CPT 64728: Carpal tunnel decompressionMedicare rate & RVUs

Surgical decompression of the median nerve at the wrist is reported when operative treatment relieves pressure within the carpal tunnel.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,343.05 for 64728 nationally in the office and $122.58 in a hospital or facility. Local office rates run $1,163.64–$1,899.48.

Medicare rate · 64728

Carpal tunnel decompression

Swap in your local Medicare rate.

Work RVUs
2.7
Total RVUs
40.21
Global days
000

National rate · 2026

$1,343.05

Office setting, before claim adjustments.

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Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 64728 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 64728 covers

A surgeon decompresses the median nerve where it passes through the carpal tunnel at the wrist, relieving pressure associated with carpal tunnel syndrome. The procedure is generally performed by a hand, orthopedic, plastic, or neurosurgeon in an operating room or ambulatory surgery setting. The operative report should identify the median nerve and carpal tunnel as the site and describe the decompression performed.

Report this code when the documented service is median nerve decompression at the carpal tunnel; distinguish it from other nerve procedures by the nerve and operative work described. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; 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 64728 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$1163.64 to $1899.48

$1163.64$1531.56$1899.48
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

64728 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$1,183.96$116.05
Alaska*$1,465.46$165.66
Arizona$1,303.31$120.67
Arkansas$1,163.64$115.26
Atlanta$1,364.85$124.85
Austin$1,414.52$123.26
Bakersfield$1,461.14$123.50
Baltimore/Surr. Cntys$1,437.27$127.70
Beaumont$1,230.44$119.82
Brazoria$1,330.80$121.32

64728 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$1,163.64

$1,679.93

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
64728 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,465.461
AL$1,183.961
AR$1,163.641
AZ$1,303.311
CA$1,460.37–$1,899.4829
CO$1,422.051
CT$1,442.391
DC$1,570.411
DE$1,327.751
FL$1,292.31–$1,406.353
GA$1,210.15–$1,364.852
GU$1,510.221
HI$1,510.221
IA$1,232.401
ID$1,239.241
IL$1,239.26–$1,383.484
IN$1,248.061
KS$1,219.571
KY$1,204.191
LA$1,199.56–$1,270.692
MA$1,408.84–$1,587.372
MD$1,358.23–$1,570.413
ME$1,240.43–$1,328.892
MI$1,235.78–$1,304.982
MN$1,373.511
MO$1,171.05–$1,283.313
MS$1,167.921
MT$1,343.031
NC$1,256.751
ND$1,338.291
NE$1,242.211
NH$1,393.091
NJ$1,461.96–$1,548.452
NM$1,241.341
NV$1,342.961
NY$1,278.43–$1,590.975
OH$1,234.811
OK$1,208.061
OR$1,335.69–$1,480.622
PA$1,240.53–$1,397.262
PR$1,356.621
RI$1,384.981
SC$1,247.241
SD$1,337.731
TN$1,226.061
TX$1,230.44–$1,414.528
UT$1,267.541
VA$1,319.53–$1,570.412
VI$1,356.621
VT$1,326.641
WA$1,408.28–$1,628.672
WI$1,285.221
WV$1,183.431
WY$1,340.971

How the 64728 rate is calculated

Each of 64728’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 · 64728

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.70Practice expense 37.27Malpractice 0.24

40.2100 adjusted RVUs×$33.4009 conversion factor=$1,343.05

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 64728

The CMS indicators that decide how 64728 is paid alongside other services.

CMS payment indicators · 64728

Carpal tunnel decompression

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

64728 without 50 · national office

$1,343.05

Carpal tunnel decompression

64728-50 · Bilateral: 150%

$2,014.58

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).

When to use modifier 50

64728 compared with similar codes

Compare codes

64728 vs 64721 vs 29848 vs 64722: national Medicare rates

Swap in your local Medicare rate.

  • 64728
    Carpal tunnel decompression · 2.7 wRVU
    $1,343.05
  • 64721
    Carpal tunnel release · 4.85 wRVU
    $482.64−$860.41
  • 29848
    Carpal tunnel release · 6.23 wRVU
    —
  • 64722
    Nerve decompression · 4.7 wRVU
    —

How to choose

64721Carpal tunnel release
Both concern the median nerve at the carpal tunnel. Choose based on whether the documented operation is decompression or neuroplasty and/or transposition.
29848Carpal tunnel release
This code describes median nerve decompression at the carpal tunnel; 29848 is used for endoscopic carpal tunnel release.
64722Nerve decompression
Use 64722 for decompression of an unspecified nerve. This code identifies the median nerve and carpal tunnel specifically.

64728 billing questions

How is this code distinguished from 64721?

Use the code that matches the documented operation: this code identifies median nerve decompression at the carpal tunnel, while 64721 describes neuroplasty and/or transposition at that site. Review the operative report for the procedure actually performed.

Can this be reported with an endoscopic carpal tunnel release?

CPT 29848 describes endoscopic release at the carpal tunnel and is generally an alternative code for that operative approach, not an additional charge for the same decompression.

Is same-day postoperative care included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

How is bilateral surgery reported?

For bilateral procedures, report modifier 50; CMS pays the bilateral service at 150%.

When can an assistant-at-surgery be paid?

Payment for an assistant at surgery requires documentation of medical necessity. Co-surgeon and team-surgery payment is not permitted.

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
RVUs for 64728PPRRVU2026_Oct_nonQPP.csv, line 7,214 (RVU26D)

Open CMS sourceHow we calculate rates

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