Billing code 64718: Ulnar nerve surgeryMedicare rate & RVUs in Illinois
Reports surgical freeing or repositioning of the ulnar nerve at the elbow, commonly for cubital tunnel symptoms or nerve irritation.
CMS doesn’t publish an office rate for 64718 in Illinois.
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 64718 covers
This operation addresses the ulnar nerve where it passes the elbow, often for cubital tunnel syndrome or nerve compression, tethering, or irritation. The surgeon frees the nerve from constricting tissue and may move it to a new position when the clinical findings call for transposition. Orthopedic, hand, plastic, or neurosurgeons commonly perform the procedure in an operating room, usually in a facility setting.
Report the code when the operative work involves the ulnar nerve at the elbow; a transposition is not required in every case. The operative report should identify the nerve and elbow site, the condition treated, and the release or repositioning performed. This major surgery has a 90-day global period that includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; 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.
Where 64718 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $640.13 |
| East St. Louis | Unavailable | $600.32 |
| Rest Of Illinois | Unavailable | $576.74 |
| Suburban Chicago | Unavailable | $621.55 |
How the 64718 rate is calculated
Each of 64718’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 · 64718
RVUs × geographic indexes × conversion factor
Work7.08
7.08 RVUs× 1.000 GPCI
Practice expense8.71
8.71 RVUs× 1.000 GPCI
Malpractice1.43
1.43 RVUs× 1.000 GPCI
Adjusted RVUs
17.2200
Conversion factor
$33.4009
Medicare rate
$575.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64718
64718 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64718
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) | 0 | Not paid without supporting documentation. |
| 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 · 64718
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
64718 without 50 · national facility
$575.16
Ulnar nerve surgery
64718-50 · Bilateral: 150%
$862.74
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).
64718 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 64719Ulnar nerve surgery
- Choose 64718 for the ulnar nerve at the elbow; 64719 identifies work on that nerve at the wrist.
- 64708Nerve neuroplasty
- 64718 specifically identifies the ulnar nerve at the elbow. Consider 64708 for a major peripheral nerve procedure that does not fit a more specific site-and-nerve code.
- 64721Carpal tunnel release
- 64721 is median nerve surgery for carpal tunnel at the wrist. It does not describe ulnar nerve surgery at the elbow.
- 64727Internal neurolysis
- 64727 describes internal neurolysis requiring an operating microscope, not the primary ulnar nerve elbow procedure.
64718 billing questions
Does the nerve have to be transposed?
No. The code covers freeing the ulnar nerve at the elbow, with transposition performed when indicated. The operative report should make clear which work was done.
How is this different from 64719?
This code is for ulnar nerve surgery at the elbow. Code 64719 concerns the ulnar nerve at the wrist.
Can the surgeon report 64727 with this procedure?
Code 64727 may be relevant when internal neurolysis requiring an operating microscope is separately performed and documented in addition to the primary nerve procedure.
How is bilateral surgery paid?
CMS pays bilateral reporting with modifier 50 at 150%. The operative documentation should support treatment of both elbows.
What happens when other procedures are performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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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