Billing code 64892: Nerve graftMedicare rate & RVUs in Washington
Reports a single-strand nerve graft under 4 cm used to bridge a nerve defect in an arm or leg when direct repair is not feasible.
CMS doesn’t publish an office rate for 64892 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 64892 covers
The surgeon bridges a gap in an arm or leg nerve by placing a single strand of nerve graft between the nerve ends. The service includes obtaining the graft. It is used when injury, resection, or another defect leaves insufficient nerve length for direct repair. Peripheral nerve, hand, plastic, orthopedic, and neurosurgeons may perform the procedure in an operating room, commonly in a hospital setting.
Select this code when the graft is a single strand, the treated nerve is in an arm or leg, and the graft length is under 4 cm. The operative report should identify the nerve and site, graft strand count and length, and why bridging was needed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; an assistant may be paid, co-surgeons require 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 64892 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $953.24 |
| Seattle (King Cnty) | Unavailable | $1,036.31 |
How the 64892 rate is calculated
Each of 64892’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 · 64892
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.35Practice expense 9.98Malpractice 3.26
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64892
64892 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64892
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) | 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 · 64892
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
64892 without 51 · national facility
$954.93
Nerve graft
64892-51 · Second procedure: 50%
$477.47
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%).
64892 compared with similar codes
Compare codes
64892 vs 64893 vs 64897 vs 64890 vs 64857: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64893Nerve graft
- Both are single-strand grafts for an arm or leg nerve; the graft length separates them. This code is for under 4 cm, while 64893 is for over 4 cm.
- 64897Nerve graft
- Both cover an arm or leg graft under 4 cm, but 64897 is for multiple strands rather than a single strand.
- 64890Nerve graft
- This code is for an arm or leg nerve; 64890 is for a hand or foot nerve. Both describe a single-strand graft under 4 cm.
- 64857Nerve repair
- 64857 describes nerve repair rather than an interposed graft. Choose the graft code when a nerve defect requires bridging with a graft.
64892 billing questions
How is this code distinguished from 64893?
Both describe a single-strand graft for an arm or leg nerve. Use 64892 for a graft under 4 cm and 64893 for a graft over 4 cm.
When would 64897 be more appropriate?
64897 describes a multiple-strand graft for an arm or leg under 4 cm. This code is for a single strand.
Is obtaining the donor graft separately reportable?
Obtaining the graft is included in this service; do not separately report the graft-harvesting work as part of the same graft service.
Can modifier 50 be used for bilateral grafting?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
What documentation supports this code?
Document the arm or leg nerve treated, the nerve defect requiring a graft, the single-strand configuration, and graft length under 4 cm.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the 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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