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Medicare Physician Fee Schedule · Q3 2026 release

CPT 64721 in Omaha, NE 05402-00

Open carpal tunnel release in ZIPs including 68102, 68508, and 68114

64721 2026 C · Omaha, NE flag05402-00 A Active
Allowed amount
$439.93
in a doctor’s own office or clinic

91.2% of the $482.64 national baseline

Medicare payment
$351.94
Patient / secondary
$87.99
Expected total to provider
$439.93

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 Omaha, NE? Copy link

The Medicare allowed amount is $439.93 in the office (non-facility) setting and $385.06 in a facility, under the Q3 2026 Physician Fee Schedule. The office amount is 8.8% below the national baseline, and the facility amount is 9.0% 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 Omaha, NE in? Copy link

CMS prices all of Nebraska as one Medicare payment locality, so this amount applies statewide, including Lincoln, Bellevue and Grand Island — not only in Omaha, NE.

Why Omaha, NE differs from the national amount Copy link

Omaha, NE (this locality)
$439.93
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 Omaha, NE at 8.8% below the national baseline.

Work GPCI
1.000
Practice expense GPCI
0.923
Malpractice GPCI
0.378
2026 conversion factor
$33.4009

Formula and inputs Copy link

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

RVU and GPCI components of the Omaha, NE allowed amount for 64721
Component RVU × GPCI = Adjusted RVU
Work 4.85 1.000 4.8500
Practice expense 8.61 0.923 7.9470
Malpractice 0.99 0.378 0.3742
Sum of adjusted RVUs 13.1712
× $33.4009 2026 conversion factor $439.93

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient or ASC), Omaha, NE allows $385.06 for 64721, versus $439.93 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 Omaha, NE. 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 Omaha, NE
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $439.93
Non-participating allowed amount 95% of the participating amount. $417.93
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount. $480.62
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met. $351.94
Beneficiary coinsurance The remaining 20%. $87.99
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share. $7.04
Medicare pays after sequestration Program payment net of the sequestration reduction. $344.90

Contracted rate: % of Medicare in Omaha, NE 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 — $439.93 in the office (non-facility) setting — not the $482.64 national baseline.

Opens the calculator already set to Omaha, NE 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 Omaha, NE rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 632 ZIP codes to this payment locality. 64721 prices identically in every one of them. 13 of them span more than one locality and need ZIP+4 for an exact match.

68001 68002 68003 68004 68005 68007 68008 68009 68010 68014 68015 68016 68017 68018 68019 68020 68022 68023 68025 68026 68028 68029 68030 68031 68033 68034 68035 68036 68037 68038 68039 68040 68041 68042 68044 68045 68046 68047 68048 68050 68054 68055 68056 68057 68058 68059 68061 68062 68063 68064 68065 68066 68067 68068 68069 68070 68071 68072 68073 68101 68102 68103 68104 68105 68106 68107 68108 68109 68110 68111 68112 68113 68114 68116 68117 68118 68119 68120 68122 68123 68124 68127 68128 68130 68131 68132 68133 68134 68135 68136 68137 68138 68139 68142 68144 68145 68147 68152 68154 68155

532 more ZIP codes map to this locality. The Omaha, NE 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 Omaha, NE, 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 Omaha, NE
Metro Allowed amount vs. Omaha, NE
Des Moines, IA $438.26 -0.4%
Kansas City, MO $464.34 +5.5%
Wichita, KS $438.63 -0.3%
Minneapolis, MN $467.70 +6.3%
Denver, CO $495.75 +12.7%
Chicago, IL $528.04 +20.0%

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

Other codes priced in Omaha, NE Copy link

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

Other curated codes and their allowed amounts in Omaha, NE
Code Service Omaha, NE vs. national
66984 Cataract Surgery $435.59 -5.8%
27447 Knee Replacement $1,046.05 -9.8%
66982 Complex Cataract Surgery With Lens Implant $593.36 -5.9%
27130 Total Hip Arthroplasty $1,047.97 -9.8%
29827 Arthroscopic Rotator Cuff Repair $884.70 -9.4%
47562 Outpatient surgery $560.94 -11.2%
29881 Outpatient surgery $468.13 -9.2%
23472 Total Shoulder Arthroplasty $1,176.31 -9.5%
49505 Outpatient surgery $451.55 -11.1%
58571 Outpatient surgery $748.43 -9.7%
19120 Outpatient surgery $517.47 -9.7%
43775 Outpatient surgery $878.37 -12.2%

Common questions Copy link

Which ZIP codes does the Omaha, NE rate for 64721 cover?
The CMS ZIP-to-locality crosswalk maps 632 ZIP codes to this payment locality, and every one of them prices 64721 identically. Examples include 68001, 68002, 68003, 68004, 68005, 68007. 13 of them span more than one payment locality, so those need ZIP+4 for an exact match.
Why is the 64721 rate in Omaha, NE 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 0.923, malpractice 0.378 — scale each RVU component before the conversion factor is applied, which is why Omaha, NE allows less than the $482.64 baseline.
Does this 64721 rate apply everywhere in Nebraska?
Yes. CMS prices Nebraska as a single Medicare payment locality, so the same GPCIs — and the same allowed amount — apply statewide, not only in Omaha, NE. That includes Lincoln, Bellevue and Grand Island. 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 Omaha, NE?
$385.06 in a facility, versus $439.93 in the office (non-facility) setting — a $54.87 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 Omaha, NE?
A non-participating provider is paid $417.93 — 95% of the $439.93 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $480.62, which is 115% of the non-participating amount.
How much of the Omaha, NE 64721 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($351.94) once the annual Part B deductible is met, and the beneficiary owes 20% ($87.99). Sequestration reduces Medicare's share by about 2% ($7.04), leaving $344.90. 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 05402-00'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 72)
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 Omaha, NE against the release that governed that date. Past releases need a free account; today's rate does not.

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