No office rate
Choose 64864 for extracranial cranial nerve repair. Code 64865 applies to intracranial repair requiring craniotomy.
On this page
CMS RVU26D · Effective 2026-10-01
64864 Facial nerve repair Medicare reimbursement rates in Hawaii
Reports surgical suture repair of an extracranial facial nerve injury, such as a transection requiring operative reconnection of the nerve ends. Compare 64864 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 64864 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
$758.03
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.
Nerve surgery
About 64864: Extracranial cranial nerve repair
Reports surgical suture repair of an extracranial facial nerve injury, such as a transection requiring operative reconnection of the nerve ends.
This service involves surgically reconnecting an injured extracranial cranial nerve, most often the facial nerve, by bringing the nerve ends together and repairing them. It may be performed by an otolaryngologist, plastic surgeon, or neurosurgeon in an operating room after facial trauma or an operative injury, including damage encountered during parotid-region surgery. The repair is distinct from reconstruction that bridges a nerve gap with a graft or redirects another nerve to restore facial function.
Report the code when the operative record supports repair of an extracranial cranial nerve and identifies the nerve and repair performed. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 64864
- 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 RVU13.07 · 58%
- Practice expense (office) RVU7.35 · 33%
- Malpractice RVU2.19 · 10%
180
Medicare services in 2024 · #4425 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.
64864 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
64864 repairs the injured nerve itself; 64866 is used for a facial-to-hypoglossal nerve connection.
No office rate
64864 describes repair by reconnecting the injured nerve. Code 64885 is for head-and-neck nerve reconstruction using a graft under 4 cm.
No office rate
Use 64886 for head-and-neck nerve graft reconstruction when the graft is over 4 cm, rather than direct repair under 64864.
Compare 64864 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
$758.03
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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 64864 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
7,262
- Code
- 64864
- Physician work
- 13.07
- Practice expense
- 7.35
- Malpractice
- 2.19
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.07 | × 1.000 | 13.0700 |
| Practice expense | 7.35 | × 1.137 | 8.3569 |
| Malpractice | 2.19 | × 0.579 | 1.2680 |
| Total RVUs | 22.6950 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$758.03
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.07 | 1 |
| Practice expense | 7.35 | 1.137 |
| Malpractice | 2.19 | 0.579 |
(13.07 × 1 + 7.35 × 1.137 + 2.19 × 0.579) × $33.4009 = $758.03
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.
64864 billing questions
How is this different from 64865?
64864 is for repair of an extracranial cranial nerve. Code 64865 describes intracranial cranial nerve repair requiring craniotomy.
When would a nerve graft code be more appropriate?
Use a head-and-neck nerve graft code when the operative reconstruction bridges a nerve defect with graft material rather than directly reconnecting the nerve ends. Codes 64885 and 64886 distinguish graft length.
Can modifier 50 be appended for repairs on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports reporting 64864?
Document the injured extracranial nerve, the operative findings, and the repair performed. The record should distinguish direct nerve repair from graft reconstruction or nerve transfer.
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.
7,25964859,,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
7,26364865,,Repair of facial nerve,A,,15.69,10.39,NA,10.39,,2.30,28.38,28.38,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,26464866,,Fusion of facial/other nerve,A,,16.41,14.29,NA,14.29,,3.04,33.74,33.74,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,26564868,,Fusion of facial/other nerve,A,,14.53,9.34,NA,9.34,,2.12,25.99,25.99,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,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