CPT 64792 Nerve Sheath Tumor Excision Reimbursement | OpenPayer

Summary & Overview

CPT 64792: Excision of Extensive Nerve Sheath Tumor

CPT code 64792 denotes surgical excision of an extensive benign or malignant tumor originating in the nerve sheath. Nationally, this code captures complex peripheral nerve tumor procedures that carry clinical importance due to potential neurologic impact and the need for specialized surgical skills. The code is used across hospital-based surgical settings and ambulatory surgical centers where complex nerve-preserving resections are performed.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of clinical context for CPT code 64792, typical sites of service, and which payers commonly reimburse for this service. The publication outlines relevant benchmarks and billing considerations, highlights typical procedural settings, and summarizes policy-related issues affecting coverage and coding for extensive nerve sheath tumor excisions.

This summary is intended to orient clinicians, coders, and policy professionals to the clinical and billing significance of CPT code 64792 and to indicate what additional operational and reimbursement details are available in the full publication.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 64792nerve sheath tumorperipheral nerve surgerysurgical oncologyoperative procedurehospital outpatient surgeryambulatory surgery centerprocedure coding

Billing Code Overview

CPT code 64792 describes excision of an extensive benign or malignant tumor arising from the nerve sheath of a nerve. This procedure represents surgical removal of a tumor that is growing along or within the nerve sheath, typically requiring delicate dissection to preserve nerve function when possible.

Service type: Surgical excision of nerve sheath tumor
Typical site of service: Operating room or surgical suite, commonly performed by surgical specialists such as neurosurgeons or peripheral nerve surgeons

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 48-year-old patient presents with progressive focal pain, numbness, and motor weakness along the distribution of a peripheral nerve in the forearm. Imaging (MRI) demonstrates a well-circumscribed enhancing mass consistent with a nerve sheath tumor measuring several centimeters along the nerve course. The patient is referred to a peripheral nerve surgeon or neurosurgeon for excision. Preoperative workflow includes history and physical, focused neurological exam, nerve conduction studies or EMG as indicated, MRI with contrast to define the extent, informed consent discussing risks (nerve injury, sensory/motor deficit), and planning for intraoperative nerve monitoring when feasible. The procedure is typically performed in an operating room or ambulatory surgery center under general or regional anesthesia. The surgeon exposes the nerve, identifies the tumor along the nerve sheath, performs microsurgical dissection to excise the extensive benign or malignant lesion while attempting to preserve functional fascicles, and, if necessary, performs nerve repair or grafting. Postoperative care includes neurologic checks, pain control, wound care, and referral for oncology or radiation if malignant pathology is confirmed. Typical site of service: hospital outpatient surgical unit, inpatient operating room, or ambulatory surgery center. Service type: operative peripheral nerve tumor excision as a surgical procedure under general or regional anesthesia.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

CPT 64788: Excision of Subcutaneous Tumor Along Cutaneous Nerve

CPT-64786-SCIATIC-NERVE-TUMOR-EXCISION

CPT 64786: Sciatic Nerve Tumor Excision

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

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

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

CPT 64795: Nerve Biopsy, Excision of Nerve Sample

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

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

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

CPT 64790: Excision of Peripheral Nerve Sheath Tumor

CPT-64774-NERVE-TUMOR-EXCISION-PERIPHERAL-NERVE

CPT 64774: Excision of Tumor from Mixed Peripheral Nerve

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

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

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Taxonomy Code	Specialty	Notes
`2084P0805X`	Neurological Surgery	Neurosurgeons frequently perform peripheral nerve tumor excisions, especially for complex lesions involving proximal nerves.
`207T00000X`	Orthopedic Surgery of the Hand	Hand/upper-extremity surgeons manage nerve sheath tumors in the upper extremity and perform microsurgical excisions.
`207L00000X`	Plastic Surgery	Plastic surgeons with peripheral nerve expertise perform reconstruction and nerve grafting when needed.
`2080P0220X`	General Surgery	General surgeons may perform peripheral nerve tumor excision in certain anatomic locations (e.g., trunk), often for benign lesions.
`208D00000X`	Physical Medicine & Rehabilitation	Not a primary operative taxonomy but commonly involved in perioperative rehabilitation planning; included for care context.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D36.1`	Benign neoplasm of peripheral nerves and autonomic nervous system	Common code for benign nerve sheath tumors (e.g., schwannoma) that are indications for `64792` when extensive.
`C47.1`	Malignant neoplasm of peripheral nerves of upper limb, including shoulder	Malignant peripheral nerve sheath tumors requiring extensive excision with `64792` when present in the upper extremity.
`C47.2`	Malignant neoplasm of peripheral nerves of lower limb, including hip	Malignant nerve sheath tumors in the lower extremity that may require extensive surgical excision.
`D36.2`	Benign neoplasm of peripheral nerves of autonomic nervous system, unspecified	Alternative benign nerve tumor coding when specific site not documented.
`M79.2`	Neuralgia and neuritis, unspecified	Related symptom code for nerve pain that often prompts evaluation leading to diagnosis and excision of nerve sheath tumor.
`G56.0`	Carpal tunnel syndrome	Included when a nerve sheath lesion causes median nerve compression and combined decompression or excision is performed.
`G55.9`	Nerve root and plexus compressive disease, unspecified	Relevant when tumor involves plexus or nerve root causing compressive neuropathy requiring surgical management.
`C47.9`	Malignant neoplasm of peripheral nerve, unspecified	Use when malignant nerve sheath tumor is present but precise anatomic site is not specified.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64792`	Excision of tumor of nerve sheath (extensive)	Primary procedure for excision of an extensive benign or malignant nerve sheath tumor; defines the operative service.
`61618`	Craniectomy for resection or ablation of intracranial lesion, with or without repair—when tumor involves cranial nerve roots (example)	Performed when nerve sheath tumor involves cranial nerve origins requiring intracranial exposure; related in complex cases.
`20680`	Removal of deep implant; e.g., nerve stimulator leads or hardware when present	May be needed if prior hardware or implanted leads interfere with access to the nerve sheath tumor.
`69990`	Microsurgical techniques, requiring use of operating microscope	Often reported when an operating microscope is required for the microsurgical dissection of nerve fascicles during `64792`.
`64450`	Injection, anesthetic agent; anesthetic block of peripheral nerve or branch (e.g., brachial plexus)	May be performed preoperatively or intraoperatively for regional anesthesia or postoperative pain control adjunct to `64792`.
`64856`	Neuroplasty and/or transposition; median nerve at carpal tunnel (when concurrent nerve decompression is needed)	Reported when concomitant nerve decompression or neuroplasty is performed at the same operative session along with tumor excision.

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