64771 Cranial nerve transection Medicare reimbursement rates in California

A surgeon reports this service when an intracranial cranial nerve is intentionally divided or avulsed. It represents destructive nerve surgery, rather than nerve decompression, repair, or removal of a nerve lesion. Neurosurgeons and other surgeons qualified to perform intracranial nerve procedures typically perform it in an operating room. The operative report should identify the nerve, its intracranial location, and the transection or avulsion performed.

Select this code when the treated nerve and operative approach fit the “other cranial nerve” category, rather than a separately named cranial nerve procedure. Documentation should establish the surgical intent and distinguish the work from procedures that preserve or decompress the nerve. Medicare assigns a 90-day global period, including 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 others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.