Open surgical release of entrapped or scarred digital nerve(s) in a single finger or toe — one or both sides of the same digit, one code.

Verified May 8, 2026 · 5 sources ↓

Medicare: $488.66
Work RVU: 6.1
Global, days: 90
Region: Hand

Drawn from CMSGenhealth

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Identify the specific digit by number and laterality (e.g., right index finger, left great toe) — 'affected finger' is not sufficient.
Describe the pathology found intraoperatively: scar tissue, fibrosis, adhesions, or compressive structure causing nerve entrapment.
Specify which digital nerve(s) were released — radial, ulnar, or both — and confirm they are within the same digit.
Document the surgical approach and technique: incision location, instruments used, tissue released, and nerve condition after decompression.
Record pre-operative symptoms (pain, numbness, tingling, loss of sensation) with duration to support medical necessity.
Note any prior conservative treatment attempted before surgical intervention, such as splinting, injections, or physical therapy.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 51 Multiple procedures 57 Decision for surgery 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

64702 covers open neuroplasty of digital nerves in a single finger or toe. The surgeon incises through scar tissue, fibrosis, or compressive soft tissue to free one or both digital nerves running along the lateral borders of the digit. One unit of 64702 covers work on both nerves of the same digit; a second digit requires a separate unit with modifier 59 or the appropriate anatomic laterality modifier.

The 90-day global period means all routine follow-up for that digit — wound checks, suture removal, dressing changes — is bundled through day 90. Any unrelated E/M or procedure in that window needs modifier 24 or 79. A separate decision-for-surgery E/M on the day before or day of surgery requires modifier 57 if it drove the surgical decision.

Top billing specialties are orthopedic surgery, hand surgery, and general surgery. The substantial site-of-service payment differential between HOPD and ASC makes facility selection a meaningful revenue and patient-cost variable — see the Site of Service comparison table.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (6.1) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (14.63) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.1
Practice expense RVU	7.44
Malpractice RVU	1.09
Total RVU	14.63
Medicare national rate	$488.66
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$488.66
HOPD (APC 5431) Hospital outpatient department	$1,995.02
ASC (PI A2) Ambulatory surgical center (freestanding)	$948.66

Common denial reasons

The recurring reasons claims for CPT 64702 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Digit or laterality not specified in the operative report or claim — missing LT/RT modifier or digit identifier triggers automatic rejection.
Lack of documented conservative treatment failure before surgery; payers frequently require evidence of non-surgical management for nerve entrapment.
Billing multiple units of 64702 for different nerves of the same digit — one unit covers both digital nerves of a single digit; only separate digits support additional units.
Global period conflict — post-op E/M billed without modifier 24 when the visit falls within the 90-day global window.
Insufficient intraoperative documentation of pathology; notes that reference 'nerve release' without describing the compressive lesion or tissue removed are flagged on audit.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Can I bill 64702 twice if I release both digital nerves of the same finger?

No. One unit of 64702 covers neuroplasty of one or both digital nerves within the same digit. Billing two units for the same digit will be denied under MUE edits. A second unit is appropriate only when a separate digit is treated on the same date, reported with modifier 59.

02What modifier do I use when operating on two different fingers on the same hand during the same session?

Report a second unit of 64702 with modifier 59 (distinct procedural service) to identify the additional digit. Document each digit separately in the operative note with its own pathology description and nerve findings.

03Does 64702 have a global period, and what does that mean for post-op visits?

Yes — 64702 carries a 90-day global period. Routine post-op visits, wound checks, and suture removal are bundled and not separately billable. Bill modifier 24 on an E/M for an unrelated problem within those 90 days, or modifier 79 for an unrelated surgical procedure in the same window.

04What ICD-10 diagnoses commonly support 64702?

Digital nerve entrapment, post-traumatic neuroma of a finger nerve, scar contracture with nerve compression, and painful digital neuritis are the most commonly accepted supporting diagnoses. The ICD-10 code must reflect the specific digit and laterality to match the procedure claim.

05Is a pre-operative nerve conduction study required for 64702?

CMS does not mandate nerve conduction studies for digital neuroplasty, but some commercial payers do require objective evidence of nerve dysfunction. Document whether NCS or EMG was obtained or explain clinically why it was not necessary. Check individual payer policies before surgery.

06How does site of service affect reimbursement for 64702?

The HOPD payment is substantially higher than the ASC payment — see the Site of Service comparison table on this page. Facility costs passed to the patient also differ significantly between settings, which can affect prior authorization requirements and patient out-of-pocket obligations.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures digit number, laterality, the specific nerve(s) released, and the intraoperative pathology (scar, fibrosis, compressive tissue) directly from dictation. It flags if the operative note omits which digital nerve was addressed or lacks a description of the compressive pathology — the two documentation gaps most likely to trigger a medical necessity denial or audit finding.

See how Mira captures CPT 64702 documentation