No office rate
Use 64905 for the first stage of the planned nerve pedicle transfer; 64907 identifies its second stage.
On this page
CMS RVU26D · Effective 2026-10-01
64905 Nerve transfer Medicare reimbursement rates in Pennsylvania
Reports the first stage of a nerve pedicle transfer performed to redirect nerve supply toward a denervated target when staged reinnervation is planned. Compare 64905 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 64905 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
$861.46–$932.19
2 of 2 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.
Peripheral nerve surgery
About 64905: First-stage nerve pedicle transfer
Reports the first stage of a nerve pedicle transfer performed to redirect nerve supply toward a denervated target when staged reinnervation is planned.
In this operation, a surgeon redirects a functioning nerve pedicle toward a target that needs new nerve input. It is generally performed by a peripheral nerve, plastic, or neurosurgeon in an operating room when the planned reconstruction uses a staged transfer rather than a graft to bridge a nerve gap. The operative note should identify the donor and recipient structures and document the transfer stage and technique.
Report 64905 for the first stage; the later stage is represented by 64907 when performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed 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 for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 64905
- 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 RVU14.73 · 55%
- Practice expense (office) RVU8.91 · 33%
- Malpractice RVU3.05 · 11%
1.8K
Medicare services in 2024 · #2541 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.
64905 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
64910 describes nerve repair using allograft material. Choose 64905 when the documented procedure is a first-stage pedicle transfer instead.
No office rate
64911 describes nerve repair using vein autograft; it is not the first stage of a nerve pedicle transfer.
Compare 64905 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$932.19
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$861.46
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64905 billing questions
How do I distinguish 64905 from 64907?
64905 represents the first stage of the nerve pedicle transfer. Report 64907 for the later, second stage when that procedure is performed.
Should 64905 be used for a nerve gap repaired with graft material?
No. This code describes a staged nerve pedicle transfer; nerve repair using graft material is coded according to the repair method and graft.
What operative documentation supports 64905?
Document the donor and recipient nerve structures, the transfer performed, and that the operation is the first stage of the planned transfer.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor or anatomy.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgical package.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
7,27864898,,Nrv grf mltst arm/leg >4 cm,A,,20.45,12.23,NA,12.23,,4.34,37.02,37.02,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,27964901,,Nerve graft add-on,A,,9.95,3.17,NA,3.17,,2.12,15.24,15.24,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,28064902,,Nerve graft add-on,A,,11.51,3.67,NA,3.67,,2.46,17.64,17.64,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,28164905,,Nerve pedicle transfer,A,,14.73,8.91,NA,8.91,,3.05,26.69,26.69,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,28264907,,Nerve pedicle transfer,A,,19.53,11.31,NA,11.31,,4.17,35.01,35.01,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,28364910,,Nerve repair w/allograft,A,,10.26,8.85,NA,8.85,,1.76,20.87,20.87,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,28464911,,Neurorraphy w/vein autograft,A,,13.65,11.89,NA,11.89,,2.91,28.45,28.45,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00