No office rate
Use 64858 for the sciatic nerve; 64857 describes repair of a major peripheral nerve in an arm or leg other than the sciatic nerve.
On this page
CMS RVU26D · Effective 2026-10-01
64858 Nerve repair Medicare reimbursement rates in Illinois
Report direct suture repair of an injured sciatic nerve when the nerve ends can be repaired without using a nerve graft. Compare 64858 office and facility rates across CMS payment localities in Illinois.
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 64858 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1102.07–$1229.72
4 of 4 localities have a supported rate.
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.
Where 64858 pays more and less in Illinois
Peripheral nerve surgery
About 64858: Direct sciatic nerve repair
Report direct suture repair of an injured sciatic nerve when the nerve ends can be repaired without using a nerve graft.
This service repairs a divided or injured sciatic nerve by bringing the nerve ends together and suturing them. It is typically performed by a peripheral nerve, neurosurgical, orthopedic, or plastic surgeon in an operating room. The operative report should identify the sciatic nerve injury and document the repair performed, including the site and whether the nerve ends were directly approximated.
Report this code for repair of the sciatic nerve, rather than a repair code for a different major peripheral nerve. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. 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 multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 64858
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU17.37 · 55%
- Practice expense (office) RVU10.78 · 34%
- Malpractice RVU3.70 · 12%
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.
64858 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
64859 is the related sciatic nerve repair code associated with transposition. The operative documentation should support the procedure selected.
No office rate
64872 is for a subsequent nerve repair. Use 64858 for the sciatic nerve repair circumstance represented by this code.
Compare 64858 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$1229.72
East St. Louis →
Office / nonfacility
Unavailable
Facility
$1160.33
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$1102.07
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$1173.01
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64858 billing questions
How is 64858 distinguished from 64857?
64858 is for repair of the sciatic nerve. Code 64857 applies to a major peripheral nerve in an arm or leg other than the sciatic nerve.
When would 64859 be considered instead?
64859 is the related sciatic nerve repair code associated with transposition. Review the operative report to determine whether transposition was performed.
What documentation supports reporting 64858?
Document the sciatic nerve injury, its anatomical location, and the repair performed. The operative note should make clear that the sciatic nerve was repaired.
Does the 90-day global period include postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the CMS standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
7,25564840,,Repair of leg nerve,A,,13.67,9.91,NA,9.91,,2.91,26.49,26.49,0,090,0.11,0.76,0.13,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,25664856,,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