No office rate
Use 64856 for the primary major peripheral nerve repair when transposition is performed. Add 64859 only when a distinct additional qualifying nerve is repaired.
On this page
CMS RVU26D · Effective 2026-10-01
64859 Nerve repair Medicare reimbursement rates in Hawaii
Reports repair of an additional major peripheral nerve in an arm or leg, other than the sciatic nerve, during a qualifying nerve-repair operation. Compare 64859 office and facility rates across CMS payment localities in Hawaii.
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 64859 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$205.62
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
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.
Peripheral nerve surgery
About 64859: Additional major peripheral nerve repair
Reports repair of an additional major peripheral nerve in an arm or leg, other than the sciatic nerve, during a qualifying nerve-repair operation.
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.
CMS billing rules for 64859
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU4.14 · 65%
- Practice expense (office) RVU1.32 · 21%
- Malpractice RVU0.89 · 14%
63
Medicare services in 2024 · #5216 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.
64859 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
Use 64857 for the primary major peripheral nerve repair without transposition. 64859 represents another nerve repaired during that operation.
No office rate
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.
No office rate
64834 addresses repair of a nerve in the hand or foot. 64859 is for an additional major peripheral nerve in an arm or leg.
Compare 64859 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.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$205.62
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64859 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
7,259
- Code
- 64859
- Physician work
- 4.14
- Practice expense
- 1.32
- Malpractice
- 0.89
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.14 | × 1.000 | 4.1400 |
| Practice expense | 1.32 | × 1.137 | 1.5008 |
| Malpractice | 0.89 | × 0.579 | 0.5153 |
| Total RVUs | 6.1562 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$205.62
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.14 | 1 |
| Practice expense | 1.32 | 1.137 |
| Malpractice | 0.89 | 0.579 |
(4.14 × 1 + 1.32 × 1.137 + 0.89 × 0.579) × $33.4009 = $205.62
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
7,25664856,,Repair/transpose nerve,A,,14.69,9.37,NA,9.37,,3.47,27.53,27.53,0,090,0.11,0.76,0.13,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,25764857,,Repair arm/leg nerve,A,,15.42,9.62,NA,9.62,,3.25,28.29,28.29,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,25864858,,Repair sciatic nerve,A,,17.37,10.78,NA,10.78,,3.70,31.85,31.85,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,25964859,,Nerve surgery,A,,4.14,1.32,NA,1.32,,0.89,6.35,6.35,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,26064861,,Repair of arm nerves,A,,20.37,16.31,NA,16.31,,8.59,45.27,45.27,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,26164862,,Repair of low back nerves,A,,20.56,12.11,NA,12.11,,4.38,37.05,37.05,0,090,0.11,0.76,0.13,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,26264864,,Repair of facial nerve,A,,13.07,7.35,NA,7.35,,2.19,22.61,22.61,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014