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Medicare Physician Fee Schedule · Q3 2026 release

CPT 64721 in Dallas, TX 04412-11

Open carpal tunnel release in ZIPs including 75201, 75225, and 75219

64721 2026 C · Dallas, TX flag04412-11 A Active
Allowed amount
$478.26
in a doctor’s own office or clinic

99.1% of the $482.64 national baseline

Medicare payment
$382.61
Patient / secondary
$95.65
Expected total to provider
$478.26

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 Dallas, TX? Copy link

The Medicare allowed amount is $478.26 in the office (non-facility) setting and $419.04 in a facility, under the Q3 2026 Physician Fee Schedule. The office amount is 0.9% below the national baseline, and the facility amount is 1.0% 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 Dallas, TX in? Copy link

CMS payment locality Dallas (04412-11). Every location in it is priced identically.

Why Dallas, TX differs from the national amount Copy link

Dallas, TX (this locality)
$478.26
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 Dallas, TX at 0.9% below the national baseline.

Work GPCI
1.009
Practice expense GPCI
0.996
Malpractice GPCI
0.858
2026 conversion factor
$33.4009

Formula and inputs Copy link

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

RVU and GPCI components of the Dallas, TX allowed amount for 64721
Component RVU × GPCI = Adjusted RVU
Work 4.85 1.009 4.8936
Practice expense 8.61 0.996 8.5756
Malpractice 0.99 0.858 0.8494
Sum of adjusted RVUs 14.3186
× $33.4009 2026 conversion factor $478.26

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient or ASC), Dallas, TX allows $419.04 for 64721, versus $478.26 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 Dallas, TX. 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 Dallas, TX
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $478.26
Non-participating allowed amount 95% of the participating amount. $454.35
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount. $522.50
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met. $382.61
Beneficiary coinsurance The remaining 20%. $95.65
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share. $7.65
Medicare pays after sequestration Program payment net of the sequestration reduction. $374.96

Contracted rate: % of Medicare in Dallas, TX 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 — $478.26 in the office (non-facility) setting — not the $482.64 national baseline.

Opens the calculator already set to Dallas, TX 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 Dallas, TX rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 186 ZIP codes to this payment locality. 64721 prices identically in every one of them. 17 of them span more than one locality and need ZIP+4 for an exact match.

75001 75006 75011 75014 75015 75016 75017 75019 75030 75037 75038 75039 75040 75041 75042 75043 75044 75045 75046 75047 75048 75049 75050 75051 75052 75053 75054 75059 75060 75061 75062 75063 75064 75080 75081 75082 75083 75084 75085 75088 75089 75099 75104 75106 75115 75116 75123 75134 75137 75138 75141 75146 75149 75150 75159 75172 75180 75181 75182 75185 75187 75201 75202 75203 75204 75205 75206 75207 75208 75209 75210 75211 75212 75214 75215 75216 75217 75218 75219 75220 75221 75222 75223 75224 75225 75226 75227 75228 75229 75230 75231 75232 75233 75234 75235 75236 75237 75238 75239 75240

86 more ZIP codes map to this locality. The Dallas, TX 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 Dallas, TX, 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 Dallas, TX
Metro Allowed amount vs. Dallas, TX
Fort Worth, TX $475.81 -0.5%
Austin, TX $495.88 +3.7%
San Antonio, TX $464.77 -2.8%
Houston, TX $494.36 +3.4%
Oklahoma City, OK $444.50 -7.1%
Wichita, KS $438.63 -8.3%

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

Other codes priced in Dallas, TX Copy link

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

Other curated codes and their allowed amounts in Dallas, TX
Code Service Dallas, TX vs. national
66984 Cataract Surgery $461.38 -0.3%
27447 Knee Replacement $1,144.48 -1.3%
66982 Complex Cataract Surgery With Lens Implant $628.78 -0.3%
27130 Total Hip Arthroplasty $1,147.00 -1.3%
29827 Arthroscopic Rotator Cuff Repair $964.94 -1.2%
47562 Outpatient surgery $621.54 -1.6%
29881 Outpatient surgery $510.17 -1.1%
23472 Total Shoulder Arthroplasty $1,284.37 -1.2%
49505 Outpatient surgery $499.92 -1.6%
58571 Outpatient surgery $818.02 -1.3%
19120 Outpatient surgery $566.69 -1.1%
43775 Outpatient surgery $980.41 -2.0%

Common questions Copy link

Which ZIP codes does the Dallas, TX rate for 64721 cover?
The CMS ZIP-to-locality crosswalk maps 186 ZIP codes to this payment locality, and every one of them prices 64721 identically. Examples include 75001, 75006, 75011, 75014, 75015, 75016. 17 of them span more than one payment locality, so those need ZIP+4 for an exact match.
Why is the 64721 rate in Dallas, TX 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 1.009, practice expense 0.996, malpractice 0.858 — scale each RVU component before the conversion factor is applied, which is why Dallas, TX allows less than the $482.64 baseline.
What is the facility rate for 64721 in Dallas, TX?
$419.04 in a facility, versus $478.26 in the office (non-facility) setting — a $59.22 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 Dallas, TX?
A non-participating provider is paid $454.35 — 95% of the $478.26 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $522.50, which is 115% of the non-participating amount.
How much of the Dallas, TX 64721 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($382.61) once the annual Part B deductible is met, and the beneficiary owes 20% ($95.65). Sequestration reduces Medicare's share by about 2% ($7.65), leaving $374.96. 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 04412-11'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 99)
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 Dallas, TX against the release that governed that date. Past releases need a free account; today's rate does not.

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