Billing code 64795: Nerve biopsyMedicare rate & RVUs in Illinois
Report a nerve biopsy when a surgeon removes peripheral nerve tissue for diagnostic evaluation, such as investigating suspected vasculitic neuropathy.
CMS doesn’t publish an office rate for 64795 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 64795 covers
A surgeon obtains a sample of peripheral nerve tissue so it can be examined to help diagnose a neuropathy. A sural nerve biopsy is a familiar example in the evaluation of suspected vasculitic neuropathy. The service is generally performed by a surgeon, such as a neurosurgeon or peripheral nerve surgeon, in an operating or procedure setting when tissue sampling is clinically indicated.
Select this code for diagnostic nerve tissue sampling, not removal of a nerve lesion as the treatment itself. The operative report should identify the nerve sampled, the diagnostic reason, and the biopsy performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. 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.
Where 64795 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 | $225.42 |
| East St. Louis | Unavailable | $211.45 |
| Rest Of Illinois | Unavailable | $197.78 |
| Suburban Chicago | Unavailable | $211.35 |
How the 64795 rate is calculated
Each of 64795’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 · 64795
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.93Practice expense 1.77Malpractice 0.88
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64795
The CMS indicators that decide how 64795 is paid alongside other services.
CMS payment indicators · 64795
Nerve biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
64795 without 51 · national facility
$186.38
Nerve biopsy
64795-51 · Second procedure: 50%
$93.19
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%).
64795 compared with similar codes
Compare codes
64795 vs 64784 vs 64790 vs 64792: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64784Neuroma excision
- Use 64795 for diagnostic nerve tissue sampling. Use 64784 when the procedure removes a nerve lesion rather than obtaining a biopsy.
- 64790Nerve tumor removal
- 64795 represents a diagnostic sample; 64790 describes removal of a nerve lesion.
- 64792Neuroma excision
- Choose 64795 for biopsy sampling. Choose 64792 when the documented procedure is nerve-lesion removal.
64795 billing questions
When should I report a nerve biopsy instead of a nerve-lesion excision code?
Report 64795 when nerve tissue is sampled to establish a diagnosis. If the procedure removes a nerve lesion as treatment, use the code that describes that lesion and its location or type.
Is same-day preoperative or postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can modifier 50 be used for biopsies on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code. Do not append modifier 50.
How does Medicare handle this service when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be paid for the biopsy?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 64795?
Document the nerve sampled, the diagnostic indication, and the tissue-sampling procedure. The record should make clear that the purpose was diagnostic biopsy rather than therapeutic removal of a nerve lesion.
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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