CPT® Code 64721

The procedure described by CPT® Code 64721 refers to neuroplasty and/or transposition of the median nerve at the carpal tunnel. This surgical intervention is specifically aimed at addressing carpal tunnel syndrome (CTS), a condition characterized by the compression of the median nerve as it passes through the carpal tunnel—a confined space located at the wrist, bordered by the carpal bones and the transverse carpal ligament. The compression of the median nerve can lead to symptoms such as pain, numbness, and weakness in the hand and fingers, particularly affecting the thumb, index, middle, and part of the ring finger. During the procedure, a regional or general anesthetic is administered to ensure patient comfort. The surgeon makes an incision in the skin over the carpal tunnel, which may extend over the wrist as necessary to provide adequate access. The palmar fascia is then exposed and incised to reveal the underlying structures. The carpal ligament, which is a key structure contributing to the compression of the median nerve, is carefully exposed and subsequently divided using surgical instruments such as scissors or a scalpel. This division alleviates the pressure on the median nerve, and in some cases, the nerve may be repositioned within the carpal tunnel to further relieve compression. Finally, the palmar fascia and skin are meticulously closed in layers to promote proper healing.