CPT 64912 Nerve Graft Repair Reimbursement | OpenPayer

Summary & Overview

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

CPT code 64912 covers surgical repair of a nerve using a donor nerve tissue graft and is billed for the first strand of each graft repair. This procedure is clinically important for restoring nerve continuity and function after traumatic or iatrogenic nerve injuries and has implications for surgical planning, resource allocation, and post‑operative care nationwide. Major national payers commonly involved in coverage and reimbursement decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn the clinical context for nerve grafting with donor tissue, how CPT code 64912 is used to report the first strand in multi-strand repairs, and the typical settings where services are provided. The publication summarizes benchmark reimbursement practice areas, common modifier usage patterns (listed separately), and policy considerations from large carriers and Medicare that affect coverage and billing for donor nerve graft procedures. It also provides concise guidance on documentation elements relevant to accurate coding and claims submission. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare64912CPTnerve graftsurgical repairoperative codingambulatory surgeryhospital services

Billing Code Overview

CPT code 64912 describes a surgical procedure in which a provider repairs a damaged nerve using a nerve tissue graft harvested from a cadaveric or living donor. The code applies to the first strand of each nerve graft repair.

Service type: Surgical nerve grafting using donor nerve tissue
Typical site of service: Hospital operating room or ambulatory surgery center, depending on clinical need and patient condition

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 42-year-old patient presents after a traumatic forearm injury with a segmental loss of the median nerve resulting in motor and sensory deficits. Imaging and intraoperative findings confirm a nerve gap unsuitable for end-to-end repair. The surgical team schedules a nerve graft procedure using a cadaveric or living-donor nerve graft to bridge the defect. The procedure is performed in an operating room setting under general anesthesia by a peripheral nerve or hand surgeon. Intraoperative steps include exposure of the proximal and distal nerve stumps, measurement of the gap, preparation and implantation of the nerve allograft (first graft strand billed with 64912), micro-suturing of graft ends to nerve stumps, and layered wound closure. Postoperative workflow includes short-term inpatient observation or same-day discharge depending on anesthesia and comorbidities, postoperative pain management, splinting, and referral to occupational therapy and hand therapy for progressive desensitization and motor re-education. Follow-up visits assess wound healing, sensory recovery, and need for additional procedures or graft strands (each additional strand billed per code rules).

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the work, time, or technical difficulty substantially exceeds the usual for .

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

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

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

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

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

CPT 64890: Peripheral Nerve Graft for Hand or Foot

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

CPT 64913: Nerve Tissue Graft, Each Additional Nerve Strand

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

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

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

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

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

CPT 64907: Reversal of Prior Nerve Transfer After Nerve Restoration

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)

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64912

Taxonomy Code	Specialty	Notes
208000000X	Orthopedic Surgery	Includes hand and upper-extremity surgeons who perform peripheral nerve repairs and grafting.
207X00000X	Plastic Surgery	Surgeons specializing in reconstructive microsurgery and peripheral nerve reconstruction.
2086S0122X	Neurological Surgery	Surgeons who may perform complex peripheral nerve or brachial plexus reconstructions.
2084P0800X	General Surgery (Hand/Peripheral subspecialty)	General surgeons with hand/peripheral nerve expertise in some settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G56.00`	Carpal tunnel syndrome, unspecified upper limb	Peripheral nerve entrapment that may require neurolysis or nerve reconstruction; included when combined procedures occur.
`S54.091A`	Injury of median nerve at forearm level, right arm, initial encounter	Traumatic nerve injury producing a segmental defect that may require nerve grafting as described by `64912`.
`S64.201A`	Injury of ulnar nerve at forearm level, unspecified arm, initial encounter	Ulnar nerve transection or segmental loss prompting graft repair.
`S44.011A`	Injury of brachial plexus, right shoulder, initial encounter	Brachial plexus injuries with nerve discontinuity where grafting may be used for reconstruction.
`G57.00`	Sciatica, unspecified side	Lower-extremity nerve injuries or compressive neuropathies that in rare cases may need reconstruction with grafting.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64831`	Suture of single peripheral nerve, arm or leg; repair of digital nerve (single)	May be used for primary end-to-end repair of a single digital nerve when no graft is required; performed when gap is small and direct repair is possible.
`64832`	Suture of single peripheral nerve, arm or leg; repair, complex	Used for more complex nerve repairs that do not require grafting; may precede decision to graft if direct repair not feasible.
`69990`	Microsurgical techniques, requiring an operating microscope (List separately in addition to code for primary procedure)	Reported in addition to `64912` when operative microscope/microsurgical augmentation is used for nerve graft coaptation.
`29515`	Application of long-arm splint (shoulder to hand), static	Postoperative immobilization code commonly used after upper-extremity nerve grafting to protect repair.
`97035`	Ultrasound therapy; each 15 minutes	Represents adjunctive physical or occupational therapy modalities used in postoperative rehabilitation following nerve grafting.
`64727`	Neuroplasty and/or transposition; median nerve at carpal tunnel	May be performed in the same patient for decompression procedures or as part of combined nerve reconstruction strategies when multiple pathologies coexist.

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