Billing code 64864: Facial nerve repairMedicare rate & RVUs in Ohio
Reports surgical suture repair of an extracranial facial nerve injury, such as a transection requiring operative reconnection of the nerve ends.
CMS doesn’t publish an office rate for 64864 in Ohio.
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 64864 covers
This service involves surgically reconnecting an injured extracranial cranial nerve, most often the facial nerve, by bringing the nerve ends together and repairing them. It may be performed by an otolaryngologist, plastic surgeon, or neurosurgeon in an operating room after facial trauma or an operative injury, including damage encountered during parotid-region surgery. The repair is distinct from reconstruction that bridges a nerve gap with a graft or redirects another nerve to restore facial function.
Report the code when the operative record supports repair of an extracranial cranial nerve and identifies the nerve and repair performed. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate. 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.
64864 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $734.42 |
How the 64864 rate is calculated
Each of 64864’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 · 64864
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.07Practice expense 7.35Malpractice 2.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64864
64864 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64864
Facial nerve repair
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 64864
Facial nerve repair
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 51 · payment effect
With and without the modifier
64864 without 51 · national facility
$755.19
Facial nerve repair
64864-51 · Second procedure: 50%
$377.60
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
64864 compared with similar codes
Compare codes
64864 vs 64865 vs 64866 vs 64885 vs 64886: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64865Facial nerve repair
- Choose 64864 for extracranial cranial nerve repair. Code 64865 applies to intracranial repair requiring craniotomy.
- 64866Facial nerve transfer
- 64864 repairs the injured nerve itself; 64866 is used for a facial-to-hypoglossal nerve connection.
- 64885Nerve graft
- 64864 describes repair by reconnecting the injured nerve. Code 64885 is for head-and-neck nerve reconstruction using a graft under 4 cm.
- 64886Nerve graft
- Use 64886 for head-and-neck nerve graft reconstruction when the graft is over 4 cm, rather than direct repair under 64864.
64864 billing questions
How is this different from 64865?
64864 is for repair of an extracranial cranial nerve. Code 64865 describes intracranial cranial nerve repair requiring craniotomy.
When would a nerve graft code be more appropriate?
Use a head-and-neck nerve graft code when the operative reconstruction bridges a nerve defect with graft material rather than directly reconnecting the nerve ends. Codes 64885 and 64886 distinguish graft length.
Can modifier 50 be appended for repairs on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 64864?
Document the injured extracranial nerve, the operative findings, and the repair performed. The record should distinguish direct nerve repair from graft reconstruction or nerve transfer.
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
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