No office rate
Both codes repair the facial nerve, but 64865 is for the intracranial segment and 64864 is for the extracranial segment.
On this page
CMS RVU26D · Effective 2026-10-01
64865 Facial nerve repair Medicare reimbursement rates in Missouri
Reports surgical suture repair of a facial nerve injury within the cranial cavity, such as an intracranial transection addressed during skull-base surgery. Compare 64865 office and facility rates across CMS payment localities in Missouri.
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 64865 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$898.03–$931.41
3 of 3 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 64865 pays more and less in Missouri
Peripheral nerve surgery
About 64865: Intracranial facial nerve repair
Reports surgical suture repair of a facial nerve injury within the cranial cavity, such as an intracranial transection addressed during skull-base surgery.
This code is for surgical repair of an injured facial nerve segment located inside the cranial cavity. A neurosurgeon or skull-base surgeon may perform the repair during an operation in which an intracranial facial nerve injury is identified, including an injury associated with tumor surgery or trauma. The key distinction from extracranial facial nerve repair is the location of the nerve being repaired, not simply the fact that the procedure involves the face.
Select the code when the operative report supports repair of the intracranial facial nerve, and document the injury site and repair performed. CMS 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 the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 64865
- 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 RVU15.69 · 55%
- Practice expense (office) RVU10.39 · 37%
- Malpractice RVU2.30 · 8%
17
Medicare services in 2024 · #6021 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.
64865 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
64866 describes anastomosis of the facial nerve to the spinal accessory nerve, not suture repair of an injured intracranial facial nerve.
No office rate
64868 describes anastomosis of the facial nerve to the hypoglossal nerve, a nerve-transfer approach rather than intracranial facial nerve repair.
No office rate
64885 is a head or neck nerve graft procedure. Choose it for the graft service rather than direct intracranial facial nerve suture repair.
Compare 64865 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$924.98
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$931.41
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$898.03
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64865 billing questions
How is this code distinguished from 64864?
Use 64865 for repair of the facial nerve within the cranial cavity. Code 64864 is for extracranial facial nerve repair.
Does modifier 50 apply when both sides are involved?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports reporting 64865?
The operative report should establish that the injured facial nerve segment was intracranial and describe the repair performed.
How does the 90-day global period affect postoperative care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
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%.
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.
7,26064861,,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
7,26464866,,Fusion of facial/other nerve,A,,16.41,14.29,NA,14.29,,3.04,33.74,33.74,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,26564868,,Fusion of facial/other nerve,A,,14.53,9.34,NA,9.34,,2.12,25.99,25.99,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,26664872,,Subsequent repair of nerve,A,,1.94,0.62,NA,0.62,,0.42,2.98,2.98,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00