No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
64898 Nerve graft Medicare reimbursement rates in California
Reports reconstruction of an arm or leg nerve defect using multiple strands of nerve graft when the graft length exceeds 4 cm. Compare 64898 office and facility rates across CMS payment localities in California.
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.
What does Medicare pay for 64898 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1220.07–$1424.93
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $204.86 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 64898 pays more and less in California
Peripheral nerve surgery
About 64898: Multiple-strand extremity nerve graft over 4 cm
Reports reconstruction of an arm or leg nerve defect using multiple strands of nerve graft when the graft length exceeds 4 cm.
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.
CMS billing rules for 64898
- 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 RVU20.45 · 55%
- Practice expense (office) RVU12.23 · 33%
- Malpractice RVU4.34 · 12%
22
Medicare services in 2024 · #5879 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.
64898 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
This code is for a single-strand graft over 4 cm in an arm or leg. Report 64898 when multiple strands are used.
No office rate
This is the multiple-strand, over-4-cm counterpart for a hand or foot nerve; 64898 is for an arm or leg nerve.
No office rate
Both describe multiple-strand grafts over 4 cm, but 64886 is for the head or neck rather than an arm or leg.
Compare 64898 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1232.02 |
| Chico | Office Unavailable | Facility $1220.07 |
| El Centro | Office Unavailable | Facility $1220.79 |
| Fresno | Office Unavailable | Facility $1220.07 |
| Hanford-Corcoran | Office Unavailable | Facility $1220.07 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1290.55 |
| Madera | Office Unavailable | Facility $1220.07 |
| Merced | Office Unavailable | Facility $1220.07 |
| Modesto | Office Unavailable | Facility $1220.07 |
| Napa | Office Unavailable | Facility $1338.11 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1275.32 |
| Redding | Office Unavailable | Facility $1220.07 |
| Rest Of California | Office Unavailable | Facility $1220.07 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1266.70 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1260.41 |
| Salinas | Office Unavailable | Facility $1255.36 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1270.67 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1390.45 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1385.52 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1424.93 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1404.78 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1237.63 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1271.41 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1256.18 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1282.87 |
| Stockton | Office Unavailable | Facility $1220.07 |
| Vallejo | Office Unavailable | Facility $1331.01 |
| Visalia | Office Unavailable | Facility $1220.07 |
| Yuba City | Office Unavailable | Facility $1220.07 |
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64898 billing questions
How is this code distinguished from 64897?
Both describe multiple-strand grafting for an arm or leg nerve. Choose 64898 when the graft length is over 4 cm; 64897 is for a graft under 4 cm.
Does the code describe multiple nerves or multiple graft strands?
It distinguishes the multiple-strand graft configuration, not simply the number of nerves treated. Document the graft strands and the reconstruction performed.
When is 64893 a closer fit?
64893 describes a single-strand graft for an arm or leg nerve over 4 cm. Use 64898 when the reconstruction uses multiple strands.
Can modifier 50 be used when both limbs are treated?
No. The descriptor or anatomy makes a bilateral adjustment inappropriate. The CMS rule for this code states that modifier 50 does not apply.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon 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.
7,27564895,,Nrv grf mltst hnd/foot <4 cm,A,,19.88,11.58,NA,11.58,,4.23,35.69,35.69,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27664896,,Nrv grf mltst hnd/foot >4 cm,A,,21.41,12.54,NA,12.54,,4.56,38.51,38.51,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27764897,,Nrv grf mltst arm/leg <4 cm,A,,18.90,11.26,NA,11.26,,4.02,34.18,34.18,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27864898,,Nrv grf mltst arm/leg >4 cm,A,,20.45,12.23,NA,12.23,,4.34,37.02,37.02,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27964901,,Nerve graft add-on,A,,9.95,3.17,NA,3.17,,2.12,15.24,15.24,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,28064902,,Nerve graft add-on,A,,11.51,3.67,NA,3.67,,2.46,17.64,17.64,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,28164905,,Nerve pedicle transfer,A,,14.73,8.91,NA,8.91,,3.05,26.69,26.69,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00