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Medicare Physician Fee Schedule · Q4 2026 release

CPT 64721 in Fort Worth, TX

Open carpal tunnel release in ZIPs including 76102, 76107, and 76109

64721 Q4 2026 · Fort Worth, TX flag04412-28
Locality-adjusted allowed amount
$475.81
in a doctor’s own office or clinic

98.6% of the $482.64 national baseline

( Work4.85 × 1.009 + Practice exp.8.61 × 0.986 + Malpractice0.99 × 0.871 ) × Conv. factor$33.4009 = $475.81

The Medicare allowed amount is $475.81 in the Office (non-facility) setting and $417.19 in a facility, under the Q4 2026 Physician Fee Schedule. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied—not necessarily what a specific claim pays.

Q4 2026 · Locality 04412-28 · Participating · Whole service · Sequestration excluded

CMS sources and method · Calculation inputs

Calculate with this locality Check service-location ZIP

What Medicare locality is Fort Worth, TX in? Copy link

Fort Worth, TX is in CMS payment locality Fort Worth (04412-28). The same amount applies everywhere in it.

Confirm the locality before using this amount. A split ZIP needs ZIP+4 for an exact match.

ZIP codes in this payment locality (98)

The CMS ZIP-to-locality crosswalk maps 98 ZIP codes to this payment locality. Use this amount only after you confirm the service location is in this locality. Of these, 9 span more than one locality and need ZIP+4 for an exact match.

76001 76002 76003 76004 76005 76006 76007 76010 76011 76012 76013 76014 76015 76016 76017 76018 76019 76020 76021 76022 76034 76036 76039 76040 76051 76052 76053 76054 76060 76063 76092 76094 76095 76096 76099 76101 76102 76103 76104 76105 76106 76107 76108 76109 76110 76111 76112 76113 76114 76115 76116 76117 76118 76119 76120 76121 76122 76123 76124 76126 76127 76129 76130 76131 76132 76133 76134 76135 76136 76137 76140 76147 76148 76150 76155 76161 76162 76163 76164 76166 76177 76178 76179 76180 76181 76182 76185 76190 76191 76192 76193 76195 76196 76197 76198 76199 76244 76248
Which ZIP codes does the Fort Worth, TX rate for 64721 cover?

The CMS ZIP-to-locality crosswalk maps 98 ZIP codes to this payment locality, and 64721 has the same amount in every one of them. Examples include 76001, 76002, 76003, 76004, 76005, 76006. Of these, 9 span more than one payment locality and need ZIP+4 for an exact match.

How locality affects the amount Copy link

Office (non-facility) · Q4 2026 · Participating · Whole service

Fort Worth, TX (this locality)
$475.81
National PFS baseline (GPCI 1.000)
$482.64

Each of this locality's geographic practice cost indices (GPCIs) scales one RVU component before the conversion factor is applied. Together they put Fort Worth, TX 1.4% below the national baseline.

Work GPCI
1.009
Practice expense GPCI
0.986
Malpractice GPCI
0.871
2026 conversion factor
$33.4009
Why is the 64721 rate in Fort Worth, 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 0.986, malpractice 0.871—scale each RVU component before the conversion factor is applied, which is why the Fort Worth, TX amount is lower than the $482.64 baseline.

Formula and inputs Copy link

For the office (non-facility) amount, each of 64721's RVU components is multiplied by its Fort Worth, TX GPCI; the products are summed and multiplied by the conversion factor.

Code
64721
DOS
Not selected; uses this release’s rates
Locality
FORT WORTH (TX)
Setting
Office (non-facility)
Participation
Participating provider
Modifiers
None
Units
1
Release
Q4 2026, revision 2
Sequestration
Shown separately from the allowed amount

Formula

(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor

Localis calculated this from CMS’s published inputs. Select an underlined value to see where it comes from.

RVU × GPCI components of Fort Worth, TX allowed amount for 64721
Component RVU × GPCI = Adjusted
Work 4.85 × 1.009 4.8936
Practice expense · Office (non-facility) 8.61 × 0.986 8.4895
Malpractice 0.99 × 0.871 0.8623
Sum of adjusted RVUs 14.2454
× 33.4009 conversion factor = formula amount $475.81

Component subtotals show four decimals. The formula amount is rounded to cents before any later adjustment.

  1. Locality-adjusted allowed amount $475.81

    After applicable fee-schedule adjustments; sequestration excluded

Citations

  • Supplies the RVUs and PFS status for this code and component.

    Physician relative value file (PPRRVU)

    Q4 2026 · revision 2

    Latest revision of this release

    Release period: October 1 – December 31, 2026

    Record details PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip (row 7,210)
    hcpcs (col 1)
    64721
    modifier (col 2)
    blank
    status_code (col 4)
    A
    work_rvu (col 6)
    4.85
    pe_rvu_nonfacility (col 7)
    8.61
    pe_rvu_facility (col 9)
    6.83
    mp_rvu (col 11)
    0.99

    SHA-256: 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

    Original source file

  • Supplies the geographic adjustment factors for this locality.

    Geographic practice cost indices (GPCI)

    Q4 2026 · revision 2

    Latest revision of this release

    Release period: October 1 – December 31, 2026

    Record details GPCI2026.csv in rvu26d-updated-08-26-2026.zip (row 100)
    mac (col 1)
    04412
    locality_code (col 3)
    28
    work_gpci (col 5)
    1.009
    pe_gpci (col 6)
    0.986
    mp_gpci (col 7)
    0.871

    SHA-256: 7850e2987d12e46930e49033f96829b5ae11f60dd1f19965329b38cf08b05264

    Original source file

  • Supplies the dollar conversion factor used in the formula.

    Physician relative value file (PPRRVU)

    Q4 2026 · revision 2

    Latest revision of this release

    Release period: October 1 – December 31, 2026

    Record details PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip (row 11)
    conversion_factor (col 26)
    33.4009

    SHA-256: 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

    Original source file

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient department or ASC), the allowed amount for 64721 in Fort Worth, TX is $417.19, versus $475.81 in the Office (non-facility) setting. Only the practice-expense RVU changes with the setting: the facility bills its own fee for overhead, so the professional amount is lower. See which setting applies to your place of service.

What is the Facility amount for 64721 in Fort Worth, TX?

$417.19 in a facility, versus $475.81 in the Office (non-facility) setting—a $58.62 difference. Only the practice-expense RVU changes with the setting: in the Office (non-facility) setting the practice carries the overhead, so the professional amount is higher; in a hospital or ASC the facility bills its own fee.

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in Fort Worth, TX. Medicare pays part of the allowed amount and the patient pays the rest; the rows below show each figure. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for 64721 in Fort Worth, TX
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $475.81
Non-participating allowed amount 95% of the participating amount. $452.02
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim—115% of the non-participating amount. $519.82
Medicare share 80% of the allowed amount, once the annual Part B deductible is met. $380.65
Patient coinsurance The remaining 20%. $95.16
Sequestration adjustment Reduces only Medicare's share—never the allowed amount or the patient's coinsurance. $7.61
Net Medicare payment Medicare's share after the sequestration reduction. $373.04
What is the non-participating amount and limiting charge for 64721 in Fort Worth, TX?

A non-participating provider is paid $452.02—95% of the $475.81 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $519.82, which is 115% of the non-participating amount.

How much of the Fort Worth, TX 64721 rate does Medicare actually pay?

Medicare pays 80% of the allowed amount ($380.65) once the annual Part B deductible is met, and the beneficiary owes 20% ($95.16). Sequestration reduces Medicare's share by about 2% ($7.61), leaving $373.04. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Contracted rate: % of Medicare in Fort Worth, TX Copy link

Commercial contracts are often written as a percentage of the Medicare fee schedule. The part that gets misread is which Medicare amount: a contract benchmarked to the fee schedule prices off this locality's allowed amount—$475.81 in the office (non-facility) setting—not the $482.64 national baseline.

Opens the calculator set to Fort Worth, TX and your selected setting, where you can also compare what a payer paid against the expected amount. See how to find your contract's actual percentage.

Compare 64721 in nearby payment localities

Payment localities in the same region as Fort Worth, TX, nearest first. Each amount is that locality's own GPCI-adjusted Office (non-facility) figure for 64721. Neighboring localities often differ.

64721 allowed amount in payment localities near Fort Worth, TX
Metro Allowed amount vs. Fort Worth, TX
Dallas, TX $478.26 +0.5%
Austin, TX $495.88 +4.2%
San Antonio, TX $464.77 -2.3%
Houston, TX $494.36 +3.9%
Oklahoma City, OK $444.50 -6.6%
Wichita, KS $438.63 -7.8%

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

Other codes priced in Fort Worth, TX Copy link

Office (non-facility) allowed amounts in this same payment locality, Q4 2026.

Other curated codes and their allowed amounts in Fort Worth, TX
Code and service Allowed vs. national
66984 Cataract Surgery $459.56 -0.7%
27447 Knee Replacement $1,142.35 -1.5%
66982 Complex Cataract Surgery With Lens Implant $626.42 -0.7%
27130 Total Hip Arthroplasty $1,144.87 -1.5%
29827 Arthroscopic Rotator Cuff Repair $962.60 -1.4%
47562 Outpatient surgery $620.69 -1.8%
29881 Outpatient surgery $508.37 -1.4%
23472 Total Shoulder Arthroplasty $1,281.92 -1.4%
49505 Outpatient surgery $499.00 -1.8%
58571 Outpatient surgery $816.91 -1.4%
19120 Outpatient surgery $564.00 -1.6%
43775 Outpatient surgery $981.08 -1.9%

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q4 2026 release: this code's RVUs from the relative value file, multiplied by payment locality 04412-28's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q4 2026 release. Past releases are never edited, so an amount for an earlier quarter always matches what CMS published for it. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q4 2026) · rvu26d-updated-08-26-2026.zip (PPRRVU2026_Oct_nonQPP.csv row 7,210)
Geographic practice cost indices (Q4 2026) · rvu26d-updated-08-26-2026.zip (GPCI2026.csv row 100)
ZIP code to carrier locality crosswalk (Q4 2026) · zip-code-carrier-locality-file-updated-08-13-2026.zip (ZIP5_OCT2026.txt)

Working a claim with an earlier date of service? The calculator prices 64721 in Fort Worth, TX against the release in effect on that date. Dates in the last 12 months don't need an account; older dates of service need a free account.

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