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See a sample rate comparisonCPT 64856 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Suture Of Major Periphral Nrve Arm Or Leg Excpt Sciatic; Inclu, Suture Of Major Peripheral Nerve Arm Or Leg Except Sciatic; Includin
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 64856 |
| Medicaid Fee Schedule | View Medicaid rates for 64856 |
National average reimbursement for CPT 64856 by major payers:
$1,255.04
$1,377.79
$1,429.51
$1,646.99
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CPT 64856
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$11,972.00Published rateHaymarket Surgery Center, LLC
Haymarket Surgery Center
$4,781.00Published rateGlasgow Medical Center LLC, Glasgow Ambulatory Surgery Center
Glasgow Medical Center, LLC
$3,000.00Published rateFort Sanders West Op Surgery Center
$2,500.00Published rateMaple Springs Podiatric Surgical Center, Inc
Maple Springs Podiatric Surgical Center Inc
$1,141.00Published rate
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See a sample payer proposalCPT 64856 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64856 code is part of the Surgery services used for Surgical Procedures on the Nervous System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 64856 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 64837-CPT | Moderate | Surgery To Repair Nerve, Surgical Repairs To Additional Nerves In The Hand Or Foot. This Procedure Is Done At The Same Time As Another Primary Surgery. |
| 64840-CPT | High | Suture Of Posterior Tibial Nerve |
| 64856-CPT | High | Suture Of Major Periphral Nrve Arm Or Leg Excpt Sciatic; Inclu, Suture Of Major Peripheral Nerve Arm Or Leg Except Sciatic; Includin |
| 64861-CPT | High | Neurorrhaphy Brachial Plexus |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64856. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64856 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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