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CMS RVU26D · Effective 2026-10-01

64862 Nerve repair Medicare reimbursement rates in Pennsylvania

Surgical repair of a peripheral nerve in the low-back region is reported when the operative service addresses a nerve injury at that site. Compare 64862 office and facility rates across CMS payment localities in Pennsylvania.

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 64862 in Pennsylvania?

Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$1196.29–$1294.68

2 of 2 localities have a supported rate.

Lowest: Rest Of Pennsylvania

Highest: Metropolitan Philadelphia

A spread of $98.39 per service.

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.

Find 64862 in your payment locality →

Peripheral nerve surgery

About 64862: Low-back peripheral nerve repair

Surgical repair of a peripheral nerve in the low-back region is reported when the operative service addresses a nerve injury at that site.

This code describes surgical repair of a peripheral nerve in the low-back region. Neurosurgeons, peripheral nerve surgeons, and other surgeons with expertise in nerve reconstruction may perform the procedure, typically in an operating room for an identified nerve injury or disruption. The operative report should establish the nerve’s location and the repair performed; a repair of a named nerve elsewhere in the body belongs to the code for that site or nerve.

The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. For a bilateral service reported with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.

CMS billing rules for 64862

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 procedure with modifier 50 is paid at 150%.
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 RVU20.56 · 55%
  • Practice expense (office) RVU12.11 · 33%
  • Malpractice RVU4.38 · 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.

64862 compared with similar codes

Office rates for Pennsylvania, from the same CMS release.

64858

Nerve repair

Sciatic nerve

No office rate

Choose 64858 when the repair is specifically of the sciatic nerve. This code is for a nerve repair in the low-back region.

64840

Leg nerve repair

Major peripheral nerve

No office rate

Code 64840 is associated with nerve repair in the leg; this code is for repair in the low-back region.

64872

Nerve repair

Secondary repair

No office rate

Code 64872 describes a subsequent nerve repair. Use this code for the low-back nerve repair service itself, rather than a later repair.

Compare 64862 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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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64862 billing questions

How is this code distinguished from the sciatic nerve repair code?

Use this code for a nerve repair in the low-back region. Code 64858 is specific to repair of the sciatic nerve.

What documentation supports reporting this code?

The operative report should identify the repaired nerve and its low-back location, describe the injury or disruption, and document the repair performed.

Does the code include related postoperative visits?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral repair paid?

When the bilateral service is reported with modifier 50, CMS pays at 150%.

Can an assistant surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment 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.

RVUs for 64862PPRRVU2026_Oct_nonQPP.csv, line 7,261 (RVU26D)
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