CPT 64892 Nerve Graft Reimbursement | OpenPayer

Summary & Overview

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

CPT code 64892 denotes surgical repair of a peripheral nerve in an arm or leg using a single-strand nerve graft up to 4 cm in length. This procedure is relevant for trauma, reconstructive, and peripheral nerve repair cases and matters nationally because it captures resource use and clinical complexity associated with microsurgical nerve reconstruction. Proper coding affects procedural tracking, clinical outcome measurement, and payer coverage determinations across major insurers.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coding intent and clinical context, typical sites of service, and the common payer landscape. The publication highlights benchmarks and policy-relevant points readers should consider when evaluating coverage and billing for peripheral nerve grafting procedures.

The content provides clinical context for use of CPT code 64892, summarizes what payers typically consider when adjudicating claims for surgical nerve grafts, and points to areas where documentation and procedure detail most influence coding and reimbursement decisions. Data not available in the input for specific payor rates, coverage policies, or associated ICD-10 diagnoses is noted where appropriate.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare64892CPTnerve graftperipheral nerve repairupper extremitylower extremitysurgical proceduremicrosurgery

Billing Code Overview

CPT code 64892 describes a surgical procedure in which a single-strand nerve graft (a portion of an unrelated donor nerve) is used to bridge or repair an injured peripheral nerve of an arm or leg. The graft length addressed by this code is up to 4 cm.

Service type: Surgical nerve grafting for peripheral nerve repair
Typical site of service: Hospital operating room or outpatient surgical center for upper or lower extremity nerve reconstruction

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 34-year-old male sustains a sharp laceration to the forearm with loss of continuity of the median nerve resulting in motor and sensory deficit in the hand. After initial wound care, nerve stimulation and electrodiagnostic testing demonstrate a focal nerve gap that cannot be repaired primarily without tension. The surgical plan is an outpatient operative nerve reconstruction using a single-strand autograft harvested from an unrelated donor nerve (such as a sural nerve segment) up to 4 cm in length, documented and reported with 64892. The typical workflow includes preoperative assessment in an ambulatory surgery center or hospital outpatient department, regional or general anesthesia with possible nerve block, surgical exposure of the injured nerve, measurement of the defect, harvest and preparation of the graft, microsurgical coaptation with fine sutures under magnification, wound closure, and postoperative immobilization and hand therapy. Typical site of service is an ambulatory surgery center or hospital outpatient surgical suite. Typical patient scenario includes traumatic nerve transection in the arm or leg with a short graft requirement (≤4 cm) where a single-strand nerve graft is indicated to bridge the defect to restore continuity and permit regeneration.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or complexity substantially greater than typical for is documented.

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

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

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

CPT-64912-NERVE-GRAFT-REPAIR-FIRST-STRAND

CPT 64912: Nerve Graft Repair Using Donor Nerve, First Strand

CPT-64895-MULTIPLE-STRAND-NERVE-GRAFT-HAND-FOOT-UP-TO-4CM

CPT 64895: Multiple Strand Nerve Graft for Hand or Foot (Up to 4 cm)

CPT-64890-NERVE-GRAFT-RECONSTRUCTION-HAND-FOOT

CPT 64890: Peripheral Nerve Graft for Hand or Foot

CPT-64898-MULTIPLE-STRAND-NERVE-GRAFT-PERIPHERAL-NERVE-REPAIR

CPT 64898: Multiple Strand Nerve Graft for Peripheral Nerve Repair

CPT-64902-SECONDARY-MULTIPLE-STRAND-NERVE-GRAFT-REPAIR

CPT 64902: Secondary Multiple-Strand Nerve Graft Repair

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

CPT 64905: Nerve Transfer for Peripheral Nerve Reconstruction

CPT-64907-NERVE-TRANSFER-REVERSAL-AFTER-RESTORATION

CPT 64907: Reversal of Prior Nerve Transfer After Nerve Restoration

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

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

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64892

Taxonomy Code	Specialty	Notes
2080S0105X	Hand Surgery	Hand surgeons commonly perform upper extremity peripheral nerve grafting.
207L00000X	Orthopedic Surgery	Orthopedic surgeons with peripheral nerve expertise perform limb nerve repairs.
2084P0801X	Plastic and Reconstructive Surgery	Microsurgical nerve repair and grafting are frequently performed by plastic surgeons.
2086S0205X	Neurological Surgery	Peripheral nerve surgery may be performed by neurosurgeons with peripheral nerve focus.
363LF0000X	Physical Medicine & Rehabilitation	PM&R physicians coordinate postoperative rehabilitation but do not perform the grafting.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S54.121A`	Laceration of ulnar nerve at forearm level, initial encounter	Direct traumatic nerve laceration requiring repair or grafting in the arm.
`S64.121A`	Laceration of radial nerve at forearm level, initial encounter	Radial nerve injuries in the forearm may require grafting when primary repair is not possible.
`S54.111A`	Laceration of median nerve at forearm level, initial encounter	Median nerve transections producing functional deficit appropriate for nerve grafting.
`S78.101A`	Laceration without foreign body of femoral nerve region, initial encounter	Major lower extremity nerve lacerations that may need autograft bridging.
`G56.0`	Carpal tunnel syndrome	Chronic compressive neuropathy generally treated without grafting, listed here for differential but not a typical indication for `64892`.
`S54.821A`	Traumatic amputation of forearm, initial encounter	Complex traumatic injuries may include nerve gaps requiring grafts as part of reconstruction.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64892`	Single strand nerve graft, arm or leg, up to 4 cm in length	Primary code describing the single-strand autograft procedure for a short peripheral nerve defect.
`69990`	Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)	Often reported in conjunction with `64892` when an operating microscope is used for microsurgical coaptation.
`25075`	Nerve repair; digital nerve, with or without graft (example local repair)	Alternative or adjunct nerve repair codes for small distal nerves; may be performed in the same anatomic region depending on injury.
`64450`	Injection, therapeutic, of other peripheral nerve or branch (e.g., for regional block)	Used preoperatively for regional anesthesia when a peripheral nerve block is performed as part of the anesthetic plan.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., diagnostic for associated joint injury)	May be performed in the same episode if joint evaluation or injection is needed in associated trauma.

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