No office rate
This code is for a digital nerve in the hand or foot. Code 64774 applies to a neuroma of a surgically identifiable cutaneous nerve.
On this page
CMS RVU26D · Effective 2026-10-01
64776 Neuroma excision Medicare reimbursement rates in Wyoming
Reports surgical excision of a neuroma involving a digital nerve in the hand or foot, typically to treat persistent focal nerve pain. Compare 64776 office and facility rates across CMS payment localities in Wyoming.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 64776 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$366.52
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Peripheral nerve surgery
About 64776: Digital nerve neuroma excision
Reports surgical excision of a neuroma involving a digital nerve in the hand or foot, typically to treat persistent focal nerve pain.
A surgeon excises a neuroma arising from a digital nerve in a finger or toe, commonly to address persistent, localized pain after nerve injury or prior surgery. The procedure may be performed by a hand, orthopedic, plastic, or foot surgeon in an operating room or ambulatory surgery setting. The operative record should identify the affected digit and nerve and describe the neuroma and its excision.
Choose this code for a digital nerve neuroma, rather than a lesion of a cutaneous or larger peripheral nerve. If additional digital nerves are excised in the same operative session, the separate add-on code is available for each additional nerve. Medicare assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 64776
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.46 · 49%
- Practice expense (office) RVU4.84 · 43%
- Malpractice RVU0.91 · 8%
308
Medicare services in 2024 · #3976 by national volume
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.
64776 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Code 64776 reports the primary digital nerve neuroma excision; 64778 is the add-on for each additional digital nerve excised.
No office rate
Use 64782 for a neuroma involving a major peripheral nerve, rather than a digital nerve in a finger or toe.
Compare 64776 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
Unavailable
Facility
$366.52
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 64776 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,230
- Code
- 64776
- Physician work
- 5.46
- Practice expense
- 4.84
- Malpractice
- 0.91
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.46 | × 1.000 | 5.4600 |
| Practice expense | 4.84 | × 1.000 | 4.8400 |
| Malpractice | 0.91 | × 0.740 | 0.6734 |
| Total RVUs | 10.9734 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$366.52
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.46 | 1 |
| Practice expense | 4.84 | 1 |
| Malpractice | 0.91 | 0.74 |
(5.46 × 1 + 4.84 × 1 + 0.91 × 0.74) × $33.4009 = $366.52
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
64776 billing questions
When should this code be selected instead of a cutaneous nerve neuroma code?
Use this code when the excised neuroma involves a digital nerve in the hand or foot. A neuroma of a surgically identifiable cutaneous nerve is represented by a different code.
How is excision of another digital nerve reported?
Code 64778 is the add-on for each additional digital nerve excised. The operative documentation should identify the additional nerve or digit treated.
Can modifier 50 be used when neuromas are excised on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the procedures according to the nerves and services documented, subject to applicable claim instructions.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is an assistant surgeon payable?
Assistant-at-surgery payment is available only when medical necessity is documented. CMS does not permit co-surgeon or team-surgery payment for this code.
How does Medicare handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,22764771,,Sever cranial nerve,A,,7.95,7.31,NA,7.31,,1.47,16.73,16.73,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,22864772,,Incision of spinal nerve,A,,7.64,6.39,NA,6.39,,1.43,15.46,15.46,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,22964774,,Remove skin nerve lesion,A,,5.66,5.48,NA,5.48,,1.19,12.33,12.33,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,23064776,,Remove digit nerve lesion,A,,5.46,4.84,NA,4.84,,0.91,11.21,11.21,0,090,0.11,0.76,0.13,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,23164778,,Digit nerve surgery add-on,A,,3.03,0.97,NA,0.97,,0.64,4.64,4.64,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,23264782,,Remove limb nerve lesion,A,,6.69,5.31,NA,5.31,,1.06,13.06,13.06,0,090,0.11,0.76,0.13,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,23364783,,Limb nerve surgery add-on,A,,3.62,1.15,NA,1.15,,0.78,5.55,5.55,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,