Billing code 64861: Nerve repairMedicare rate & RVUs in Utah
Repair of an injured brachial plexus by nerve suturing, reported for operative reconstruction when the surgical work involves the plexus itself.
CMS doesn’t publish an office rate for 64861 in Utah.
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 64861 covers
This service repairs an injured brachial plexus by surgically joining nerve tissue. It is typically performed in an operating room by a surgeon experienced in peripheral nerve reconstruction, such as a neurosurgeon or plastic surgeon. A common clinical setting is operative treatment of a traumatic plexus injury; the operative report should identify the plexus structures treated and describe the repair performed.
Report 64861 when the operative work is on the brachial plexus, rather than a separate major peripheral nerve in the arm or leg. Documentation should establish the injury, operative findings, structures repaired, and laterality. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. With other procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; 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.
64861 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $1,450.11 |
How the 64861 rate is calculated
Each of 64861’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 · 64861
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 20.37Practice expense 16.31Malpractice 8.59
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64861
64861 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64861
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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 64861
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 50 · payment effect
With and without the modifier
64861 without 50 · national facility
$1,512.06
Nerve repair
64861-50 · Bilateral: 150%
$2,268.09
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
64861 compared with similar codes
Compare codes
64861 vs 64856 vs 64858 vs 64872: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64856Brachial plexus repair
- 64861 is specific to the brachial plexus. Choose 64856 when the operative repair is of a major peripheral nerve in the arm or leg.
- 64858Nerve repair
- 64858 is for the sciatic nerve. It is not the appropriate choice for repair of the brachial plexus.
- 64872Nerve repair
- 64872 identifies subsequent nerve repair. Use 64861 when the operative service is repair of the brachial plexus, not a subsequent repair service.
64861 billing questions
When should 64861 be chosen over a major peripheral nerve repair code?
Use 64861 when the repaired structure is the brachial plexus. A repair of a separate major nerve in the arm or leg is represented by a different code.
Are related postoperative visits separately reported?
Related postoperative care is included in the 90-day global period, along with the day-before preoperative visit.
How is bilateral brachial plexus repair handled?
For bilateral procedures reported with modifier 50, CMS applies the bilateral payment rule of 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports 64861?
The operative report should identify the brachial plexus structures involved, describe the injury and findings, and explain the repair performed and its laterality.
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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