2025 CPT code 64857

Surgical repair of a major peripheral nerve in the arm or leg (excluding the sciatic nerve) using sutures, without nerve transposition.

Adhere to the official CPT coding guidelines for surgical procedures and nerve repairs.Appropriate modifiers may need to be added depending on the circumstances of the procedure (e.g., multiple procedures, assistant surgeon).

Modifiers such as 51 (multiple procedures), 59 (distinct procedural service), 80 (assistant surgeon), and others may be applicable depending on the specific circumstances of the case.Careful consideration of the official CPT guidelines is required to ensure appropriate modifier use.

The medical necessity for this procedure is established by the presence of a clinically significant peripheral nerve injury that impairs sensory or motor function and causes symptoms such as pain, numbness, weakness, or paralysis.The repair is deemed medically necessary to restore function and alleviate symptoms.The extent of injury and the resulting functional deficit must be documented to justify medical necessity.

The surgeon is responsible for performing the entire procedure, including incision, nerve exposure, preparation, suturing, and wound closure.Anesthesiology services may be provided by a separate provider.Post-operative care and follow up is also a clinical responsibility.

IMPORTANT If nerve transposition is performed, code 64856 should be used instead.Code 64859 is used for each additional major peripheral nerve sutured. Codes 64872, 64874, and 64876 address more complex nerve repairs requiring secondary sutures, extensive mobilization, or bone shortening, respectively.

In simple words: The doctor repairs a damaged major nerve in your arm or leg (not the sciatic nerve) by carefully stitching it back together.

This procedure involves the surgical repair of a damaged major peripheral nerve in the arm or leg, excluding the sciatic nerve.The surgeon makes an incision to expose the injured nerve, carefully cleans the damaged nerve ends, aligns them precisely, and then uses fine sutures to connect the nerve ends.The procedure is performed without transposition (relocating the nerve). The wound is then closed.

Example 1: A patient presents with a deep laceration to the forearm resulting in a transected median nerve.The surgeon performs a neurorrhaphy of the median nerve using code 64857., During a motorcycle accident, a patient sustains a complete transection of the radial nerve at the elbow.Repair is accomplished using 64857., A patient presents with a partial laceration to the ulnar nerve near the wrist after being injured by a sharp object. The surgeon meticulously repairs the ulnar nerve using microsurgical techniques, documenting the repair with code 64857.

Detailed operative report outlining the surgical approach, nerve identification, preparation of nerve ends, suturing technique, and wound closure. Preoperative and postoperative diagnoses and imaging studies (e.g., nerve conduction studies, MRI) demonstrating the nerve injury and its repair.Any relevant pathology reports.

** The use of a microscope may be indicated in some cases.The documentation should clearly specify the location and extent of the nerve injury, the type of repair performed, and the postoperative outcome.

  • Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
  • RVU: This information is not available in the provided source.Consult the most recent CPT codebook or your payer's fee schedule for RVU values.
  • Global Days : This information is not available in the provided source.The global period will vary based on payer policies and the complexity of the procedure.
  • Payment Status: Active
  • Modifier TC rule: This information is not available in the provided source.Consult the most recent CPT codebook or your payer's fee schedule for information regarding the application of technical component modifiers.
  • Fee Schedule : This information is not available in the provided source. Historical fee schedule data will vary by payer and geographical location.
  • Specialties:Orthopedic Surgery, Neurosurgery, Plastic Surgery, Hand Surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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