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Medicare Physician Fee Schedule · Q3 2026 release

CPT 64721 in Sacramento, CA 01112-63

Open carpal tunnel release in ZIPs including 95814, 95661, and 95630

64721 2026 C · Sacramento, CA flag01112-63 A Active
Allowed amount
$520.01
in a doctor’s own office or clinic

107.7% of the $482.64 national baseline

Medicare payment
$416.01
Patient / secondary
$104.00
Expected total to provider
$520.01

Patient / secondary and expected total to provider assume the Part B annual deductible is already met. If it isn't, the patient owes more than the amount shown here.

Locality-adjusted Physician Fee Schedule pricing

How much does Medicare allow for CPT 64721 in Sacramento, CA? Copy link

The Medicare allowed amount is $520.01 in the office (non-facility) setting and $450.86 in a facility, under the Q3 2026 Physician Fee Schedule. The office amount is 7.7% above the national baseline, and the facility amount is 6.5% above the national baseline. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied — not necessarily what a specific claim pays.

What Medicare locality is Sacramento, CA in? Copy link

CMS payment locality Sacramento-Roseville-Folsom. The same amount applies across the whole locality, including Roseville and Folsom.

Why Sacramento, CA differs from the national amount Copy link

Sacramento, CA (this locality)
$520.01
National PFS baseline (GPCI 1.000)
$482.64

The national figure is a baseline, not an amount any provider is paid. This locality's geographic practice cost indices scale each RVU component before the conversion factor is applied, which puts Sacramento, CA at 7.7% above the national baseline.

Work GPCI
1.036
Practice expense GPCI
1.163
Malpractice GPCI
0.536
2026 conversion factor
$33.4009

Formula and inputs Copy link

The office (non-facility) amount for 64721 in Sacramento, CA: each component's RVU times its GPCI, summed, then multiplied by the conversion factor.

RVU and GPCI components of the Sacramento, CA allowed amount for 64721
Component RVU × GPCI = Adjusted RVU
Work 4.85 1.036 5.0246
Practice expense 8.61 1.163 10.0134
Malpractice 0.99 0.536 0.5306
Sum of adjusted RVUs 15.5687
× $33.4009 2026 conversion factor $520.01

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient or ASC), Sacramento, CA allows $450.86 for 64721, versus $520.01 in the office. Only the practice-expense RVU changes with the setting. In a facility, the hospital bills its own fee, so the professional payment is lower. Which setting applies to your place of service.

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in Sacramento, CA. The allowed amount is not the program payment — the rows below separate them. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for 64721 in Sacramento, CA
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $520.01
Non-participating allowed amount 95% of the participating amount. $494.01
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount. $568.11
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met. $416.01
Beneficiary coinsurance The remaining 20%. $104.00
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share. $8.32
Medicare pays after sequestration Program payment net of the sequestration reduction. $407.69

Contracted rate: % of Medicare in Sacramento, CA Copy link

Commercial contracts are usually written as a percentage of the Medicare fee schedule. Which Medicare amount they mean is the part that gets misread: a contract benchmarked to the fee schedule prices off this locality's allowed amount — $520.01 in the office (non-facility) setting — not the $482.64 national baseline.

Opens the calculator already set to Sacramento, CA and the office (non-facility) setting. It also compares what a payer actually paid against the expected amount. See how to find your contract's actual percentage.

ZIP codes this Sacramento, CA rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 219 ZIP codes to this payment locality. 64721 prices identically in every one of them. 9 of them span more than one locality and need ZIP+4 for an exact match.

94203 94204 94205 94206 94207 94208 94209 94211 94229 94230 94232 94234 94235 94236 94237 94239 94240 94243 94244 94245 94246 94247 94248 94249 94250 94252 94253 94254 94256 94257 94258 94259 94261 94262 94263 94267 94268 94269 94271 94273 94274 94277 94278 94279 94280 94282 94283 94284 94285 94286 94287 94288 94289 94290 94291 94293 94294 94295 94296 94297 94298 94299 95602 95603 95604 95605 95606 95607 95608 95609 95610 95611 95612 95613 95614 95615 95616 95617 95618 95619 95621 95623 95624 95626 95627 95628 95630 95631 95632 95633 95634 95635 95636 95637 95638 95639 95641 95645 95648 95650

119 more ZIP codes map to this locality. The Sacramento, CA locality page lists the full set.

Resolves the ZIP to its payment locality, so you can confirm whether this amount applies.

64721 in nearby payment localities Copy link

Payment localities in the same region as Sacramento, CA, nearest first. Each amount is that locality's own GPCI-adjusted office (non-facility) figure for 64721. Proximity doesn't imply similar pricing — neighbouring localities often differ.

64721 allowed amount in payment localities near Sacramento, CA
Metro Allowed amount vs. Sacramento, CA
San Francisco, CA $596.93 +14.8%
San Jose, CA $607.63 +16.8%
Fresno, CA $497.66 -4.3%
Bakersfield, CA $500.40 -3.8%
Los Angeles, CA $530.80 +2.1%
Ventura County, CA $527.05 +1.4%

Every payment locality nationwide is on the CPT 64721 rate map.

Other codes priced in Sacramento, CA Copy link

Office (non-facility) allowed amounts in this same payment locality, Q3 2026.

Other curated codes and their allowed amounts in Sacramento, CA
Code Service Sacramento, CA vs. national
66984 Cataract Surgery $496.28 +7.3%
27447 Knee Replacement $1,183.07 +2.0%
66982 Complex Cataract Surgery With Lens Implant $674.48 +7.0%
27130 Total Hip Arthroplasty $1,185.55 +2.0%
29827 Arthroscopic Rotator Cuff Repair $1,007.10 +3.2%
47562 Outpatient surgery $635.73 +0.6%
29881 Outpatient surgery $541.39 +5.0%
23472 Total Shoulder Arthroplasty $1,329.40 +2.2%
49505 Outpatient surgery $514.99 +1.4%
58571 Outpatient surgery $839.49 +1.3%
19120 Outpatient surgery $611.74 +6.7%
43775 Outpatient surgery $968.58 -3.1%

Common questions Copy link

Which ZIP codes does the Sacramento, CA rate for 64721 cover?
The CMS ZIP-to-locality crosswalk maps 219 ZIP codes to this payment locality, and every one of them prices 64721 identically. Examples include 94203, 94204, 94205, 94206, 94207, 94208. 9 of them span more than one payment locality, so those need ZIP+4 for an exact match.
Why is the 64721 rate in Sacramento, CA different from the national amount?
The national figure is a GPCI 1.000 baseline, not an amount any provider is paid. This locality's geographic practice cost indices — work 1.036, practice expense 1.163, malpractice 0.536 — scale each RVU component before the conversion factor is applied, which is why Sacramento, CA allows more than the $482.64 baseline.
Which cities does the Sacramento, CA rate for 64721 cover?
This payment locality also covers Roseville and Folsom. Every location in it prices 64721 identically — the label names the largest metro, not a city-specific amount.
What is the facility rate for 64721 in Sacramento, CA?
$450.86 in a facility, versus $520.01 in the office (non-facility) setting — a $69.15 difference. Only the practice-expense RVU changes with the setting: in an office the practice carries the overhead, so the professional payment is higher; in a hospital or ASC the facility bills its own fee.
What is the non-participating amount and limiting charge for 64721 in Sacramento, CA?
A non-participating provider is paid $494.01 — 95% of the $520.01 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $568.11, which is 115% of the non-participating amount.
How much of the Sacramento, CA 64721 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($416.01) once the annual Part B deductible is met, and the beneficiary owes 20% ($104.00). Sequestration reduces Medicare's share by about 2% ($8.32), leaving $407.69. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q3 2026 release : this code's RVUs from the relative value file, multiplied by payment locality 01112-63's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q3 2026 release . Releases are immutable: an amount retrieved for a past quarter always reflects that PFS release. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 7,150)
Geographic practice cost indices (Q3 2026) · rvu26c-updated-06-30-2026.zip (GPCI2026.csv row 21)
ZIP code to carrier locality crosswalk (Q3 2026) · zip-code-carrier-locality-file-updated-05-13-2026.zip (ZIP5_JUL2026.txt)

Working a claim with an earlier date of service? The calculator prices 64721 in Sacramento, CA against the release that governed that date. Past releases need a free account; today's rate does not.

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