No office rate
64861 is specific to the brachial plexus. Choose 64856 when the operative repair is of a major peripheral nerve in the arm or leg.
On this page
CMS RVU26D · Effective 2026-10-01
64861 Nerve repair Medicare reimbursement rates in Iowa
Repair of an injured brachial plexus by nerve suturing, reported for operative reconstruction when the surgical work involves the plexus itself. Compare 64861 office and facility rates across CMS payment localities in Iowa.
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 64861 in Iowa?
Iowa 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
$1292.74
1 of 1 localities have a supported rate.
Payment area: Iowa
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 64861: Brachial plexus nerve repair
Repair of an injured brachial plexus by nerve suturing, reported for operative reconstruction when the surgical work involves the plexus itself.
This service repairs an injured brachial plexus by surgically joining nerve tissue. It is typically performed in an operating room by a surgeon experienced in peripheral nerve reconstruction, such as a neurosurgeon or plastic surgeon. A common clinical setting is operative treatment of a traumatic plexus injury; the operative report should identify the plexus structures treated and describe the repair performed.
Report 64861 when the operative work is on the brachial plexus, rather than a separate major peripheral nerve in the arm or leg. Documentation should establish the injury, operative findings, structures repaired, and laterality. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. With other procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 64861
- 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 RVU20.37 · 45%
- Practice expense (office) RVU16.31 · 36%
- Malpractice RVU8.59 · 19%
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.
64861 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
64858 is for the sciatic nerve. It is not the appropriate choice for repair of the brachial plexus.
No office rate
64872 identifies subsequent nerve repair. Use 64861 when the operative service is repair of the brachial plexus, not a subsequent repair service.
Compare 64861 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
Iowa →
Office / nonfacility
Unavailable
Facility
$1292.74
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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 64861 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
7,260
- Code
- 64861
- Physician work
- 20.37
- Practice expense
- 16.31
- Malpractice
- 8.59
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 20.37 | × 1.000 | 20.3700 |
| Practice expense | 16.31 | × 0.915 | 14.9236 |
| Malpractice | 8.59 | × 0.397 | 3.4102 |
| Total RVUs | 38.7039 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$1292.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 20.37 | 1 |
| Practice expense | 16.31 | 0.915 |
| Malpractice | 8.59 | 0.397 |
(20.37 × 1 + 16.31 × 0.915 + 8.59 × 0.397) × $33.4009 = $1292.74
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.
64861 billing questions
When should 64861 be chosen over a major peripheral nerve repair code?
Use 64861 when the repaired structure is the brachial plexus. A repair of a separate major nerve in the arm or leg is represented by a different code.
Are related postoperative visits separately reported?
Related postoperative care is included in the 90-day global period, along with the day-before preoperative visit.
How is bilateral brachial plexus repair handled?
For bilateral procedures reported with modifier 50, CMS applies the bilateral payment rule of 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports 64861?
The operative report should identify the brachial plexus structures involved, describe the injury and findings, and explain the repair performed and its laterality.
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.
7,25764857,,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
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136