Summary & Overview
CPT 64784: Peripheral Nerve Tumor Excision, Non-Sciatic
CPT code 64784 represents surgical removal of a tumor or mass from one of the seven major peripheral nerves (excluding the sciatic nerve) to relieve pain and restore nerve function lost from a neuroma after injury or trauma. This code captures a targeted peripheral nerve surgical service that has implications for surgical specialty billing, facility utilization, and post-operative care pathways nationally. Clarity on coding for peripheral nerve tumor excision matters for appropriate reimbursement, accurate claims reporting, and clinical documentation that supports medical necessity.
Key payers considered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the procedure and service setting, common claim modifiers reported with the code, and guidance on where to locate supporting documentation and diagnosis linkage. The summary highlights clinical context relevant to neuroma management and the typical operative environments—ambulatory surgery centers and hospital operating rooms—where this service is delivered.
This publication provides benchmarks and policy-relevant information useful for coding professionals, surgical practices, and revenue cycle staff seeking a national perspective on billing for peripheral nerve tumor excision. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 64784 describes surgical excision of a tumor or mass from one of the seven major peripheral nerves of the body other than the sciatic nerve. The procedure is typically performed to relieve pain and restore nerve function that has been lost due to a neuroma caused by injury or trauma.
-
Service type: Surgical procedure, peripheral nerve tumor excision
-
Typical site of service: Operative setting such as an ambulatory surgery center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to an outpatient peripheral nerve surgery clinic with a painful, palpable mass along the course of the ulnar nerve at the elbow following a prior traumatic laceration. The patient reports burning neuropathic pain, numbness in the ulnar distribution, and progressive motor weakness in the intrinsic hand muscles. Physical exam demonstrates Tinel sign over the mass and decreased two-point discrimination. Imaging with ultrasound and MRI demonstrates a localized neuroma/mechanical mass on a major peripheral nerve (non-sciatic).
Preoperative workflow includes history and physical, informed consent documenting risks/benefits, nerve conduction studies if indicated, and surgical scheduling as an ambulatory or outpatient hospital procedure depending on complexity and facility. Intraoperative steps involve exploration of the affected peripheral nerve, microsurgical excision of the neuroma or mass with preservation or repair of viable nerve fascicles, and possible intraoperative nerve repair or grafting if required. Postoperative care includes wound care, pain control, documentation of repair or resection, and outpatient follow-up with physical therapy and sensory motor assessments to document functional recovery and any persistent deficits.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician's professional component if technical component billed separately by facility. |