CPT code 15821: Lower eyelid surgery, prominent fat-pad prolapse2026 Medicare rate & RVUs in Alabama

Reports lower-eyelid blepharoplasty that addresses pronounced protrusion of orbital fat pads, with the operative work and findings supporting the selected level.

CMS RVU26DEffective Oct 1, 2026One payment locality465 Medicare services in 2024

In Alabama, Medicare pays $576.14 for 15821 in the office and $444.33 when it’s performed in a hospital or facility.

$576.14Office (non-facility)
$444.33Hospital or facility
−9.2%vs the national office rate ($634.28)

Check a contract rate as a % of Medicare · 15821 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 15821 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alabama
  2. What 15821 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 15821 covers

This procedure reshapes the lower eyelid when prominent orbital fat pads create under-eye bulging. The surgeon may remove or reposition protruding fat and address redundant skin as part of the lid contouring. Oculoplastic, plastic, or facial plastic surgeons commonly perform it in an ambulatory surgery center or hospital, and sometimes in an office-based operating setting. The operative note should identify the lower lid treated, describe the extent of fat prolapse, and document the work performed and the clinical indication.

Select this code when the lower-lid operation involves substantial fat-pad prolapse; use 15820 for lower-lid blepharoplasty without that extent of fat involvement. For both eyelids, CMS pays modifier 50 at 150% of the unilateral payment. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Alabama compares for 15821

Across 109 of 109 payment localities, the office rate for 15821 runs from $568.79 in Arkansas to $821.00 in San Benito County, CA. Alabama pays $576.14. The RVUs are the same everywhere; the geographic indexes change the dollars.

15821 in Alabama vs other payment areas
  1. Alabama · this page$576.14
  2. Los Angeles, CA · California$707.45+$131.31
  3. Washington, DC area · District of Columbia$718.15+$142.01
  4. Miami, FL · Florida$683.46+$107.32
  5. Chicago, IL · Illinois$665.91+$89.77
  6. Manhattan, NY · New York$724.41+$148.27
  7. Alaska · Alaska$761.26+$185.12

Other areas in Alabama first, then benchmark localities. Bars start at $0.

Every other payment area

15821 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$568.79$439.40
ArizonaArizona$619.07$473.11
Bakersfield, CACalifornia$667.45$502.35
Chico, CACalifornia$665.42$500.32
El Centro, CACalifornia$665.52$500.43
Fresno, CACalifornia$665.42$500.32
Hanford, CACalifornia$665.42$500.32
Madera, CACalifornia$665.42$500.32

15821 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$568.79

$761.26

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
15821 office rate range by state
State / territoryOffice rate rangeLocalities
AK$761.261
AL$576.141
AR$568.791
AZ$619.071
CA$665.42–$821.0029
CO$657.151
CT$673.311
DC$718.151
DE$628.531
FL$628.05–$683.463
GA$596.35–$645.552
GU$678.541
HI$678.541
IA$588.061
ID$591.661
IL$612.59–$665.914
IN$594.671
KS$586.091
KY$589.171
LA$588.55–$614.242
MA$654.10–$716.652
MD$639.41–$718.153
ME$594.89–$622.762
MI$603.17–$635.532
MN$630.301
MO$579.93–$615.623
MS$574.441
MT$634.241
NC$600.331
ND$621.391
NE$590.771
NH$647.551
NJ$681.16–$712.162
NM$606.291
NV$631.051
NY$608.35–$740.825
OH$600.551
OK$587.731
OR$626.28–$675.562
PA$601.13–$658.462
PR$638.251
RI$649.031
SC$601.401
SD$619.871
TN$588.761
TX$597.66–$654.868
UT$608.681
VA$621.27–$718.152
VI$638.251
VT$619.661
WA$652.65–$729.932
WI$602.891
WV$592.581
WY$628.641

See 15821 in every payment locality

How the 15821 rate is calculated

Each of 15821’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 15821

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.67

6.67 RVUs× 1.000 GPCI

Practice expense11.67

11.67 RVUs× 1.000 GPCI

Malpractice0.65

0.65 RVUs× 1.000 GPCI

Adjusted RVUs

18.9900

Conversion factor

$33.4009

Medicare rate

$634.28

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Alabama inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,562

Code
15821
Physician work
6.67
Practice expense
11.67
Malpractice
0.65

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Office calculation for 15821 in Alabama
ComponentRVULocality factorAdjusted
Physician work6.67× 1.0006.6700
Practice expense11.67× 0.87510.2112
Malpractice0.65× 0.5660.3679
Total RVUs17.2492
Conversion factor× 33.4009

Office rate, Alabama$576.14

Office: (6.67 × 1 + 11.67 × 0.875 + 0.65 × 0.566) × $33.4009 = $576.14

Facility: (6.67 × 1 + 7.16 × 0.875 + 0.65 × 0.566) × $33.4009 = $444.33

Open 15821 in the RVU calculator

Payment rules and modifiers for 15821

15821 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15821

Lower eyelid surgery, prominent fat-pad prolapse

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 15821

Lower eyelid surgery, prominent fat-pad prolapse

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

15821 without 50 · national office

$634.28

Lower eyelid surgery, prominent fat-pad prolapse

15821-50 · Bilateral: 150%

$951.42

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

How 15821 has changed in Alabama

15821 · Office / nonfacility

$576.14

Effective 2026-10-01

The base rate is $31.16 higher than on 2025-10-01, moving from $544.98 to $576.14 (5.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $544.98changed to$576.14

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.84 changed to 6.67
    • Practice expense RVU 11.10 changed to 11.67
    • Malpractice RVU 0.63 changed to 0.65
    • Practice expense GPCI 0.869 changed to 0.875
    • Malpractice GPCI 0.575 changed to 0.566

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $563.63changed to$544.98

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.19 changed to 11.10
    • Malpractice RVU 0.64 changed to 0.63

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $554.43changed to$563.63

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $575.50changed to$554.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.99 changed to 11.19
    • Malpractice RVU 0.66 changed to 0.64
    • Practice expense GPCI 0.878 changed to 0.869
    • Malpractice GPCI 0.748 changed to 0.575
  5. January 1, 2023

    RVU23A

    $589.04changed to$575.50

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.76 changed to 10.99
    • Malpractice RVU 0.68 changed to 0.66
    • Practice expense GPCI 0.888 changed to 0.878
    • Malpractice GPCI 0.921 changed to 0.748

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $585.83changed to$589.04

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.53 changed to 10.76
    • Malpractice RVU 0.65 changed to 0.68

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $582.23changed to$585.83

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.96 changed to 10.53
    • Malpractice RVU 0.62 changed to 0.65
    • Practice expense GPCI 0.889 changed to 0.888
    • Malpractice GPCI 0.707 changed to 0.921

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $575.25changed to$582.23

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.89 changed to 9.96
    • Malpractice RVU 0.65 changed to 0.62
    • Practice expense GPCI 0.890 changed to 0.889
    • Malpractice GPCI 0.492 changed to 0.707

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $574.44changed to$575.25

    • Conversion factor 35.9996 changed to 36.0391
    • Malpractice RVU 0.64 changed to 0.65

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$574.44

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$576.14$444.33RVU26D
2026-07-01$576.14$444.33RVU26C
2026-04-01$576.14$444.33RVU26B
2026-01-01$576.14$444.33RVU26A
2025-10-01$544.98$486.23RVU25D
2025-07-01$544.98$486.23RVU25C
2025-04-01$544.98$486.23RVU25B
2025-01-01$544.98$486.23RVU25A
2024-10-01$563.63$501.15RVU24D
2024-07-01$563.63$501.15RVU24C
2024-04-01$563.63$501.15RVU24B
2024-03-09$563.63$501.15RVU24AR
2024-01-01$554.43$492.97RVU24A
2023-10-01$575.50$511.53RVU23D
2023-07-01$575.50$511.53RVU23C
2023-04-01$575.50$511.53RVU23B
2023-01-01$575.50$511.53RVU23A
2022-10-01$589.04$523.58RVU22D
2022-07-01$589.04$523.58RVU22C
2022-04-01$589.04$523.58RVU22B
2022-01-01$589.04$523.58RVU22A
2021-10-01$585.83$521.38RVU21D
2021-07-01$585.83$521.38RVU21C
2021-04-01$585.83$521.38RVU21B
2021-01-01$585.83$521.38RVU21A
2020-10-01$582.23$521.59RVU20D
2020-07-01$582.23$521.59RVU20C
2020-04-01$582.23$521.59RVU20B
2020-01-01$582.23$521.59RVU20A
2019-10-01$575.25$516.23RVU19D
2019-07-01$575.25$516.23RVU19C
2019-04-01$575.25$516.23RVU19B
2019-01-01$575.25$516.23RVU19A
2018-10-01$574.44$516.45RVU18D
2018-07-01$574.44$516.45RVU18C
2018-04-01$574.44$516.45RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 15821 for an earlier date of service

Where the Alabama rate applies

Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.

  • Abanda
  • Abbeville
  • Adamsville
  • Addison
  • Akron
  • Alabaster
  • Albertville
  • Alexander City

Browse all communities in Alabama

15821 billing questions

How does 15821 differ from 15820?

Use 15821 when the lower-lid blepharoplasty addresses pronounced prolapse of orbital fat pads. Use 15820 for lower-lid blepharoplasty without that degree of fat-pad involvement.

Can 15820 also be reported for the same lower eyelid?

Do not separately report 15820 for the same lower-lid blepharoplasty represented by 15821. Document the fat-pad findings and the operative work supporting 15821.

How should bilateral lower-lid surgery be reported?

Report the bilateral procedure with modifier 50. CMS pays it at 150% of the unilateral payment.

What happens when another procedure is performed in the same session?

CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction.

What postoperative care is included in the global period?

The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.

When is assistant-at-surgery payment allowed?

CMS pays an assistant at surgery only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 15821PPRRVU2026_Oct_nonQPP.csv, line 1,562 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

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