CPT code 67599: Unlisted orbit procedure, no dedicated CPT code2026 Medicare rate & RVUs in Texas
Report this code for an orbital procedure without a dedicated CPT code when no listed procedure code accurately describes the service.
CMS doesn’t publish an office rate for 67599 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 67599 covers
This code identifies a procedure involving the orbit for which no dedicated CPT code describes the service. It is selected based on the procedure performed, rather than simply because care involves the eye socket. Listed orbital procedures include implant insertion, implant revision, and optic nerve decompression; those specific services should be reported with their dedicated codes when they accurately describe the work. This code is for a different orbital procedure that lacks a matching listed code.
For Medicare physician fee schedule purposes, status C means CMS publishes no national payment amount and the Medicare Administrative Contractor sets payment for each claim. The contractor also determines the global period. In a session with multiple procedures, the highest-valued procedure is paid in full and the others at 50%; a bilateral procedure reported with modifier 50 is paid at 150%.
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.
Where 67599 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
How the 67599 rate is calculated
Each of 67599’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 · 67599
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67599
The CMS indicators that decide how 67599 is paid alongside other services.
CMS payment indicators · 67599
Unlisted orbit procedure, no dedicated CPT code
| Rule | CMS value | What it means |
|---|---|---|
| Global period | YYY | The Medicare contractor sets the global period. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67599 without 50 · national facility
$0.00
Unlisted orbit procedure, no dedicated CPT code
67599-50 · Bilateral: 150%
$0.00
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).
67599 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67550Orbital implantMuscles attached
- 67550 identifies orbital implant insertion. Choose 67599 only when the procedure performed is not accurately represented by that code or another dedicated code.
- 67560Socket implant revisionExisting orbital implant
- 67560 identifies orbital implant revision. Use 67599 for a different orbital procedure that lacks a matching dedicated code.
- 67570Optic nerve surgeryDecompression
- 67570 identifies optic nerve decompression. Use 67599 for a different orbital procedure that lacks a matching dedicated code.
67599 billing questions
When should 67599 be used instead of a listed orbital procedure code?
Use it when no dedicated CPT code accurately describes the orbital procedure performed. Use a listed code when it accurately describes the service, such as implant insertion, implant revision, or optic nerve decompression.
How does Medicare price 67599?
It has physician fee schedule status C: CMS publishes no national payment amount, and the Medicare Administrative Contractor sets payment for each claim.
Who sets the global period?
The Medicare contractor sets the global period for this code.
How are multiple procedures treated in the same session?
The highest-valued procedure is paid in full, and the other procedures are paid at 50%.
How does Medicare treat bilateral reporting with modifier 50?
A bilateral procedure reported with modifier 50 is paid at 150%.
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
Fee sheets · Coming soon
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