No office rate
Both are single-strand hand or foot grafts; the documented graft length separates the codes. Use 64890 for a length up to 4 cm and 64891 when it exceeds 4 cm.
On this page
CMS RVU26D · Effective 2026-10-01
64891 Nerve graft Medicare reimbursement rates in Missouri
Reports microsurgical placement of one nerve-graft strand longer than 4 cm to bridge a nerve gap in the hand or foot. Compare 64891 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 64891 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
$988.64–$1023.97
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 64891 pays more and less in Missouri
Peripheral nerve surgery
About 64891: Single-strand hand or foot nerve graft
Reports microsurgical placement of one nerve-graft strand longer than 4 cm to bridge a nerve gap in the hand or foot.
A surgeon uses this service to bridge a peripheral nerve gap in the hand or foot when the nerve ends cannot be brought together for direct repair. The graft restores continuity across the defect, such as after traumatic nerve loss or excision of a damaged nerve segment. Hand, plastic, orthopedic, and peripheral nerve surgeons commonly perform the procedure in an operating room using microsurgical technique. The code specifies one graft strand and a graft length exceeding 4 cm at a hand or foot site.
Choose the code from the operative report’s documented anatomic site, number of strands, and graft length; distinguish it from shorter grafts and grafts for other body regions. Documentation should identify the injured or resected nerve, the gap bridged, the graft configuration, and its length. The service has 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. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are not permitted.
CMS billing rules for 64891
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU16.92 · 54%
- Practice expense (office) RVU10.63 · 34%
- Malpractice RVU3.61 · 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.
64891 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Both describe a single-strand graft longer than 4 cm. Choose 64891 for a hand or foot nerve and 64893 for an arm or leg nerve.
No office rate
Both cover a hand or foot graft longer than 4 cm, but 64896 is for a multiple-strand graft rather than one strand.
Compare 64891 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
$1016.34
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$1023.97
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$988.64
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64891 billing questions
How is this code distinguished from 64890?
Both describe a single-strand graft for a hand or foot nerve. Select this code when the graft length exceeds 4 cm; 64890 is for a graft up to 4 cm.
When should 64893 be considered instead?
64893 describes a single-strand graft longer than 4 cm for an arm or leg nerve. This code is for a hand or foot site.
What operative details support code selection?
Document the nerve and operative site, the nerve gap being bridged, the use of one graft strand, and graft length exceeding 4 cm.
Can modifier 50 be used for grafting both sides?
CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate under the descriptor and anatomy. Document the treated site or sites.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be allowed. Co-surgeons and team surgery are not permitted for this code under the CMS facts.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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.
7,26964885,,Nerve graft head/neck <4 cm,A,,17.16,8.15,NA,8.15,,2.50,27.81,27.81,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27064886,,Nerve graft head/neck >4 cm,A,,20.30,9.95,NA,9.95,,3.22,33.47,33.47,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27164890,,Nrv grf 1strnd hnd/foot <4cm,A,,15.83,10.13,NA,10.13,,3.37,29.33,29.33,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27264891,,Nrv grf 1strnd hnd/foot >4cm,A,,16.92,10.63,NA,10.63,,3.61,31.16,31.16,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27364892,,Nrv grf 1strnd arm/leg <4cm,A,,15.35,9.98,NA,9.98,,3.26,28.59,28.59,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27464893,,Nrv grf 1strnd arm/leg >4 cm,A,,16.45,10.48,NA,10.48,,3.50,30.43,30.43,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27564895,,Nrv grf mltst hnd/foot <4 cm,A,,19.88,11.58,NA,11.58,,4.23,35.69,35.69,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00