Summary & Overview
CPT 64704: Open Neuroplasty/Nerve Decompression of Hand or Foot
CPT code 64704 represents an open surgical neuroplasty or decompression of a peripheral nerve in the hand or foot, performed to release scar tissue or other compressive structures that cause tension on sensory and motor nerves. Nationally, this code captures an important class of procedures used to address entrapment neuropathies, scar-related pain, and functional impairment in the upper and lower extremities. Utilization and correct coding of 64704 affect surgical billing, payer coverage determinations, and quality measurement for peripheral nerve procedures.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines typical payer handling, common modifiers seen in practice, and clinical context necessary for accurate claim submission and audit readiness.
Readers will learn a concise clinical and billing profile of CPT code 64704, expected sites of service, and how this code is positioned among related operative nerve procedures. The report also summarizes benchmark considerations, documentation elements that support medical necessity, and areas where policy updates or payer-specific edits commonly influence reimbursement. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 64704 describes an open surgical neuroplasty procedure in which a provider incises scar tissue or other constricting structures to relieve tension or compression on a nerve in the hand or foot. The procedure targets both sensory and motor nerves that innervate the dorsal and palmar (or plantar) surfaces of the hand or foot.
Service type: Surgical — open neuroplasty/nerve decompression
Typical site of service: Hospital operating room or ambulatory surgical center, and may also be performed in other appropriate sterile surgical settings for procedures on the hand or foot.
Clinical & Coding Specifications
Clinical Context
A 54-year-old woman presents to an orthopedic hand surgeon with progressive numbness, paresthesia, and intermittent weakness in the ulnar distribution of her right hand over 8 months, refractory to conservative care (splinting, activity modification, and corticosteroid injection). Examination demonstrates decreased two-point discrimination in the small and ring fingers and positive Tinel sign over Guyon canal. Electrodiagnostic testing confirms ulnar nerve entrapment at the wrist. The surgeon schedules an open neurolysis/limited decompression of the ulnar nerve in the wrist/hand under regional block with monitored anesthesia care. The patient is admitted to an ambulatory surgery center; the operative report documents an open incision, release of constricting fibrotic tissue and scar bands, external neurolysis of the ulnar nerve, hemostasis, and layered wound closure. Postoperative workflow includes postoperative pain control, brief monitored recovery, discharge with wound care and activity restrictions, and follow-up for wound check and hand therapy if indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
51 | Multiple procedures | When other distinct procedures are performed during the same operative session in addition to the open neurolysis. |
52 |