No office rate
Choose 64857 when the major arm or leg nerve is repaired without transposition; 64856 describes repair that includes transposition.
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CMS RVU26D · Effective 2026-10-01
64857 Nerve repair Medicare reimbursement rates in Kentucky
Reports direct repair of a major peripheral nerve in an arm or leg, excluding the sciatic nerve, when the repair does not include transposition. Compare 64857 office and facility rates across CMS payment localities in Kentucky.
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 64857 in Kentucky?
Kentucky 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
$900.02
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 64857: Major peripheral nerve repair without transposition
Reports direct repair of a major peripheral nerve in an arm or leg, excluding the sciatic nerve, when the repair does not include transposition.
A surgeon uses this code for direct suture repair of a major peripheral nerve in an arm or leg, such as after a traumatic transection. The repair does not include transposition, and the code excludes the sciatic nerve. These procedures are typically performed in an operating room by a surgeon with peripheral nerve expertise, often using magnification to align and join the nerve ends. It is not the code for repair of a small digital nerve in a finger or toe.
The operative report should identify the nerve and site, describe the injury and direct repair, and make clear that transposition was not performed. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. 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 adjustment is inappropriate for this code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 64857
- 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 RVU15.42 · 55%
- Practice expense (office) RVU9.62 · 34%
- Malpractice RVU3.25 · 11%
182
Medicare services in 2024 · #4412 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.
64857 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
64858 is for sciatic nerve repair. 64857 is for a major peripheral nerve in an arm or leg other than the sciatic nerve.
No office rate
64831 applies to repair of a digital nerve. 64857 is for a major peripheral nerve in an arm or leg, not a small finger or toe nerve.
Compare 64857 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$900.02
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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 64857 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,257
- Code
- 64857
- Physician work
- 15.42
- Practice expense
- 9.62
- Malpractice
- 3.25
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.42 | × 1.000 | 15.4200 |
| Practice expense | 9.62 | × 0.889 | 8.5522 |
| Malpractice | 3.25 | × 0.915 | 2.9737 |
| Total RVUs | 26.9459 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$900.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.42 | 1 |
| Practice expense | 9.62 | 0.889 |
| Malpractice | 3.25 | 0.915 |
(15.42 × 1 + 9.62 × 0.889 + 3.25 × 0.915) × $33.4009 = $900.02
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.
64857 billing questions
How does 64857 differ from 64856?
64857 describes major peripheral nerve repair in an arm or leg without transposition. Use 64856 when the repair includes transposition.
Can 64857 be used for sciatic nerve repair?
No. Sciatic nerve repair is reported with 64858; 64857 is for an eligible major peripheral nerve in an arm or leg other than the sciatic nerve.
Is routine postoperative care separately reported?
The 90-day global period includes related postoperative care, as well as the day-before preoperative visit.
Should modifier 50 be used for repairs on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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.
7,25464837,,Repair nerve add-on,A,,6.09,1.94,NA,1.94,,1.30,9.33,9.33,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631