CPT 64885 Nerve Graft Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 64885: Nerve Graft for Head or Neck, Up to 4 cm

CPT code 64885 represents a surgical nerve graft procedure using a healthy nerve segment up to 4 cm to replace damaged nerve in the head or neck, restoring sensory and/or motor function after injury. This code is clinically important for trauma, reconstructive, and head and neck surgical practices and has implications for surgical resource use, post-operative rehabilitation, and durable medical equipment needs.

Key payers included in the coverage discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national-level overview of the code’s clinical context, typical sites of service, and the procedural scope. The publication summarizes benchmarking metrics where available, highlights relevant policy and coding guidance that affect billing and coverage decisions, and outlines the clinical scenarios in which the procedure is commonly applied.

The content is designed to inform billing managers, surgical providers, and policy analysts about the procedural definition, expected care setting, and payer landscape for CPT code 64885. Data not provided in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare64885CPTnerve graftperipheral nerve repairhead and neck surgerysurgical procedureoperating roomambulatory surgery

Billing Code Overview

CPT code 64885 describes a surgical nerve graft procedure in which a healthy nerve segment up to 4 cm long is used to replace a damaged portion of a nerve in the head or neck. The procedure is intended to restore sensory and/or motor function when nerves are injured or severed due to trauma.

Service type: Surgical nerve grafting / peripheral nerve repair

Typical site of service: Hospital operating room or ambulatory surgery center

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 34-year-old male presents after a facial laceration and partial transection of the infraorbital branch of the trigeminal nerve following a motor vehicle collision. Physical exam demonstrates numbness over the left cheek and decreased sensation of the upper lip. Imaging excludes bony injury. After conservative measures fail to show recovery over several weeks and intraoperative findings confirm a segmental nerve defect of approximately 3 cm, the surgical team performs an autograft nerve repair using a healthy donor sensory nerve segment to bridge the defect in the head and neck.

The clinical workflow includes preoperative evaluation and informed consent, nerve exploration and debridement under general anesthesia, measurement of the gap, harvest of a suitable donor nerve segment (e.g., sural nerve or greater auricular nerve) of up to 4 cm, microsurgical coaptation of graft to proximal and distal stumps, hemostasis and layered closure, and postoperative monitoring for sensory and motor recovery with scheduled follow-up visits and possible referral to occupational/physical therapy for rehabilitation.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician component separate from technical services (rare for this surgical procedure).

CPT 64902: Secondary Multiple-Strand Nerve Graft Repair

CPT-64896-MULTIPLE-STRAND-NERVE-GRAFT-HAND-FOOT

CPT 64896: Multiple Strand Nerve Graft for Hand or Foot Repair

CPT-64905-NERVE-TRANSFER-RECONSTRUCTIVE-PERIPHERAL-NERVE-SURGERY

CPT 64905: Nerve Transfer for Peripheral Nerve Reconstruction

CPT-64910-NERVE-RECONSTRUCTION-WITH-CONDUIT-OR-VEIN-GRAFT

CPT 64910: Nerve Reconstruction Using Conduit or Vein Graft

CPT-64913-NERVE-TISSUE-GRAFT-ADDITIONAL-NERVE-STRAND

CPT 64913: Nerve Tissue Graft, Each Additional Nerve Strand

CPT-64892-NERVE-GRAFT-UP-TO-4CM-UPPER-LOWER-EXTREMITY

CPT 64892: Single-Strand Nerve Graft for Arm or Leg (≤4 cm)

CPT-64886-NERVE-GRAFT-HEAD-NECK-GRAFT-LONGER-THAN-4CM

CPT 64886: Nerve Graft, Head and Neck, Donor Segment >4 cm

CPT-64893-SINGLE-STRAND-NERVE-GRAFT-ARM-LEG-GRAFT-GREATER-THAN-4CM

CPT 64893: Single-Strand Nerve Graft for Arm or Leg (>4 cm)

CPT-64901-ADDITIONAL-SINGLE-STRAND-NERVE-GRAFT-REPAIR

CPT 64901: Additional Single-Strand Nerve Graft Repair

CPT-64897-NERVE-GRAFT-MULTIPLE-STRAND-UPPER-OR-LOWER-EXTREMITY

CPT 64897: Multiple Strand Nerve Graft for Arm or Leg Repair

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Taxonomy Code	Specialty	Notes
2080S0001X	Plastic and Reconstructive Surgery	Microsurgical nerve repair in head/neck performed by plastic surgeons specializing in reconstruction.
2084P0800X	Otolaryngology	Head and neck surgeons repair peripheral facial and trigeminal branches.
207L00000X	Neurological Surgery	Peripheral nerve repair when neurosurgical expertise is required.
208600000X	Oral and Maxillofacial Surgery	Repair of nerves in facial and oral regions during trauma reconstruction.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64885`	Nerve graft, with lower extremity or other autograft up to 4 cm, head and neck area (use when applicable)	Primary procedure: autologous nerve graft to repair a defect up to 4 cm in the head or neck.
`64831`	Repair of traumatic facial nerve, primary or secondary, with nerve graft	Used for facial nerve repairs when grafting is required; may be performed in similar clinical settings for motor nerve reconstruction.
`61618`	Excision or repair of peripheral nerve lesion; trigeminal nerve, intracranial	May be performed when proximal intracranial work is required in conjunction with peripheral grafting.
`66990`	Microsurgical techniques, requiring operating microscope (list separately in addition to primary code)	Reported when operative microscope or microinstruments are used for nerve coaptation during grafting.
`64718`	Neuroplasty and/or transposition; major peripheral nerve	Performed for scar release or neurolysis of adjacent nerve segments during planning for grafting.

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