Billing code 64859: Nerve repairMedicare rate & RVUs in Georgia
Reports repair of an additional major peripheral nerve in an arm or leg, other than the sciatic nerve, during a qualifying nerve-repair operation.
CMS doesn’t publish an office rate for 64859 in Georgia.
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 9 sections
What 64859 covers
This add-on represents microsurgical repair of another major peripheral nerve in an arm or leg during the same operation as a primary major-nerve repair. It is relevant when an injury, such as a traumatic laceration, affects more than one major nerve and the surgeon directly sutures each damaged nerve. The operating surgeon may be a peripheral nerve, hand, plastic, orthopedic, or neurosurgical specialist working in an operative setting.
Report 64859 only with the qualifying primary nerve-repair procedure, such as 64856 or 64857, when the operative record supports repair of a distinct additional nerve. Document the nerve’s name and location, the injury, and the repair performed; a second repair of the same nerve or multiple sutures within one repair do not establish another nerve. CMS identifies this as an add-on code: it is billed with the primary procedure, and payment falls within that procedure’s global period.
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 64859 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $219.19 |
| Rest Of Georgia | Unavailable | $213.04 |
How the 64859 rate is calculated
Each of 64859’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 · 64859
RVUs × geographic indexes × conversion factor
Work4.14
4.14 RVUs× 1.000 GPCI
Practice expense1.32
1.32 RVUs× 1.000 GPCI
Malpractice0.89
0.89 RVUs× 1.000 GPCI
Adjusted RVUs
6.3500
Conversion factor
$33.4009
Medicare rate
$212.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64859
The CMS indicators that decide how 64859 is paid alongside other services.
CMS payment indicators · 64859
Nerve repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
64859 without 80 · national facility
$212.10
Nerve repair
64859-80 · Assistant: 16%
$33.94
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
64859 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 64856Brachial plexus repair
- Use 64856 for the primary major peripheral nerve repair when transposition is performed. Add 64859 only when a distinct additional qualifying nerve is repaired.
- 64857Nerve repair
- Use 64857 for the primary major peripheral nerve repair without transposition. 64859 represents another nerve repaired during that operation.
- 64858Nerve repair
- 64858 is the specific repair code for the sciatic nerve. 64859 covers an additional major nerve in an arm or leg other than the sciatic nerve.
- 64834Nerve repair
- 64834 addresses repair of a nerve in the hand or foot. 64859 is for an additional major peripheral nerve in an arm or leg.
64859 billing questions
Can 64859 be billed by itself?
No. It is an add-on for an additional major peripheral nerve repair and must be reported with a qualifying primary procedure, such as 64856 or 64857.
What supports reporting an additional unit?
The record should identify a distinct additional major nerve and describe its injury and separate repair. Multiple sutures used to repair one nerve do not make it an additional nerve.
How does 64859 differ from 64858?
64859 describes repair of an additional major nerve in an arm or leg, excluding the sciatic nerve. 64858 is the specific code for repair of the sciatic nerve.
How do 64856 and 64857 differ from 64859?
64856 or 64857 reports the primary major peripheral nerve repair, with the applicable code reflecting whether transposition is performed. 64859 is added for another qualifying nerve repaired in the operation.
Can 64831 or 64834 be used for a second nerve?
Those codes describe repairs in different anatomic categories, such as a digital nerve or a nerve of the hand or foot. Use 64859 only when the additional nerve meets its major arm-or-leg nerve scope.
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
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