Billing code 64837: Nerve repairMedicare rate & RVUs in Washington
Reports repair with transposition of each additional non-digital nerve in the hand or foot during the same operation as the primary nerve repair.
CMS doesn’t publish an office rate for 64837 in Washington.
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 64837 covers
This add-on represents repair of an additional non-digital nerve in the hand or foot when the surgeon also transposes that nerve. Transposition moves the nerve into a different position or tissue bed as part of the repair. It is typically performed by a hand, orthopedic, plastic, or peripheral nerve surgeon in an operating room after traumatic injury or during reconstruction when more than one nerve requires this treatment.
Report 64837 only with the primary repair code 64836 for the first nerve repaired with transposition. The operative report should identify the additional nerve and document its repair and transposition; the add-on is for another nerve, not another nerve end or a repeat repair of the same nerve. CMS classifies it as an add-on code: it is billed only with a primary procedure and its payment falls within that procedure's global period.
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 64837 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $307.33 |
| Seattle (King Cnty) | Unavailable | $328.56 |
How the 64837 rate is calculated
Each of 64837’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 · 64837
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.09Practice expense 1.94Malpractice 1.30
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64837
The CMS indicators that decide how 64837 is paid alongside other services.
CMS payment indicators · 64837
Nerve repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
64837 without 80 · national facility
$311.63
Nerve repair
64837-80 · Assistant: 16%
$49.86
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
64837 compared with similar codes
Compare codes
64837 vs 64836 vs 64835 vs 64832: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64836Nerve repair
- Use 64836 for the first non-digital hand or foot nerve repaired with transposition; 64837 reports each additional qualifying nerve.
- 64835Nerve repair
- Use 64835 for an additional non-digital hand or foot nerve repaired without the transposition represented by 64837.
- 64832Nerve repair
- Use 64832 for each additional digital nerve. Code 64837 is for additional non-digital nerves of the hand or foot repaired with transposition.
64837 billing questions
Which primary code must accompany 64837?
Report 64837 with 64836, which represents repair with transposition of the first qualifying hand or foot nerve. The additional nerve must also be repaired with transposition.
Can 64837 be used for an additional digital nerve?
No. Code 64837 applies to additional non-digital nerves of the hand or foot; 64832 is the add-on for an additional digital nerve.
How does 64837 differ from 64835?
Both concern additional non-digital hand or foot nerves, but 64837 is for repair with transposition. Code 64835 describes an additional nerve repair without that transposition distinction.
What should the operative report document?
Identify the additional nerve and describe its repair and transposition. The record should also support the primary 64836 service for the first nerve.
Is 64837 billed as a stand-alone service?
No. CMS identifies it as an add-on code, so it is billed only with a primary procedure; payment is within that procedure's global period.
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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