839 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$934.69
Open 64857 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.42 | 1.017 |
| Practice expense | 9.62 | 1.096 |
| Malpractice | 3.25 | 0.541 |
(15.42 × 1.017 + 9.62 × 1.096 + 3.25 × 0.541) × $33.4009 = $934.69
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
64857 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $934.69 | RVU26D |
| 2026-07-01 | Not available in this setting | $934.69 | RVU26C |
| 2026-04-01 | Not available in this setting | $934.69 | RVU26B |
| 2026-01-01 | Not available in this setting | $934.69 | RVU26A |
| 2025-10-01 | Not available in this setting | $1029.67 | RVU25D |
| 2025-07-01 | Not available in this setting | $1029.67 | RVU25C |
| 2025-04-01 | Not available in this setting | $1029.67 | RVU25B |
| 2025-01-01 | Not available in this setting | $1029.67 | RVU25A |
64857 billing questions
How does 64857 differ from 64856?
64857 describes major peripheral nerve repair in an arm or leg without transposition. Use 64856 when the repair includes transposition.
Can 64857 be used for sciatic nerve repair?
No. Sciatic nerve repair is reported with 64858; 64857 is for an eligible major peripheral nerve in an arm or leg other than the sciatic nerve.
Is routine postoperative care separately reported?
The 90-day global period includes related postoperative care, as well as the day-before preoperative visit.
Should modifier 50 be used for repairs on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,25464837,,Repair nerve add-on,A,,6.09,1.94,NA,1.94,,1.30,9.33,9.33,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,25564840,,Repair of leg nerve,A,,13.67,9.91,NA,9.91,,2.91,26.49,26.49,0,090,0.11,0.76,0.13,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,25664856,,Repair/transpose nerve,A,,14.69,9.37,NA,9.37,,3.47,27.53,27.53,0,090,0.11,0.76,0.13,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,25764857,,Repair arm/leg nerve,A,,15.42,9.62,NA,9.62,,3.25,28.29,28.29,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,25864858,,Repair sciatic nerve,A,,17.37,10.78,NA,10.78,,3.70,31.85,31.85,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,25964859,,Nerve surgery,A,,4.14,1.32,NA,1.32,,0.89,6.35,6.35,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,26064861,,Repair of arm nerves,A,,20.37,16.31,NA,16.31,,8.59,45.27,45.27,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664