Billing code 64802: Cervical sympathectomyMedicare rate & RVUs in Maine
Reports operative interruption of the cervical sympathetic pathway for a selected disorder involving sympathetic-mediated symptoms in the head, neck, or upper limb.
CMS doesn’t publish an office rate for 64802 in Maine.
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 64802 covers
Cervical sympathectomy surgically interrupts the sympathetic pathway in the neck. A surgeon exposes and treats the cervical sympathetic chain in an operating room; the code is distinguished by the cervical location, not simply by the patient’s symptoms or the surgical approach. It may be considered for selected disorders attributed to cervical sympathetic activity, including refractory vasospastic or ischemic symptoms involving the upper limb. The operative report should identify the treated anatomy and side.
Report this service for surgery on the cervical sympathetic pathway, rather than a sympathectomy at the cervicothoracic, thoracolumbar, lumbar, or peripheral arterial level. Documentation should support the indication, anatomic level, laterality, and work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. For bilateral performance, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 64802 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | Unavailable | $793.40 |
| Southern Maine | Unavailable | $823.02 |
How the 64802 rate is calculated
Each of 64802’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 · 64802
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.11Practice expense 11.95Malpractice 4.26
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64802
64802 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64802
Cervical sympathectomy
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 64802
Cervical sympathectomy
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
64802 without 50 · national facility
$879.11
Cervical sympathectomy
64802-50 · Bilateral: 150%
$1,318.67
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).
64802 compared with similar codes
Compare codes
64802 vs 64804 vs 64809 vs 64820: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64804Sympathectomy
- This code is for a cervicothoracic target. Use 64802 when the operative report identifies the cervical sympathetic pathway as the treated level.
- 64809Sympathectomy
- This code identifies thoracolumbar sympathectomy, not surgery on the cervical pathway.
- 64820Sympathectomy
- This code targets sympathetic fibers at a digital artery. It is not selected for surgery on the cervical sympathetic chain.
64802 billing questions
How is 64802 distinguished from 64804?
Choose 64802 when the operative target is the cervical sympathetic pathway. Use 64804 when the documented target is cervicothoracic.
Can modifier 50 be reported for bilateral cervical sympathectomy?
Yes. CMS treats this as a bilateral procedure; modifier 50 is paid at 150% when the service is performed bilaterally.
Are related postoperative visits separately reported?
Related postoperative care during the 90-day global period is included. The global period also includes the day-before preoperative visit.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports reporting 64802?
The operative report should identify the cervical sympathetic pathway treated, the side or sides, and the operative work. The documented anatomic target distinguishes this service from sympathectomy at other levels or at a peripheral artery.
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
Fee sheets
Put 64802 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →