CPT code 64721: Carpal tunnel release, median nerve at carpal tunnel2026 Medicare rate & RVUs in Maine
Reports open surgical release of the median nerve at the carpal tunnel, typically by dividing the transverse carpal ligament to relieve compression.
Medicare pays $447.14–$467.85 for 64721 in the office in Maine, from Rest of Maine to Southern Maine, ME. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 64721 covers
A hand or orthopedic surgeon typically performs this open operation for median nerve compression at the wrist, often when carpal tunnel symptoms warrant surgical decompression. The surgeon opens the wrist or palm and releases the transverse carpal ligament to reduce pressure on the median nerve. The procedure is commonly performed in an operating room or ambulatory surgery setting.
Report 64721 for the documented open median nerve release at the carpal tunnel; the operative note should identify the side and describe the release performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 identifies bilateral surgery, paid at 150%. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 64721 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | $447.14 | $392.44 |
| Southern Maine, ME | $467.85 | $408.93 |
How the 64721 rate is calculated
Each of 64721’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 64721
RVUs × geographic indexes × conversion factor
Work4.85
4.85 RVUs× 1.000 GPCI
Practice expense8.61
8.61 RVUs× 1.000 GPCI
Malpractice0.99
0.99 RVUs× 1.000 GPCI
Adjusted RVUs
14.4500
Conversion factor
$33.4009
Medicare rate
$482.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 64721
64721 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 64721
Carpal tunnel release, median nerve at carpal tunnel
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 64721
Carpal tunnel release, median nerve at carpal tunnel
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
64721 without 50 · national office
$482.64
Carpal tunnel release, median nerve at carpal tunnel
64721-50 · Bilateral: 150%
$723.96
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
64721 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 29848Carpal tunnel releaseEndoscopic approach
- 29848 describes endoscopic carpal tunnel release. Use 64721 for the open median nerve release.
- 64728Carpal tunnel decompressionMedian nerve
- Both concern median nerve decompression at the carpal tunnel, but they are distinct procedure codes. Match the code to the operative service documented rather than treating them as interchangeable.
- 64719Ulnar nerve surgeryAt wrist
- 64719 addresses ulnar nerve decompression at the wrist, not median nerve compression within the carpal tunnel.
64721 billing questions
How does 64721 differ from endoscopic carpal tunnel release?
Use 64721 for the open median nerve release at the carpal tunnel. The endoscopic approach is reported with 29848.
Can internal neurolysis be reported with 64721?
CPT 64727 is an add-on for qualifying internal neurolysis requiring an operating microscope. The operative documentation should support that additional work.
How is bilateral carpal tunnel release reported?
Report modifier 50 for bilateral surgery; CMS pays the bilateral procedure at 150%.
Are routine postoperative visits separately payable?
Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.
Can an assistant or co-surgeon be billed for 64721?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when 64721 is performed with another procedure?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session are paid at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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