CPT 64897 Multiple Strand Nerve Graft Reimbursement | OpenPayer

Summary & Overview

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

CPT code 64897 denotes a multiple strand nerve graft procedure used to repair a damaged nerve in an arm or leg, with individual grafts up to 4 cm in length. This surgical code captures a specialized peripheral nerve reconstruction technique that can influence surgical resource use, facility planning, and post-operative rehabilitation needs. Nationally, accurate coding for nerve grafting is important for case classification, payment integrity, and tracking utilization of reconstructive nerve surgeries.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes how CPT code 64897 is billed across typical surgical settings and what operational and clinical contexts it represents.

Readers will learn: a concise clinical description of the procedure; typical sites of service and service type; common administrative considerations tied to this code; and what data elements are available versus not provided. The report also outlines benchmarking and policy-relevant implications for payers and providers, and highlights areas where supplemental documentation and coding specificity affect claims processing. Data not available in the input is noted where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 64897peripheral nerve repairnerve graftingsurgical proceduresorthopedic surgeryambulatory surgeryhospital services

Billing Code Overview

CPT code 64897 describes a surgical multiple strand nerve graft procedure to repair a damaged nerve in an arm or leg. The technique involves using one or more graft strands to span the injured nerve segment, with graft material sized up to 4 cm in length.

Service type: Surgical nerve repair / peripheral nerve grafting

Typical site of service: Hospital operating room or ambulatory surgery center, performed by a surgical specialist such as a peripheral nerve or orthopedic surgeon.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 35–55-year-old adult who sustained a traumatic laceration to the forearm or lower leg with transection of a peripheral motor or sensory nerve (for example, the median nerve in the forearm or the tibial nerve in the calf). The patient presents to the emergency department or surgical clinic with sensory loss, motor deficit, and electrodiagnostic or ultrasound findings consistent with a segmental nerve defect. After initial wound care, imaging, and assessment of the gap length, the surgeon plans an operative repair using a multiple-strand nerve graft technique with autograft or processed allograft material sized up to 4 cm in total graft length. The procedure is performed in an operating room or ambulatory surgical center under general or regional anesthesia. Intraoperative steps include exploration of the nerve injury, resection of devitalized nerve ends to healthy fascicles, preparation of multiple small-caliber nerve graft strands, coaptation of graft strands to proximal and distal nerve stumps with microsurgical technique, and layered wound closure. Postoperative workflow includes standard PACU recovery, outpatient wound checks, referral to hand therapy or physical therapy for rehabilitation, and periodic clinical and electrodiagnostic follow-up to monitor reinnervation and function recovery.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the work required to perform the nerve graft is substantially greater than typical (extensive dissection, dense scar, infected field) and documentation supports additional work.

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

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-64885-NERVE-GRAFT-HEAD-NECK

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

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

CPT 64901: Additional Single-Strand Nerve Graft Repair

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

CPT 64905: Nerve Transfer for Peripheral Nerve Reconstruction

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

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

CPT-64911-AUTOGENOUS-VEIN-NERVE-GRAFT-REPAIR

CPT 64911: Nerve Repair with Autogenous Vein Graft

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

CPT 64902: Secondary Multiple-Strand Nerve Graft Repair

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

CPT 64907: Reversal of Prior Nerve Transfer After Nerve Restoration

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Taxonomy Code	Specialty	Notes
207L00000X	Orthopaedic Surgery	Orthopedic surgeons commonly manage traumatic extremity nerve injuries and perform nerve repairs.
2080P0108X	Plastic Surgery	Plastic/microsurgeons often perform microsurgical nerve grafting and complex soft tissue reconstruction.
207R00000X	Hand Surgery	Hand surgeons specialize in peripheral nerve repairs in the upper extremity and coordinate therapy.
2084P0800X	Peripheral Nerve Surgery	Specialists focused on peripheral nerve reconstruction and advanced grafting techniques.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S54.1X1A`	Laceration of radial nerve at forearm level, initial encounter	Radial nerve laceration with gap requiring grafting in the forearm is a common upper-extremity indication.
`S64.2X1A`	Laceration of ulnar nerve at forearm level, initial encounter	Ulnar nerve transection with motor and sensory loss often requires nerve graft reconstruction.
`S54.5X1A`	Laceration of median nerve at forearm level, initial encounter	Median nerve injuries in the forearm causing significant functional deficit are repaired with nerve grafts when direct repair is not possible.
`S84.1X1A`	Laceration of sciatic nerve at thigh level, initial encounter	Major lower-extremity nerve lacerations with segmental loss may be managed with grafting techniques.
`T79.A1XA`	Traumatic amputation of limb partial, initial encounter	Peripheral nerve reconstruction may be needed as part of limb salvage or reconstruction efforts.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64897`	Repair, multiple strand nerve graft, arm or leg; size up to 4 cm	Primary procedure for segmental peripheral nerve reconstruction with multiple strand grafting up to 4 cm.
`64895`	Repair, single strand nerve graft, arm or leg; size up to 4 cm	Alternative technique when a single larger-caliber graft is used instead of multiple strands.
`64899`	Unlisted procedure, nerve	Use for nerve repair techniques or graft lengths not described by specific CPT codes; may support billing when unique techniques are used.
`69990`	Microsurgical techniques, requiring use of an operating microscope (list separately in addition to code for primary procedure)	Often billed in conjunction when operative microscope is used for nerve coaptation and fascicular repair.
`97605`	Negative pressure wound therapy (wound therapy)	May be performed pre- or postoperatively for complex soft tissue wounds associated with nerve injury (when clinically indicated).

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