No office rate
Both are facial nerve fusion codes. Confirm the operative service and applicable code distinction in the current CPT descriptor before selecting between them.
On this page
CMS RVU26D · Effective 2026-10-01
64868 Nerve anastomosis Medicare reimbursement rates in Nebraska
Reports operative joining of the facial nerve with another nerve as a reconstructive procedure, rather than repair of a nerve gap with a graft. Compare 64868 office and facility rates across CMS payment localities in Nebraska.
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 64868 in Nebraska?
Nebraska 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
$800.02
1 of 1 localities have a supported rate.
Payment area: Nebraska
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.
Nerve surgery
About 64868: Facial nerve anastomosis
Reports operative joining of the facial nerve with another nerve as a reconstructive procedure, rather than repair of a nerve gap with a graft.
The surgeon microsurgically joins the facial nerve with another nerve to restore a pathway for nerve signals, typically during reconstruction for facial nerve injury or loss of function. The operation is performed by a surgeon experienced in peripheral nerve or facial nerve reconstruction, usually in an operating room. The operative report should identify the nerves joined and describe the anastomosis performed.
Report this code for the facial-to-other-nerve joining procedure, not simply for direct repair of a divided facial nerve or for a nerve graft. Medicare assigns a 90-day global period, including the day-before preoperative visit and 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 multiple-procedure 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 64868
- 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 RVU14.53 · 56%
- Practice expense (office) RVU9.34 · 36%
- Malpractice RVU2.12 · 8%
40
Medicare services in 2024 · #5510 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.
64868 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Use 64864 for direct extracranial facial nerve repair; use 64868 when the documented operation joins the facial nerve with another nerve.
No office rate
64865 describes direct intracranial facial nerve repair, not an anastomosis joining the facial nerve with another nerve.
No office rate
64885 describes a head-and-neck nerve graft service. Choose it when the documented procedure is grafting rather than the facial-to-other-nerve joining represented by 64868.
Compare 64868 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$800.02
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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 64868 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
7,265
- Code
- 64868
- Physician work
- 14.53
- Practice expense
- 9.34
- Malpractice
- 2.12
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.53 | × 1.000 | 14.5300 |
| Practice expense | 9.34 | × 0.923 | 8.6208 |
| Malpractice | 2.12 | × 0.378 | 0.8014 |
| Total RVUs | 23.9522 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$800.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.53 | 1 |
| Practice expense | 9.34 | 0.923 |
| Malpractice | 2.12 | 0.378 |
(14.53 × 1 + 9.34 × 0.923 + 2.12 × 0.378) × $33.4009 = $800.02
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.
64868 billing questions
How is this different from direct facial nerve repair?
This code represents joining the facial nerve with another nerve. Codes 64864 and 64865 describe facial nerve repair in extracranial and intracranial locations, respectively.
What should the operative note document?
Document the facial nerve and the other nerve joined, the anastomosis performed, and the clinical reason for reconstruction.
Can modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 90-day global period affect postoperative billing?
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 other 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.
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.
7,26264864,,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
7,26764874,,Repair & revise nerve add-on,A,,2.91,0.93,NA,0.93,,0.61,4.45,4.45,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,26864876,,Repair nerve/shorten bone,A,,3.29,1.05,NA,1.05,,0.69,5.03,5.03,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068