2025 CPT code 64742
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Neurosurgery - Transection or Avulsion Procedures Surgery Feed
Transection or avulsion of the facial nerve, either partially or completely.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 22 for increased procedural services, 52 for reduced services). Consult the CPT manual for appropriate modifier application.
Medical necessity is established by documenting significant chronic and intractable facial pain refractory to conservative treatment modalities. The procedure should be considered a last resort after other less invasive treatments have failed.
The neurosurgeon or other qualified physician performs the procedure after patient preparation and anesthesia.The surgeon makes the incision, identifies the nerve, performs the transection or avulsion, and closes the incision.
- Surgery
- Surgical Procedures on the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System
In simple words: The doctor cuts or tears a facial nerve to reduce severe facial pain.This is done through a small cut behind the ear. The goal is to lessen the sensation and thus reduce the pain.
This procedure involves the transection (cutting) or avulsion (tearing away) of the facial nerve or its branches.The goal is to alleviate chronic facial pain by reducing nerve sensation.The surgeon makes a post-auricular incision (behind the ear), locates the facial nerve, and then either cuts or tears the nerve or a specific branch. The incision is subsequently closed with sutures.
Example 1: A patient presents with intractable trigeminal neuralgia unresponsive to medical management.The surgeon performs a selective transection of the facial nerve branch contributing to the pain., A patient experiences chronic pain secondary to a facial nerve injury.Partial avulsion of a specific branch is carried out to improve pain and restore function., A patient is diagnosed with hemifacial spasm due to facial nerve hyperactivity.Complete transection of the facial nerve is performed to alleviate the spasms, although this may result in facial weakness.
* Detailed history and physical examination documenting the nature and severity of the pain.* Imaging studies (e.g., MRI, CT) to confirm the diagnosis and rule out other conditions.* Documentation of prior medical treatments and their ineffectiveness.* Operative report detailing the procedure performed, including nerve identification, the method of transection or avulsion, and assessment of the surgical field.* Postoperative course and pain management strategies.
** This procedure carries a risk of facial nerve paralysis.Appropriate informed consent should be obtained from the patient.
- Revenue Code: P5E (Ambulatory Procedures - Other)
- RVU: Refer to the current year's Medicare Physician Fee Schedule for RVU values.These values vary by geographic location and other factors.
- Global Days: The global period for this procedure will vary depending on payer and other circumstances.Consult the appropriate guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable for this procedure.
- Fee Schedule: Refer to historical fee schedules from CMS or other payers. Fee schedules are subject to change.
- Specialties:Neurosurgery, Neurosurgery
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Office