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CMS RVU26D · Effective 2026-10-01

64858 Nerve repair Medicare reimbursement rates in Vermont

Report direct suture repair of an injured sciatic nerve when the nerve ends can be repaired without using a nerve graft. Compare 64858 office and facility rates across CMS payment localities in Vermont.

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 64858 in Vermont?

Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$999.17

1 of 1 localities have a supported rate.

Payment area: Vermont

One mapped payment locality.

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 64858 in your payment locality →

Peripheral nerve surgery

About 64858: Direct sciatic nerve repair

Report direct suture repair of an injured sciatic nerve when the nerve ends can be repaired without using a nerve graft.

This service repairs a divided or injured sciatic nerve by bringing the nerve ends together and suturing them. It is typically performed by a peripheral nerve, neurosurgical, orthopedic, or plastic surgeon in an operating room. The operative report should identify the sciatic nerve injury and document the repair performed, including the site and whether the nerve ends were directly approximated.

Report this code for repair of the sciatic nerve, rather than a repair code for a different major peripheral nerve. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. 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 multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 64858

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 paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU17.37 · 55%
  • Practice expense (office) RVU10.78 · 34%
  • Malpractice RVU3.70 · 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.

64858 compared with similar codes

Office rates for Vermont, from the same CMS release.

64857

Nerve repair

Arm or leg, no transposition

No office rate

Use 64858 for the sciatic nerve; 64857 describes repair of a major peripheral nerve in an arm or leg other than the sciatic nerve.

64859

Nerve repair

Each additional major nerve

No office rate

64859 is the related sciatic nerve repair code associated with transposition. The operative documentation should support the procedure selected.

64872

Nerve repair

Secondary repair

No office rate

64872 is for a subsequent nerve repair. Use 64858 for the sciatic nerve repair circumstance represented by this code.

Compare 64858 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.

1 of 1 payment localities

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

  • Vermont →

    Office / nonfacility

    Unavailable

    Facility

    $999.17

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64858 in Vermont.

PPRRVU2026_Oct_nonQPP.csv

7,258

Code
64858
Physician work
17.37
Practice expense
10.78
Malpractice
3.70

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Facility calculation for 64858 in Vermont
ComponentRVULocality factorAdjusted
Physician work17.37× 1.00017.3700
Practice expense10.78× 0.99010.6722
Malpractice3.70× 0.5061.8722
Total RVUs29.9144
Conversion factor× 33.4009

Facility rate, Vermont$999.17

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work17.371
Practice expense10.780.99
Malpractice3.70.506

(17.37 × 1 + 10.78 × 0.99 + 3.7 × 0.506) × $33.4009 = $999.17

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

64858 billing questions

How is 64858 distinguished from 64857?

64858 is for repair of the sciatic nerve. Code 64857 applies to a major peripheral nerve in an arm or leg other than the sciatic nerve.

When would 64859 be considered instead?

64859 is the related sciatic nerve repair code associated with transposition. Review the operative report to determine whether transposition was performed.

What documentation supports reporting 64858?

Document the sciatic nerve injury, its anatomical location, and the repair performed. The operative note should make clear that the sciatic nerve was repaired.

Does the 90-day global period include postoperative care?

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

How are other procedures in the same session paid?

Under the CMS standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant 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 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 64858PPRRVU2026_Oct_nonQPP.csv, line 7,258 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet