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Medicare Physician Fee Schedule · Q3 2026 release

CPT 64721 in San Francisco, CA 01112-05

Open carpal tunnel release in ZIPs including 94102, 94609, and 94704

64721 2026 C · San Francisco, CA flag01112-05 A Active
Allowed amount
$596.93
in a doctor’s own office or clinic

123.7% of the $482.64 national baseline

Medicare payment
$477.54
Patient / secondary
$119.39
Expected total to provider
$596.93

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 San Francisco, CA? Copy link

The Medicare allowed amount is $596.93 in the office (non-facility) setting and $513.10 in a facility, under the Q3 2026 Physician Fee Schedule. The office amount is 23.7% above the national baseline, and the facility amount is 21.2% 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 San Francisco, CA in? Copy link

CMS payment locality San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County). The same amount applies across the whole locality, including Oakland and Berkeley.

CMS splits this metro across more than one payment locality

The amount above covers only the counties in San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County). CMS prices other parts of the same metro area separately, with their own GPCIs and amounts. Check the service-location ZIP before applying this figure.

Why San Francisco, CA differs from the national amount Copy link

San Francisco, CA (this locality)
$596.93
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 San Francisco, CA at 23.7% above the national baseline.

Work GPCI
1.095
Practice expense GPCI
1.410
Malpractice GPCI
0.425
2026 conversion factor
$33.4009

Formula and inputs Copy link

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

RVU and GPCI components of the San Francisco, CA allowed amount for 64721
Component RVU × GPCI = Adjusted RVU
Work 4.85 1.095 5.3108
Practice expense 8.61 1.410 12.1401
Malpractice 0.99 0.425 0.4208
Sum of adjusted RVUs 17.8716
× $33.4009 2026 conversion factor $596.93

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient or ASC), San Francisco, CA allows $513.10 for 64721, versus $596.93 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 San Francisco, 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 San Francisco, CA
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $596.93
Non-participating allowed amount 95% of the participating amount. $567.08
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount. $652.14
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met. $477.54
Beneficiary coinsurance The remaining 20%. $119.39
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share. $9.55
Medicare pays after sequestration Program payment net of the sequestration reduction. $467.99

Contracted rate: % of Medicare in San Francisco, 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 — $596.93 in the office (non-facility) setting — not the $482.64 national baseline.

Opens the calculator already set to San Francisco, 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 San Francisco, CA rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 254 ZIP codes to this payment locality. 64721 prices identically in every one of them. 2 of them span more than one locality and need ZIP+4 for an exact match.

94002 94003 94005 94010 94011 94012 94013 94014 94015 94016 94017 94018 94019 94020 94021 94025 94026 94027 94028 94029 94030 94031 94037 94038 94044 94045 94059 94060 94061 94062 94063 94064 94065 94066 94067 94070 94071 94074 94080 94083 94096 94098 94099 94101 94102 94103 94104 94105 94106 94107 94108 94109 94110 94111 94112 94114 94115 94116 94117 94118 94119 94120 94121 94122 94123 94124 94125 94126 94127 94128 94129 94130 94131 94132 94133 94134 94135 94136 94137 94138 94139 94140 94141 94142 94143 94144 94145 94146 94147 94150 94151 94152 94153 94154 94155 94156 94157 94158 94159 94160

154 more ZIP codes map to this locality. The San Francisco, 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 San Francisco, 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 San Francisco, CA
Metro Allowed amount vs. San Francisco, CA
San Jose, CA $607.63 +1.8%
Sacramento, CA $520.01 -12.9%
Fresno, CA $497.66 -16.6%
Bakersfield, CA $500.40 -16.2%
Ventura County, CA $527.05 -11.7%
Los Angeles, CA $530.80 -11.1%

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

Other codes priced in San Francisco, CA Copy link

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

Other curated codes and their allowed amounts in San Francisco, CA
Code Service San Francisco, CA vs. national
66984 Cataract Surgery $559.07 +20.9%
27447 Knee Replacement $1,301.36 +12.2%
66982 Complex Cataract Surgery With Lens Implant $758.06 +20.2%
27130 Total Hip Arthroplasty $1,304.14 +12.2%
29827 Arthroscopic Rotator Cuff Repair $1,116.33 +14.3%
47562 Outpatient surgery $695.78 +10.1%
29881 Outpatient surgery $609.02 +18.1%
23472 Total Shoulder Arthroplasty $1,462.93 +12.5%
49505 Outpatient surgery $567.23 +11.7%
58571 Outpatient surgery $916.79 +10.6%
19120 Outpatient surgery $699.74 +22.1%
43775 Outpatient surgery $1,027.92 +2.8%

Common questions Copy link

Which ZIP codes does the San Francisco, CA rate for 64721 cover?
The CMS ZIP-to-locality crosswalk maps 254 ZIP codes to this payment locality, and every one of them prices 64721 identically. Examples include 94002, 94003, 94005, 94010, 94011, 94012. 2 of them span more than one payment locality, so those need ZIP+4 for an exact match.
Why is the 64721 rate in San Francisco, 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 1.095, practice expense 1.410, malpractice 0.425 — scale each RVU component before the conversion factor is applied, which is why San Francisco, CA allows more than the $482.64 baseline.
Which cities does the San Francisco, CA rate for 64721 cover?
This payment locality also covers Oakland and Berkeley. 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 San Francisco, CA?
$513.10 in a facility, versus $596.93 in the office (non-facility) setting — a $83.83 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 San Francisco, CA?
A non-participating provider is paid $567.08 — 95% of the $596.93 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $652.14, which is 115% of the non-participating amount.
How much of the San Francisco, CA 64721 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($477.54) once the annual Part B deductible is met, and the beneficiary owes 20% ($119.39). Sequestration reduces Medicare's share by about 2% ($9.55), leaving $467.99. 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 01112-05'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 24)
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 San Francisco, CA against the release that governed that date. Past releases need a free account; today's rate does not.

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