Billing code 64858: Nerve repairMedicare rate & RVUs in Washington
Report direct suture repair of an injured sciatic nerve when the nerve ends can be repaired without using a nerve graft.
CMS doesn’t publish an office rate for 64858 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 64858 covers
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.
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 64858 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,060.91 |
| Seattle (King Cnty) | Unavailable | $1,151.95 |
How the 64858 rate is calculated
Each of 64858’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 · 64858
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.37Practice expense 10.78Malpractice 3.70
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64858
64858 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64858
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 · 64858
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
64858 without 50 · national facility
$1,063.82
Nerve repair
64858-50 · Bilateral: 150%
$1,595.73
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).
64858 compared with similar codes
Compare codes
64858 vs 64857 vs 64859 vs 64872: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64857Nerve repair
- Use 64858 for the sciatic nerve; 64857 describes repair of a major peripheral nerve in an arm or leg other than the sciatic nerve.
- 64859Nerve repair
- 64859 is the related sciatic nerve repair code associated with transposition. The operative documentation should support the procedure selected.
- 64872Nerve repair
- 64872 is for a subsequent nerve repair. Use 64858 for the sciatic nerve repair circumstance represented by this code.
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 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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