Billing code 64740: Nerve neurotomyMedicare rate & RVUs in Virginia
Reports surgical division of the nerve supplying the tongue, typically to interrupt persistent nerve-mediated symptoms such as refractory neuropathic pain.
CMS doesn’t publish an office rate for 64740 in Virginia.
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 64740 covers
The surgeon exposes and deliberately divides the nerve supplying the tongue to interrupt its function. This is a targeted nerve procedure, not tongue-tissue removal or simple nerve decompression. It may be performed by an oral and maxillofacial surgeon, otolaryngologist, or other surgeon treating selected patients with persistent nerve-mediated tongue symptoms, such as refractory neuropathic pain.
Report the service when the operative note supports deliberate division of the tongue nerve, including the nerve treated and the reason for the procedure. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. 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. For bilateral procedures, modifier 50 is paid at 150%. 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.
Where 64740 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $480.16 |
| Virginia | Unavailable | $418.52 |
How the 64740 rate is calculated
Each of 64740’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 · 64740
RVUs × geographic indexes × conversion factor
Work6.06
6.06 RVUs× 1.000 GPCI
Practice expense5.95
5.95 RVUs× 1.000 GPCI
Malpractice0.88
0.88 RVUs× 1.000 GPCI
Adjusted RVUs
12.8900
Conversion factor
$33.4009
Medicare rate
$430.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64740
64740 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64740
Nerve neurotomy
| 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) | 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 · 64740
Nerve neurotomy
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
64740 without 50 · national facility
$430.54
Nerve neurotomy
64740-50 · Bilateral: 150%
$645.81
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).
64740 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 64738Nerve neurectomy
- Choose 64740 for deliberate division of the tongue nerve; 64738 is for a jaw-region nerve.
- 64742Facial nerve surgery
- 64742 addresses the facial nerve, while 64740 is specific to the nerve supplying the tongue.
- 64716Cranial nerve surgery
- 64740 reports division of the tongue nerve. 64716 concerns revision of a cranial nerve, not this targeted neurotomy.
64740 billing questions
How is this different from a tongue nerve decompression?
This service represents deliberate nerve division. Use a decompression code when the surgeon relieves pressure on a nerve without dividing it.
What operative documentation supports reporting this code?
Document the tongue nerve treated, the operative steps showing intentional division, and the clinical reason for interrupting the nerve.
Can modifier 50 be reported for bilateral treatment?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
How does the multiple-procedure reduction affect another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard 50% reduction.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be allowed. CMS does not permit co-surgeons or team surgery for this code.
What postoperative care is included?
The major-surgery global period 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
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