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Medicare Physician Fee Schedule · Q3 2026 release

CPT 64721 in Charlotte, NC 11502-00

Open carpal tunnel release in ZIPs including 28202, 27601, and 27701

64721 2026 C · Charlotte, NC flag11502-00 A Active
Allowed amount
$451.44
in a doctor’s own office or clinic

93.5% of the $482.64 national baseline

Medicare payment
$361.15
Patient / secondary
$90.29
Expected total to provider
$451.44

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 Charlotte, NC? Copy link

The Medicare allowed amount is $451.44 in the office (non-facility) setting and $395.97 in a facility, under the Q3 2026 Physician Fee Schedule. The office amount is 6.5% below the national baseline, and the facility amount is 6.4% below 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 Charlotte, NC in? Copy link

CMS prices all of North Carolina as one Medicare payment locality, so this amount applies statewide, including Raleigh, Durham, Greensboro and Winston-Salem — not only in Charlotte, NC.

Why Charlotte, NC differs from the national amount Copy link

Charlotte, NC (this locality)
$451.44
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 Charlotte, NC at 6.5% below the national baseline.

Work GPCI
1.000
Practice expense GPCI
0.933
Malpractice GPCI
0.639
2026 conversion factor
$33.4009

Formula and inputs Copy link

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

RVU and GPCI components of the Charlotte, NC allowed amount for 64721
Component RVU × GPCI = Adjusted RVU
Work 4.85 1.000 4.8500
Practice expense 8.61 0.933 8.0331
Malpractice 0.99 0.639 0.6326
Sum of adjusted RVUs 13.5157
× $33.4009 2026 conversion factor $451.44

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient or ASC), Charlotte, NC allows $395.97 for 64721, versus $451.44 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 Charlotte, NC. 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 Charlotte, NC
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $451.44
Non-participating allowed amount 95% of the participating amount. $428.87
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount. $493.20
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met. $361.15
Beneficiary coinsurance The remaining 20%. $90.29
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share. $7.22
Medicare pays after sequestration Program payment net of the sequestration reduction. $353.93

Contracted rate: % of Medicare in Charlotte, NC 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 — $451.44 in the office (non-facility) setting — not the $482.64 national baseline.

Opens the calculator already set to Charlotte, NC 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 Charlotte, NC rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 1,102 ZIP codes to this payment locality. 64721 prices identically in every one of them.

27006 27007 27009 27010 27011 27012 27013 27014 27016 27017 27018 27019 27020 27021 27022 27023 27024 27025 27027 27028 27030 27031 27040 27041 27042 27043 27045 27046 27047 27048 27049 27050 27051 27052 27053 27054 27055 27094 27098 27099 27101 27102 27103 27104 27105 27106 27107 27108 27109 27110 27111 27113 27114 27115 27116 27117 27120 27127 27130 27150 27151 27152 27155 27156 27157 27198 27199 27201 27202 27203 27204 27205 27207 27208 27209 27212 27213 27214 27215 27216 27217 27220 27228 27229 27230 27231 27233 27235 27237 27239 27242 27243 27244 27247 27248 27249 27252 27253 27256 27258

1,002 more ZIP codes map to this locality. The Charlotte, NC 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 Charlotte, NC, 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 Charlotte, NC
Metro Allowed amount vs. Charlotte, NC
Charleston, SC $455.83 +1.0%
Richmond, VA $468.03 +3.7%
Atlanta, GA $494.38 +9.5%
Nashville, TN $441.16 -2.3%
Washington, DC $546.32 +21.0%
Birmingham, AL $432.34 -4.2%

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

Other codes priced in Charlotte, NC Copy link

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

Other curated codes and their allowed amounts in Charlotte, NC
Code Service Charlotte, NC vs. national
66984 Cataract Surgery $442.35 -4.4%
27447 Knee Replacement $1,084.96 -6.4%
66982 Complex Cataract Surgery With Lens Implant $602.96 -4.4%
27130 Total Hip Arthroplasty $1,087.16 -6.4%
29827 Arthroscopic Rotator Cuff Repair $914.96 -6.3%
47562 Outpatient surgery $586.23 -7.2%
29881 Outpatient surgery $482.74 -6.4%
23472 Total Shoulder Arthroplasty $1,218.66 -6.3%
49505 Outpatient surgery $471.22 -7.2%
58571 Outpatient surgery $776.73 -6.3%
19120 Outpatient surgery $533.43 -6.9%
43775 Outpatient surgery $925.84 -7.4%

Common questions Copy link

Which ZIP codes does the Charlotte, NC rate for 64721 cover?
The CMS ZIP-to-locality crosswalk maps 1,102 ZIP codes to this payment locality, and every one of them prices 64721 identically. Examples include 27006, 27007, 27009, 27010, 27011, 27012.
Why is the 64721 rate in Charlotte, NC 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 1.000, practice expense 0.933, malpractice 0.639 — scale each RVU component before the conversion factor is applied, which is why Charlotte, NC allows less than the $482.64 baseline.
Does this 64721 rate apply everywhere in North Carolina?
Yes. CMS prices North Carolina as a single Medicare payment locality, so the same GPCIs — and the same allowed amount — apply statewide, not only in Charlotte, NC. That includes Raleigh, Durham, Greensboro and Winston-Salem. The city name here is a search-facing label for a statewide payment locality, not a city-specific rate.
What is the facility rate for 64721 in Charlotte, NC?
$395.97 in a facility, versus $451.44 in the office (non-facility) setting — a $55.47 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 Charlotte, NC?
A non-participating provider is paid $428.87 — 95% of the $451.44 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $493.20, which is 115% of the non-participating amount.
How much of the Charlotte, NC 64721 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($361.15) once the annual Part B deductible is met, and the beneficiary owes 20% ($90.29). Sequestration reduces Medicare's share by about 2% ($7.22), leaving $353.93. 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 11502-00'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 83)
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 Charlotte, NC against the release that governed that date. The last 12 months price without an account; older dates of service need a free account.

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