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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.

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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.

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

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Get alerted when payer policies referencing 64897 are released or updated.

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Billing Code Overview

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.
`23`	Unusual anesthesia	Use when general anesthesia is medically necessary for a procedure that is normally done with local or regional anesthesia; document reason.
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct portions of the procedure concurrently (for example, orthopedic and plastic microsurgeon collaboration).
`63`	Procedure performed on infants less than 4 kg	Use if the patient is an infant meeting the weight criteria and special considerations apply.
`66`	Surgical team (multiple surgeons)	Use when services are provided using a surgical team model.
`50`	Bilateral procedure	Use when identical nerve grafting is performed on contralateral limbs during the same operative session.
`52`	Reduced services	Use when the full extent of the described procedure is not performed (document reason and extent).
`53`	Discontinued procedure	Use when the procedure is started but discontinued for patient-related or intraoperative reasons; document reason.
`59`	Distinct procedural service	Use to indicate a separate, independent procedure not normally reported together when performed at a separate anatomic site or distinct session (support with operative note).
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later during the postoperative period.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure during the postoperative period.
`78`	Unplanned return to the OR for a related procedure during the postoperative period	Use when a return to OR occurs for complications related to the original nerve graft.
`79`	Unrelated procedure or service by same physician during postoperative period	Use when an unrelated procedure is performed during the global period.
`LT`	Left side	Use to report laterality when the procedure is performed on the left arm or leg.

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).

Related Codes

CPT-64885-NERVE-GRAFT-HEAD-NECK

CPT 64885: Nerve Graft for Head or Neck, 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-64890-NERVE-GRAFT-RECONSTRUCTION-HAND-FOOT

CPT 64890: Peripheral Nerve Graft for Hand or Foot

CPT-64891-NERVE-GRAFT-HAND-FOOT-LONG-SEGMENT

CPT 64891: Autologous Nerve Graft for Hand or Foot (>4 cm)

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

CPT 64892: Single-Strand Nerve Graft for Arm or Leg (≤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-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-64896-MULTIPLE-STRAND-NERVE-GRAFT-HAND-FOOT

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

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

CPT 64898: Multiple Strand Nerve Graft for Peripheral Nerve Repair

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

CPT 64901: Additional Single-Strand Nerve Graft Repair

Showing 1–10 of 17

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

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.
`23`	Unusual anesthesia	Use when general anesthesia is medically necessary for a procedure that is normally done with local or regional anesthesia; document reason.
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct portions of the procedure concurrently (for example, orthopedic and plastic microsurgeon collaboration).
`63`	Procedure performed on infants less than 4 kg	Use if the patient is an infant meeting the weight criteria and special considerations apply.
`66`	Surgical team (multiple surgeons)	Use when services are provided using a surgical team model.
`50`	Bilateral procedure	Use when identical nerve grafting is performed on contralateral limbs during the same operative session.
`52`	Reduced services	Use when the full extent of the described procedure is not performed (document reason and extent).
`53`	Discontinued procedure	Use when the procedure is started but discontinued for patient-related or intraoperative reasons; document reason.
`59`	Distinct procedural service	Use to indicate a separate, independent procedure not normally reported together when performed at a separate anatomic site or distinct session (support with operative note).
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later during the postoperative period.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure during the postoperative period.
`78`	Unplanned return to the OR for a related procedure during the postoperative period	Use when a return to OR occurs for complications related to the original nerve graft.
`79`	Unrelated procedure or service by same physician during postoperative period	Use when an unrelated procedure is performed during the global period.
`LT`	Left side	Use to report laterality when the procedure is performed on the left arm or leg.

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).

Related Codes

CPT-64885-NERVE-GRAFT-HEAD-NECK

CPT 64885: Nerve Graft for Head or Neck, 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-64890-NERVE-GRAFT-RECONSTRUCTION-HAND-FOOT

CPT 64890: Peripheral Nerve Graft for Hand or Foot

CPT-64891-NERVE-GRAFT-HAND-FOOT-LONG-SEGMENT

CPT 64891: Autologous Nerve Graft for Hand or Foot (>4 cm)

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

CPT 64892: Single-Strand Nerve Graft for Arm or Leg (≤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-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-64896-MULTIPLE-STRAND-NERVE-GRAFT-HAND-FOOT

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

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

CPT 64898: Multiple Strand Nerve Graft for Peripheral Nerve Repair

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

CPT 64901: Additional Single-Strand Nerve Graft Repair

Showing 1–10 of 17

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.