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CPT®
64870

CPT® Code 64870
Deleted

Official Description

Anastomosis; facial-phrenic

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 64870 refers to the surgical procedure known as facial-phrenic anastomosis, which is a type of facial nerve reconstruction. This procedure is performed to restore function to the facial nerve by connecting it to the phrenic nerve. The phrenic nerve, which originates from the cervical spinal cord, is primarily responsible for innervating the diaphragm and facilitating breathing. In this context, it is utilized as a donor nerve to reinnervate the facial nerve, which may have been damaged due to injury or disease. The surgical approach involves making an incision near the ear, allowing access to the facial nerve, and carefully dissecting the surrounding tissues to identify and isolate the phrenic nerve. The procedure aims to create a functional connection that can help restore facial movement and expression, which is critical for both aesthetic and functional purposes. The detailed steps of the procedure involve meticulous dissection and anastomosis techniques to ensure a successful outcome.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The facial-phrenic anastomosis procedure (CPT® Code 64870) is indicated for patients who have experienced facial nerve damage or dysfunction. This may occur due to various conditions, including:

  • Facial Nerve Injury: Trauma or surgical complications that result in the loss of facial nerve function.
  • Facial Nerve Tumors: Neoplasms affecting the facial nerve that necessitate surgical intervention.
  • Bell's Palsy: A condition characterized by sudden, temporary weakness or paralysis of the facial muscles.
  • Neuropathies: Conditions that affect the facial nerve's ability to transmit signals effectively.

2. Procedure

The facial-phrenic anastomosis procedure involves several critical steps to ensure successful nerve reconstruction:

  • Step 1: An incision is made just in front of the auricle of the ear, extending around the ear lobe and along the mandible. This incision allows for adequate exposure of the surgical field.
  • Step 2: A skin flap is elevated to expose the parotid gland. The inferior aspect of the parotid gland is carefully dissected off the sternocleidomastoid muscle to gain access to the underlying structures.
  • Step 3: Dissection continues to the digastric muscle, where the tissue anterior to the tip and superior to the tragus is meticulously dissected to identify the facial nerve as it exits the stylomastoid foramen.
  • Step 4: The facial nerve is dissected to the point of injury or damage and transected distal to this point to prepare for anastomosis.
  • Step 5: The phrenic nerve is then isolated by following its anatomical course, dissected distally until sufficient length is achieved for a tension-free anastomosis with the facial nerve.
  • Step 6: The phrenic nerve is transposed and sutured to the distal end of the facial nerve using a perineural or epineural technique, ensuring a secure connection that promotes nerve regeneration.

3. Post-Procedure

After the facial-phrenic anastomosis procedure, patients typically require careful monitoring and follow-up care. Post-operative care may include pain management, wound care, and physical therapy to facilitate recovery and improve facial function. Patients are advised to avoid strenuous activities during the initial healing phase. The expected recovery period can vary, with gradual improvement in facial movement and expression as the nerves regenerate and reinnervate the facial muscles. Regular follow-up appointments are essential to assess the healing process and the effectiveness of the anastomosis.
Short Descr FUSION OF FACIAL/OTHER NERVE
Medium Descr ANASTOMOSIS FACIAL-PHRENIC
Long Descr Anastomosis; facial-phrenic
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 9 - Other OR therapeutic nervous system procedures
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2015-01-01 Deleted Code deleted
Pre-1990 Added Code added.
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