Surgical excision of a neuroma located on a peripheral nerve of the hand or foot, excluding digital nerves of individual digits.

Verified May 8, 2026 · 7 sources ↓

Medicare: $436.22
Work RVU: 6.69
Global, days: 90
Region: Hand

Drawn from AAPCFindacodeFastrvuAshlinkEmedny

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify nerve location and confirm it is NOT a digital nerve (digital nerve excision maps to 64776/64778)
Document failure of at least two conservative treatments prior to surgery (PT, orthotics, padding, injections)
Operative note must identify the nerve by name and describe the excision technique — 'standard approach' language flags audits
ICD-10 diagnosis code must match the nerve location and laterality (e.g., G57.91 for right lower limb mononeuropathy for foot cases)
If 64783 or 64787 is billed, document each additional nerve separately and note implantation into bone or muscle if applicable
Record intractable pain duration and prior treatment timeline to support medical necessity

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 59 Distinct service 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side AS PA/NP/CNS assistant

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 64782 covers open excision of a neuroma from a non-digital peripheral nerve of the hand or foot. The surgeon identifies the affected nerve, isolates the neuroma, and resects it to relieve intractable pain and restore nerve function. The code is site-specific: it does not apply to digital nerve neuromas (those are 64776/64778) and it does not apply to Morton's interdigital neuromas (use 28080 instead). Misapplying 64782 to either of those scenarios is a common audit flag.

When additional non-digital nerves in the same hand or foot require excision at the same session, report 64783 as an add-on for each additional nerve. If the nerve end is implanted into bone or muscle following excision, 64787 may also be added. The 90-day global period means all routine postoperative management through day 90 is bundled — unrelated problems billed in that window need modifier 24 or 25.

Medical necessity hinges on documented failure of conservative care. Most payers — including American Specialty Health's published CPG — require intractable pain plus failure of at least two non-operative treatments (physical therapy, orthotics, padding, or injections) before approving surgical excision. Diagnosis codes must correlate precisely with the nerve location and CPT code selected.

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 (6.69) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (13.06) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.69
Practice expense RVU	5.31
Malpractice RVU	1.06
Total RVU	13.06
Medicare national rate	$436.22
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	$436.22
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 64782 get rejected.

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

Wrong code selection: 64782 used for Morton's interdigital neuroma — correct code is 28080
Wrong code selection: 64782 used for digital nerve neuroma — correct codes are 64776/64778
Medical necessity not established: no documentation of failed conservative treatment before surgery
Diagnosis-CPT mismatch: ICD-10 code does not correlate with the nerve location described in the operative note
Global period conflict: post-op E/M billed without modifier 24 during the 90-day global window

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Can I use 64782 for a Morton's neuroma excision?

No. Morton's neuroma is an interdigital lesion — use 28080 (single) for that. CPT 64782 explicitly excludes digital nerves and interdigital neuromas. Billing 64782 for a Morton's excision is incorrect coding and will draw payer scrutiny.

02What is the difference between 64782 and 64776?

64776 is for excision of a neuroma on a digital nerve (one or both, same digit). 64782 is for non-digital peripheral nerve neuromas of the hand or foot. The distinction is the nerve involved, not the anatomic region — both codes can apply to the hand or foot.

03When do I add 64783?

Report 64783 for each additional non-digital nerve neuroma excised in the same hand or foot during the same operative session. It is an add-on code and cannot be billed alone.

04What ICD-10 codes pair with 64782 for foot cases?

American Specialty Health's CPG maps 64782 to G57.90–G57.93 (unspecified mononeuropathy, lower limb by laterality). Confirm the laterality modifier on the diagnosis matches the operative side and the procedure code.

05Is 64782 bilateral-eligible, and how do I bill it?

Yes. If neuromas are excised from both limbs at the same session, append modifier 50 to a single line. Standard bilateral reimbursement rules apply — most payers pay 150% of the single-procedure allowable.

06What conservative treatment failures do payers require before approving 64782?

Most managed care and specialty health payers require documented failure of at least two of the following: physical therapy, bracing or orthotics, padding, or nerve injections. Document the duration and outcome of each failed treatment explicitly in the pre-op note.

07Does the 90-day global period affect how I bill post-op visits?

Yes. Routine post-op visits through day 90 are bundled into 64782. Bill unrelated E/M visits with modifier 24, and new problems requiring a decision for surgery with modifier 25. Complications requiring a return to the OR for a related procedure use modifier 78.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the nerve name, anatomic location, laterality, and excision technique directly from dictation — and flags if the documentation describes a digital or interdigital nerve, which would require 64776 or 28080 instead of 64782. It also pulls conservative treatment history from the visit note to populate the medical necessity narrative, preventing denials for undocumented failed conservative care.

See how Mira captures CPT 64782 documentation