Billing code 64898: Nerve graftMedicare rate & RVUs in Texas
Reports reconstruction of an arm or leg nerve defect using multiple strands of nerve graft when the graft length exceeds 4 cm.
CMS doesn’t publish an office rate for 64898 in Texas.
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 64898 covers
This procedure bridges a peripheral nerve defect in an arm or leg with multiple strands of graft arranged as cables. It may be used after traumatic nerve injury or when a segment must be removed and direct repair would not close the gap without tension. Peripheral nerve, hand, plastic, orthopedic, or neurosurgeons may perform it in an operating room. The operative report should identify the recipient nerve and extremity, explain the need for graft reconstruction, and document the number of strands and graft length.
Select this code when the graft uses multiple strands and its length is over 4 cm; the site must be an arm or leg rather than the hand, foot, head, or neck. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor. Assistant-at-surgery payment may be made; 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.
Where 64898 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,245.03 |
| Beaumont | Unavailable | $1,189.44 |
| Brazoria | Unavailable | $1,206.40 |
| Dallas | Unavailable | $1,220.43 |
| Fort Worth | Unavailable | $1,218.23 |
| Galveston | Unavailable | $1,214.17 |
| Houston | Unavailable | $1,293.61 |
| Rest Of Texas | Unavailable | $1,201.61 |
How the 64898 rate is calculated
Each of 64898’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 · 64898
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 20.45Practice expense 12.23Malpractice 4.34
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64898
64898 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64898
Nerve graft
| 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 · 64898
Nerve graft
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
64898 without 51 · national facility
$1,236.50
Nerve graft
64898-51 · Second procedure: 50%
$618.25
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%).
64898 compared with similar codes
Compare codes
64898 vs 64897 vs 64893 vs 64896 vs 64886: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64897Nerve graft
- Both cover multiple-strand grafting in an arm or leg. The length distinction is the key: 64897 is for under 4 cm, while 64898 is for over 4 cm.
- 64893Nerve graft
- This code is for a single-strand graft over 4 cm in an arm or leg. Report 64898 when multiple strands are used.
- 64896Nerve graft
- This is the multiple-strand, over-4-cm counterpart for a hand or foot nerve; 64898 is for an arm or leg nerve.
- 64886Nerve graft
- Both describe multiple-strand grafts over 4 cm, but 64886 is for the head or neck rather than an arm or leg.
64898 billing questions
How is this code distinguished from 64897?
Both describe multiple-strand grafting for an arm or leg nerve. Choose 64898 when the graft length is over 4 cm; 64897 is for a graft under 4 cm.
Does the code describe multiple nerves or multiple graft strands?
It distinguishes the multiple-strand graft configuration, not simply the number of nerves treated. Document the graft strands and the reconstruction performed.
When is 64893 a closer fit?
64893 describes a single-strand graft for an arm or leg nerve over 4 cm. Use 64898 when the reconstruction uses multiple strands.
Can modifier 50 be used when both limbs are treated?
No. The descriptor or anatomy makes a bilateral adjustment inappropriate. The CMS rule for this code states that modifier 50 does not apply.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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 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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