CPT 64911
Global 090 ActiveNeurorraphy w/vein autograft
CPT 64911 Billing & Documentation Guide
CPT code 64911 (Neurorraphy w/vein autograft) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 13.65, a non-facility practice expense RVU of 11.89, and a malpractice RVU of 2.91, a total non-facility RVU of 28.45 and facility RVU of 28.45. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $962.9, though rates vary from $847.12 to $1160.39 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64911, 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 64911 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 64911 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 64911
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 13.65 | 13.65 |
| Practice Expense RVU | 11.89 | 11.89 |
| Malpractice RVU | 2.91 | 2.91 |
| Total RVU | 28.45 | 28.45 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64911
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $994.89 | $994.89 | $951.03 - $1130.84 | 29 |
| Florida | $1043.59 | $1043.59 | $981.67 - $1115.15 | 3 |
| Georgia | $951.77 | $951.77 | $926.03 - $977.51 | 2 |
| Illinois | $1027 | $1027 | $970.43 - $1081.3 | 4 |
| Michigan | $965.64 | $965.64 | $928.24 - $1003.03 | 2 |
| North Carolina | $888.56 | $888.56 | $888.56 - $888.56 | 1 |
| New York | $1052.73 | $1052.73 | $901.53 - $1137.79 | 5 |
| Ohio | $916.48 | $916.48 | $916.48 - $916.48 | 1 |
| Pennsylvania | $952.92 | $952.92 | $912.34 - $993.5 | 2 |
| Texas | $939.7 | $939.7 | $907.61 - $987.67 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 64911
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64911 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01250 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01320 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01470 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01610 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01710 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01810 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 64911
What does CPT code 64911 mean? +
CPT code 64911 represents: Neurorraphy w/vein autograft. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 64911? +
The 2026 Medicare national average non-facility payment for CPT 64911 is $962.9. Rates range from $847.12 to $1160.39 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64911? +
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 64911? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on April 17, 2026.
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