Billing code 15821: Lower eyelid surgeryMedicare rate & RVUs

Medicare pays $634.28 for 15821 nationally in the office and $483.65 in a hospital or facility. Local office rates run $568.79–$821.00.

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

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.

Where 15821 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

15821 rates by state

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

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.

Payment rules and modifiers for 15821

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

What modifiers do to the payment

When to use modifier 50

15821 compared with similar codes

How to choose

15820Lower eyelid surgery

Both address lower-lid blepharoplasty, but 15821 is selected when the operation addresses pronounced orbital fat-pad prolapse; 15820 is for the lower-lid procedure without that extent of fat involvement.

15822Upper eyelid surgery

15822 describes upper-eyelid blepharoplasty. Use 15821 for the lower eyelid with prominent orbital fat-pad prolapse.

15823Upper eyelid surgery

15823 concerns upper-lid blepharoplasty with excess skin. It is not the code for lower-lid fat-pad contouring.

Codes related to 15821

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates