CPT 2026 · Surgery (Endocrine/Nervous/Eye/Ear)

CPT 64597

Global ZZZ

Ins/rplcm prq eltrd ra pn ea

Effective 2026-04-01 Conv. factor $33.4009

No national RVU

Payment Methodology

Status Indicator

NCCI Partners

ZZZ

Global Period

No national RVU

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

CPT 64597 Billing & Documentation Guide

CPT code 64597 (Ins/rplcm prq eltrd ra pn ea) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of ZZZ. This code uses the No national RVU payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.

When billing 64597, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 64597 with related codes; this code has 2 PTP bundling relationships on file (see table below).

Payment Status & Global Period

CMS Status Indicator

Carrier-priced (MAC determines payment locally)

Global Period

ZZZ

Add-on code (global concept does not apply)

MUE Limit (Medically Unlikely Edits)

Max units per beneficiary per date of service

Rationale: Code Descriptor / CPT Instruction

Adjudication: Date of Service (Clinical)

Source: CMS NCCI MUE Practitioner Services, effective 2026-04-01.

Submitting more than 1 units of 64597 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.

NCCI Bundling Edits, CPT 64597

Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64597 on the same date of service, review the modifier indicator and payer policy before submission.

Partner Code	Relationship	Modifier Allowed	Rationale
69990	Column 1 (primary), can be billed with modifier	No	Misuse of Column Two code with Column One code
64590	Column 2 (secondary), bundled into primary	No	CPT Manual or CMS manual coding instruction

Frequently Asked Questions, CPT 64597

What does CPT code 64597 mean? +

CPT code 64597 represents: Ins/rplcm prq eltrd ra pn ea. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of ZZZ.

What is the Medicare reimbursement for CPT 64597? +

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

What modifiers can I use with CPT 64597? +

Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.

What bundling edits apply to CPT 64597? +

This code has 2 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.