No office rate
29848 describes endoscopic carpal tunnel release. Use 64721 for the open median nerve release.
On this page
CMS RVU26D · Effective 2026-10-01
64721 Carpal tunnel release Medicare reimbursement rates in Virginia
Reports open surgical release of the median nerve at the carpal tunnel, typically by dividing the transverse carpal ligament to relieve compression. Compare 64721 office and facility rates across CMS payment localities in Virginia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 64721 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$468.03–$546.32
2 of 2 localities have a supported rate.
Facility setting
$409.59–$476.28
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Peripheral nerve surgery
About 64721: Open median nerve carpal tunnel release
Reports open surgical release of the median nerve at the carpal tunnel, typically by dividing the transverse carpal ligament to relieve compression.
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.
CMS billing rules for 64721
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.85 · 34%
- Practice expense (office) RVU8.61 · 60%
- Malpractice RVU0.99 · 7%
153.3K
Medicare services in 2024 · #445 by national volume
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.
64721 compared with similar codes
Office rates for Virginia, from the same CMS release.
$1,319.53–$1,570.41
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.
No office rate
64719 addresses ulnar nerve decompression at the wrist, not median nerve compression within the carpal tunnel.
Compare 64721 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$546.32
Facility
$476.28
Virginia →
Office / nonfacility
$468.03
Facility
$409.59
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,20764716,,Revision of cranial nerve,A,,6.82,6.10,NA,6.10,,1.15,14.07,14.07,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20864718,,Revise ulnar nerve at elbow,A,,7.08,8.71,NA,8.71,,1.43,17.22,17.22,0,090,0.11,0.76,0.13,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,20964719,,Revise ulnar nerve at wrist,A,,4.85,5.80,NA,5.80,,0.96,11.61,11.61,0,090,0.11,0.76,0.13,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,21064721,,Carpal tunnel surgery,A,,4.85,8.61,,6.83,,0.99,14.45,12.67,0,090,0.11,0.76,0.13,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,21164722,,Decompression unspec nerve,A,,4.70,5.36,NA,5.36,,1.11,11.17,11.17,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,21264726,,Dcmprn plantar digital nerve,A,,4.16,3.14,NA,3.14,,0.43,7.73,7.73,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,21364727,,Internal neurolysis,A,,3.02,1.06,NA,1.06,,0.26,4.34,4.34,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00