Billing code 64912: Nerve repairMedicare rate & RVUs in Guam
Reports microsurgical repair of a peripheral nerve gap using the first strand of nerve allograft to bridge the defect.
CMS doesn’t publish an office rate for 64912 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 64912 covers
A surgeon uses a nerve allograft to bridge a gap in a damaged peripheral nerve, then coapts the graft to the nerve ends under microsurgical technique. Common settings include hospital operating rooms for traumatic nerve injuries or defects left after tumor excision. The graft provides a bridge without harvesting the patient’s own nerve. Report this code for the first allograft strand used for each nerve; additional strands are reported with 64913.
The operative report should identify the nerve repaired, the gap or defect, use of nerve allograft, and the number of strands. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 50% reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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.
64912 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $835.53 |
How the 64912 rate is calculated
Each of 64912’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 · 64912
RVUs × geographic indexes × conversion factor
Work11.70
11.70 RVUs× 1.000 GPCI
Practice expense10.56
10.56 RVUs× 1.000 GPCI
Malpractice2.26
2.26 RVUs× 1.000 GPCI
Adjusted RVUs
24.5200
Conversion factor
$33.4009
Medicare rate
$818.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64912
64912 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64912
Nerve repair
| 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) | 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. |
| 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 · 64912
Nerve repair
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 51 · payment effect
With and without the modifier
64912 without 51 · national facility
$818.99
Nerve repair
64912-51 · Second procedure: 50%
$409.50
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
64912 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64913Nerve repair
- 64912 covers the first allograft strand for a nerve; 64913 reports each additional strand.
- 64911Nerve repair
- Choose 64912 when nerve allograft is used. 64911 describes nerve repair using a vein autograft.
- 64905Nerve transfer
- 64912 bridges a nerve defect with allograft. 64905 describes a nerve pedicle transfer, a different reconstructive technique.
64912 billing questions
When should 64912 be reported instead of 64913?
Report 64912 for the first nerve allograft strand used to repair a nerve. Report 64913 for each additional strand.
What documentation supports reporting this code?
Document the nerve repaired, the defect being bridged, use of a nerve allograft, and the number of strands used. The operative note should support that a repair was performed rather than a nerve transfer.
Can modifier 50 be used when both sides are repaired?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care for 90 days are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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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