Billing code 64891: Nerve graftMedicare rate & RVUs in Utah
Reports microsurgical placement of one nerve-graft strand longer than 4 cm to bridge a nerve gap in the hand or foot.
CMS doesn’t publish an office rate for 64891 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 64891 covers
A surgeon uses this service to bridge a peripheral nerve gap in the hand or foot when the nerve ends cannot be brought together for direct repair. The graft restores continuity across the defect, such as after traumatic nerve loss or excision of a damaged nerve segment. Hand, plastic, orthopedic, and peripheral nerve surgeons commonly perform the procedure in an operating room using microsurgical technique. The code specifies one graft strand and a graft length exceeding 4 cm at a hand or foot site.
Choose the code from the operative report’s documented anatomic site, number of strands, and graft length; distinguish it from shorter grafts and grafts for other body regions. Documentation should identify the injured or resected nerve, the gap bridged, the graft configuration, and its length. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are 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.
64891 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $1,007.17 |
How the 64891 rate is calculated
Each of 64891’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 · 64891
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.92Practice expense 10.63Malpractice 3.61
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64891
64891 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64891
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) | 0 | Not permitted. |
| 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 · 64891
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
64891 without 51 · national facility
$1,040.77
Nerve graft
64891-51 · Second procedure: 50%
$520.39
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%).
64891 compared with similar codes
Compare codes
64891 vs 64890 vs 64893 vs 64896: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64890Nerve graft
- Both are single-strand hand or foot grafts; the documented graft length separates the codes. Use 64890 for a length up to 4 cm and 64891 when it exceeds 4 cm.
- 64893Nerve graft
- Both describe a single-strand graft longer than 4 cm. Choose 64891 for a hand or foot nerve and 64893 for an arm or leg nerve.
- 64896Nerve graft
- Both cover a hand or foot graft longer than 4 cm, but 64896 is for a multiple-strand graft rather than one strand.
64891 billing questions
How is this code distinguished from 64890?
Both describe a single-strand graft for a hand or foot nerve. Select this code when the graft length exceeds 4 cm; 64890 is for a graft up to 4 cm.
When should 64893 be considered instead?
64893 describes a single-strand graft longer than 4 cm for an arm or leg nerve. This code is for a hand or foot site.
What operative details support code selection?
Document the nerve and operative site, the nerve gap being bridged, the use of one graft strand, and graft length exceeding 4 cm.
Can modifier 50 be used for grafting both sides?
CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate under the descriptor and anatomy. Document the treated site or sites.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be allowed. Co-surgeons and team surgery are not permitted for this code under the CMS facts.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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
Fee sheets
Put 64891 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →