CPT 64774 Nerve Tumor Excision Reimbursement | OpenPayer

Summary & Overview

CPT 64774: Excision of Tumor from Mixed Peripheral Nerve

CPT code 64774 denotes surgical excision of a tumor or mass originating from a mixed peripheral nerve that supplies a cutaneous region. This operative code covers procedures to remove nerve-based growths that can follow trauma, amputation, or prior surgery. Nationally, accurate use of this code is important for appropriate surgical claims, consistent clinical documentation, and proper classification of nerve tumor procedures within surgical specialties.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a focused examination of clinical context for 64774, typical sites of service, and common billing considerations. The publication summarizes benchmarks where available, clarifies coding scope and procedure intent, and outlines policy and coverage themes relevant to payers and providers.

The report is intended for a national audience of surgeons, billing professionals, and payer policy staff. It provides concise clinical context for when 64774 applies, what settings are typical, and what documentation elements support correct reporting. Data not available in the input is identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare64774CPTnerve tumorperipheral nerve surgerysurgical excisionoutpatient surgeryoperative coding

Billing Code Overview

CPT code 64774 describes surgical removal of a tumor or mass arising from a peripheral nerve that supplies a region of skin. The procedure addresses growths on a mixed peripheral nerve that may result from trauma, amputation, or prior surgery.

Service type: Surgical excision of a peripheral nerve mass (neuroplasty/nerve tumor resection)
Typical site of service: Outpatient surgical suite or hospital operating room, depending on complexity and patient needs.

Clinical & Coding Specifications

Clinical Context

A 48-year-old male presents with a progressively enlarging, painful subcutaneous mass along the course of the superficial branch of a mixed peripheral nerve in the forearm following a prior traumatic laceration six months earlier. Examination demonstrates a 1.5–2.5 cm tender, mobile mass with intermittent paresthesia in the dermatome supplied by the affected nerve. Imaging with ultrasound or MRI suggests a well-circumscribed nerve sheath tumor adherent to the nerve fascicles. After preoperative evaluation and informed consent, the patient is scheduled for operative excision of the nerve-associated tumor under general anesthesia. Intraoperative steps include exposure of the affected nerve, microscopic dissection to separate tumor from functioning fascicles, removal of the mass (neurogenic tumor or neuroma), hemostasis, and layered closure. Postoperative workflow includes recovery monitoring, pain management, wound care instructions, and outpatient follow-up for neurologic assessment and pathology review. Typical site of service is an ambulatory surgery center or hospital operating room. Service type is operative peripheral nerve tumor excision of a mixed peripheral nerve supplying cutaneous sensation, consistent with 64774.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when intraoperative complexity (extensive dissection, prolonged time) significantly exceeds typical for .

CPT 64792: Excision of Extensive Nerve Sheath Tumor

CPT-64788-EXCISION-SUBCUTANEOUS-TUMOR-CUTANEOUS-NERVE

CPT 64788: Excision of Subcutaneous Tumor Along Cutaneous Nerve

CPT-64783-PERIPHERAL-NERVE-NEUROMA-EXCISION-HAND-FOOT-ADDITIONAL

CPT 64783: Additional Peripheral Nerve Neuroma Excision of Hand or Foot

CPT-64786-SCIATIC-NERVE-TUMOR-EXCISION

CPT 64786: Sciatic Nerve Tumor Excision

CPT-64776-DIGITAL-NERVE-TUMOR-EXCISION-FINGER-TOE

CPT 64776: Excision of Tumor or Mass on Digital Nerve (Finger/Toe)

CPT-64787-NERVE-END-IMPLANTATION-AFTER-NEUROMA-EXCISION

CPT 64787: Nerve End Implantation After Neuroma Excision

CPT-64795-NERVE-BIOPSY-NERVE-SAMPLE-EXCISION

CPT 64795: Nerve Biopsy, Excision of Nerve Sample

CPT-64782-PERIPHERAL-NERVE-TUMOR-EXCISION-HAND-FOOT

CPT 64782: Excision of Peripheral Nerve Tumor, Hand or Foot

CPT-64790-PERIPHERAL-NERVE-SHEATH-TUMOR-EXCISION

CPT 64790: Excision of Peripheral Nerve Sheath Tumor

CPT-64778-PERIPHERAL-NERVE-TUMOR-EXCISION-ADDITIONAL-DIGIT

CPT 64778: Excision of Additional Peripheral Nerve Tumor in Finger or Toe

Showing 1–10 of 11

64774

Taxonomy Code	Specialty	Notes
`207P00000X`	Plastic Surgery	Performs soft tissue and peripheral nerve tumor excisions in extremities and reconstructive closure.
`2084P0800X`	Hand Surgery	Manages peripheral nerve tumors of the upper extremity with microsurgical technique.
`2086S0122X`	Orthopedic Surgery of the Hand	Performs nerve tumor excision when musculoskeletal involvement exists.
`208800000X`	Neurological Surgery	Manages complex peripheral nerve tumors, nerve sheath tumors, or lesions involving major mixed nerves.
`363L00000X`	Wound Care/Hyperbaric (Ancillary)	Involved when advanced wound management is required postoperatively.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G56.01`	Carpal tunnel syndrome, right upper limb	Compression neuropathy may coexist with nerve sheath lesions affecting sensory distribution addressed by `64774`.
`G56.02`	Carpal tunnel syndrome, left upper limb	As above for the contralateral limb when bilateral symptoms or procedures occur.
`G57.0`	Sciatic nerve disorder	Peripheral nerve tumors or traumatic neuromas of major mixed nerves like the sciatic may present similarly and require excision.
`G56.3`	Lesion of ulnar nerve	Ulnar nerve lesions, including neuroma or tumor, are common indications for peripheral nerve tumor excision.
`M79.2`	Neuralgia and neuritis, unspecified	Symptom code used when neuralgic pain from a nerve tumor is the primary presenting complaint.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29848`	Endoscopic carpal tunnel release	Performed when median nerve decompression is indicated in the same operative episode for compressive neuropathy.
`64718`	Neuroplasty and/or transposition; major peripheral nerve (e.g., ulnar nerve at elbow)	Performed when concomitant neuroplasty or transposition is required after tumor excision to restore nerve alignment.
`64450`	Injection, anesthetic agent; other peripheral nerve or branch	Performed preoperatively for diagnostic or therapeutic nerve block or intraoperative anesthetic infiltration.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder)	Performed if adjacent joint evaluation or injection is required in the same setting (less common).
`11042`	Debridement, subcutaneous tissue (skin, subcutaneous tissue and muscle)	Performed when tumor excision necessitates debridement of surrounding infected or necrotic tissue.

OpenPayer