Billing code 64719: Ulnar nerve surgeryMedicare rate & RVUs in Guam
Surgical freeing or repositioning of the ulnar nerve at the wrist is reported for compression or tethering in the Guyon canal region.
CMS doesn’t publish an office rate for 64719 in Guam.
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 64719 covers
This operation frees the ulnar nerve from constricting tissue or repositions it at the wrist. It is commonly performed for ulnar nerve compression in or near Guyon canal, which may cause symptoms in the ring and small fingers or weakness in the hand. Hand, orthopedic, plastic, or neurosurgeons may perform it in a hospital or ambulatory surgery setting. The wrist location distinguishes it from surgery on the ulnar nerve at the elbow.
Report the service when the operative note supports surgical treatment of the ulnar nerve at the wrist, such as release of compression or nerve repositioning; a diagnosis of ulnar neuropathy alone does not establish the procedure. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are 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.
64719 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $400.83 |
How the 64719 rate is calculated
Each of 64719’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 · 64719
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.85Practice expense 5.80Malpractice 0.96
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64719
64719 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64719
Ulnar nerve surgery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 64719
Ulnar nerve surgery
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
64719 without 50 · national facility
$387.78
Ulnar nerve surgery
64719-50 · Bilateral: 150%
$581.67
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
64719 compared with similar codes
Compare codes
64719 vs 64718 vs 64721 vs 64704: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64718Ulnar nerve surgery
- The key distinction is the operative site: this code is for the ulnar nerve at the wrist; 64718 is for the ulnar nerve at the elbow.
- 64721Carpal tunnel release
- 64721 addresses median nerve decompression for carpal tunnel syndrome. This code addresses the ulnar nerve at the wrist, including compression near Guyon canal.
- 64704Nerve neuroplasty
- Use 64704 for neuroplasty or repositioning of another nerve in the hand or foot. This code is specific to the ulnar nerve at the wrist.
64719 billing questions
When should this code be selected instead of 64718?
Use this code for surgery on the ulnar nerve at the wrist, typically in the Guyon canal region. Code 64718 is for the ulnar nerve at the elbow.
Can this be reported with carpal tunnel surgery?
Yes, when the surgeon also performs a separately documented median nerve decompression at the wrist. The operative note should identify the distinct nerve and procedure treated.
How is bilateral wrist surgery reported?
For bilateral procedures, report modifier 50. CMS pays the bilateral procedure at 150%.
Does the global period include routine postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What documentation supports reporting this procedure?
Document the wrist-level ulnar nerve condition and the operative work performed, including the site and whether the nerve was freed from compression or repositioned.
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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