Billing code 64897: Nerve graftMedicare rate & RVUs in Washington
Reports placement of a short, multiple-strand nerve graft to bridge a peripheral nerve defect in an arm or leg, outside the hand or foot.
CMS doesn’t publish an office rate for 64897 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 64897 covers
A surgeon uses multiple strands of nerve graft to bridge a defect in a peripheral nerve in the arm or leg. This may follow traumatic nerve injury or removal of damaged nerve tissue when the remaining ends cannot be joined directly. Peripheral nerve, hand, plastic, orthopedic, or neurosurgeons may perform the reconstruction, typically in a hospital or ambulatory surgical setting. The graft length for this code is under 4 cm; hand and foot sites have separate codes in this family.
Choose the code based on the recipient site, number of graft strands, and graft length. The operative report should identify the arm or leg nerve reconstructed, document use of multiple strands, and support a graft length under 4 cm. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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 64897 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,137.69 |
| Seattle (King Cnty) | Unavailable | $1,234.01 |
How the 64897 rate is calculated
Each of 64897’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 · 64897
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 18.90Practice expense 11.26Malpractice 4.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 64897
64897 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64897
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 · 64897
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
64897 without 51 · national facility
$1,141.64
Nerve graft
64897-51 · Second procedure: 50%
$570.82
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%).
64897 compared with similar codes
Compare codes
64897 vs 64898 vs 64892 vs 64895 vs 64893: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 64898Nerve graft
- Both describe multiple-strand grafting in an arm or leg; select 64898 when the graft length is over 4 cm rather than under 4 cm.
- 64892Nerve graft
- This code covers a single-strand graft in an arm or leg under 4 cm. Use 64897 when multiple strands are used.
- 64895Nerve graft
- Both describe multiple-strand grafts under 4 cm, but 64895 is for a hand or foot site; 64897 is for an arm or leg site.
- 64893Nerve graft
- This code is for a single-strand graft in an arm or leg over 4 cm; 64897 is for multiple strands under 4 cm.
64897 billing questions
How does this differ from a single-strand nerve graft code?
This code is for multiple graft strands in an arm or leg, with graft length under 4 cm. A single-strand graft uses a different code in the same family.
When should the longer-length sibling be used?
Use the longer-length code when the documented graft length is over 4 cm. The operative report should support the length used to select the code.
Should modifier 50 be appended for grafts on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used for bilateral reporting.
What documentation supports reporting multiple strands?
The operative report should describe the nerve and arm or leg site reconstructed, the use of multiple graft strands, and a graft length under 4 cm.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment 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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