CPT 64912
Global 090 ActiveNrv rpr w/nrv algrft 1st
CPT 64912 Billing & Documentation Guide
CPT code 64912 (Nrv rpr w/nrv algrft 1st) 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 11.7, a non-facility practice expense RVU of 10.56, and a malpractice RVU of 2.26, a total non-facility RVU of 24.52 and facility RVU of 24.52. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $831.49, though rates vary from $732.65 to $1003.42 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 64912, 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 64912 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 3 units of 64912 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 64912
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 11.7 | 11.7 |
| Practice Expense RVU | 10.56 | 10.56 |
| Malpractice RVU | 2.26 | 2.26 |
| Total RVU | 24.52 | 24.52 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 64912
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 | $863.09 | $863.09 | $824.47 - $982.85 | 29 |
| Florida | $891.63 | $891.63 | $841.44 - $948.87 | 3 |
| Georgia | $818.19 | $818.19 | $795.39 - $840.98 | 2 |
| Illinois | $877.22 | $877.22 | $830.8 - $921.24 | 4 |
| Michigan | $828.23 | $828.23 | $798.04 - $858.43 | 2 |
| North Carolina | $768.11 | $768.11 | $768.11 - $768.11 | 1 |
| New York | $905.44 | $905.44 | $778.94 - $975.36 | 5 |
| Ohio | $788.91 | $788.91 | $788.91 - $788.91 | 1 |
| Pennsylvania | $820.48 | $820.48 | $785.92 - $855.05 | 2 |
| Texas | $810.3 | $810.3 | $781.89 - $848.03 | 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 64912
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 64912 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 |
| 01782 | 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 | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 64912
What does CPT code 64912 mean? +
CPT code 64912 represents: Nrv rpr w/nrv algrft 1st. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 64912? +
The 2026 Medicare national average non-facility payment for CPT 64912 is $831.49. Rates range from $732.65 to $1003.42 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 64912? +
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 64912? +
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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