No office rate
Both concern orbital reconstruction, but selection depends on the specific procedure documented. Compare the full operative work with the full descriptor rather than relying on the abbreviated CMS label.
On this page
CMS RVU26D · Effective 2026-10-01
21267 Orbital repositioning Medicare reimbursement rates
Reports surgical repositioning of one orbit using periorbital osteotomies to correct an orbital position or craniofacial skeletal deformity. Compare 21267 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 21267?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 21267 pays more and less
Craniofacial surgery
About 21267: Unilateral orbital repositioning with osteotomies
Reports surgical repositioning of one orbit using periorbital osteotomies to correct an orbital position or craniofacial skeletal deformity.
This service repositions the bony orbit on one side by making osteotomies around the orbit and moving the orbital framework. Craniofacial, oculoplastic, or plastic surgeons may perform it for a structural orbital deformity, such as orbital dystopia, in a hospital operating room. The operative report should establish that the work involved orbital bone cuts and repositioning, rather than soft-tissue eyelid repair alone or a limited canthal procedure.
Report the unilateral service when the documented operation matches this extent and method; include the side, osteotomy sites, and movement achieved. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral work, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21267
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU20.17 · 46%
- Practice expense (office) RVU19.99 · 46%
- Malpractice RVU3.75 · 9%
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.
21267 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
This code is for orbital repositioning through periorbital osteotomies. Code 21275 is considered for revision of orbitofacial bones when that is the service performed.
No office rate
Code 21280 addresses medial canthal support. It is not a substitute for repositioning the bony orbit with osteotomies.
No office rate
Both involve orbital reconstruction, but the operative technique and extent determine which code applies. Use this code when the documented service is unilateral orbital repositioning with periorbital osteotomies.
See how rates vary across the country
21267 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 21267 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $1328.81 |
| Alaska* | Office Unavailable | Facility $1790.64 |
| Arizona | Office Unavailable | Facility $1427.90 |
| Arkansas | Office Unavailable | Facility $1311.74 |
| Atlanta | Office Unavailable | Facility $1504.51 |
| Austin | Office Unavailable | Facility $1492.43 |
| Bakersfield | Office Unavailable | Facility $1494.56 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1555.84 |
| Beaumont | Office Unavailable | Facility $1397.65 |
| Brazoria | Office Unavailable | Facility $1438.46 |
| Chicago | Office Unavailable | Facility $1636.89 |
| Chico | Office Unavailable | Facility $1484.07 |
| Colorado | Office Unavailable | Facility $1490.02 |
| Connecticut | Office Unavailable | Facility $1557.82 |
| Dallas | Office Unavailable | Facility $1452.24 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1636.01 |
| Delaware | Office Unavailable | Facility $1449.34 |
| Detroit | Office Unavailable | Facility $1529.19 |
| East St. Louis | Office Unavailable | Facility $1540.23 |
| El Centro | Office Unavailable | Facility $1484.69 |
| Fort Lauderdale | Office Unavailable | Facility $1576.52 |
| Fort Worth | Office Unavailable | Facility $1447.19 |
| Fresno | Office Unavailable | Facility $1484.07 |
| Galveston | Office Unavailable | Facility $1445.81 |
| Hanford-Corcoran | Office Unavailable | Facility $1484.07 |
| Hawaii, Guam | Office Unavailable | Facility $1505.37 |
| Houston | Office Unavailable | Facility $1514.44 |
| Idaho | Office Unavailable | Facility $1347.21 |
| Indiana | Office Unavailable | Facility $1353.51 |
| Iowa | Office Unavailable | Facility $1334.35 |
| Kansas | Office Unavailable | Facility $1340.41 |
| Kentucky | Office Unavailable | Facility $1381.87 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1574.36 |
| Madera | Office Unavailable | Facility $1484.07 |
| Manhattan | Office Unavailable | Facility $1691.31 |
| Merced | Office Unavailable | Facility $1484.07 |
| Metropolitan Boston | Office Unavailable | Facility $1610.01 |
| Metropolitan Kansas City | Office Unavailable | Facility $1423.02 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1530.31 |
| Metropolitan St. Louis | Office Unavailable | Facility $1434.84 |
| Miami | Office Unavailable | Facility $1685.52 |
| Minnesota | Office Unavailable | Facility $1397.82 |
| Mississippi | Office Unavailable | Facility $1341.13 |
| Modesto | Office Unavailable | Facility $1484.07 |
| Montana** | Office Unavailable | Facility $1466.38 |
| Napa | Office Unavailable | Facility $1659.78 |
| Nebraska | Office Unavailable | Facility $1337.31 |
| Nevada** | Office Unavailable | Facility $1446.38 |
| New Hampshire | Office Unavailable | Facility $1478.35 |
| New Mexico | Office Unavailable | Facility $1436.39 |
| New Orleans | Office Unavailable | Facility $1444.27 |
| North Carolina | Office Unavailable | Facility $1376.68 |
| North Dakota** | Office Unavailable | Facility $1392.23 |
| Northern Nj | Office Unavailable | Facility $1624.42 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1743.28 |
| Ohio | Office Unavailable | Facility $1409.55 |
| Oklahoma | Office Unavailable | Facility $1367.26 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1559.79 |
| Portland | Office Unavailable | Facility $1519.46 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1586.68 |
| Puerto Rico | Office Unavailable | Facility $1472.10 |
| Queens | Office Unavailable | Facility $1686.63 |
| Redding | Office Unavailable | Facility $1484.07 |
| Rest Of California | Office Unavailable | Facility $1484.07 |
| Rest Of Florida | Office Unavailable | Facility $1500.26 |
| Rest Of Georgia | Office Unavailable | Facility $1418.57 |
| Rest Of Illinois | Office Unavailable | Facility $1479.06 |
| Rest Of Louisiana | Office Unavailable | Facility $1384.59 |
| Rest Of Maine | Office Unavailable | Facility $1365.87 |
| Rest Of Maryland | Office Unavailable | Facility $1471.11 |
| Rest Of Massachusetts | Office Unavailable | Facility $1487.37 |
| Rest Of Michigan | Office Unavailable | Facility $1424.70 |
| Rest Of Missouri | Office Unavailable | Facility $1371.24 |
| Rest Of New Jersey | Office Unavailable | Facility $1567.16 |
| Rest Of New York | Office Unavailable | Facility $1396.05 |
| Rest Of Oregon | Office Unavailable | Facility $1426.76 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1404.99 |
| Rest Of Texas | Office Unavailable | Facility $1420.43 |
| Rest Of Washington | Office Unavailable | Facility $1480.84 |
| Rhode Island | Office Unavailable | Facility $1487.94 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1524.45 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1541.60 |
| Salinas | Office Unavailable | Facility $1535.56 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1560.34 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1736.62 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1732.36 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1777.74 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1760.33 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1512.78 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1566.22 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1538.21 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1580.96 |
| Seattle (King Cnty) | Office Unavailable | Facility $1628.96 |
| South Carolina | Office Unavailable | Facility $1397.10 |
| South Dakota** | Office Unavailable | Facility $1383.47 |
| Southern Maine | Office Unavailable | Facility $1414.41 |
| Stockton | Office Unavailable | Facility $1484.07 |
| Suburban Chicago | Office Unavailable | Facility $1586.07 |
| Tennessee | Office Unavailable | Facility $1347.88 |
| Utah | Office Unavailable | Facility $1413.80 |
| Vallejo | Office Unavailable | Facility $1653.64 |
| Vermont | Office Unavailable | Facility $1398.08 |
| Virgin Islands | Office Unavailable | Facility $1472.10 |
| Virginia | Office Unavailable | Facility $1418.46 |
| Visalia | Office Unavailable | Facility $1484.07 |
| West Virginia | Office Unavailable | Facility $1433.15 |
| Wisconsin | Office Unavailable | Facility $1351.92 |
| Wyoming** | Office Unavailable | Facility $1434.07 |
| Yuba City | Office Unavailable | Facility $1484.07 |
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21267 billing questions
When is this code a better fit than a canthopexy code?
Use this code for repositioning the bony orbit with periorbital osteotomies. Medial or lateral canthopexy codes describe work on the canthal support structures, not orbital bone repositioning.
What documentation supports reporting the service?
The operative report should identify the affected side, the periorbital osteotomies, and how the bony orbit was repositioned. A description limited to eyelid or canthal soft-tissue work does not establish this service.
How is bilateral work reported?
CMS identifies this as a bilateral procedure: modifier 50 is paid at 150%. Document the work performed on each side.
Does the service include related postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,93121260,,Revise eye sockets,A,,17.45,16.80,NA,16.80,,3.23,37.48,37.48,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93221261,,Revise eye sockets,A,,33.22,25.75,NA,25.75,,6.17,65.14,65.14,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93321263,,Revise eye sockets,A,,30.23,24.66,NA,24.66,,5.61,60.50,60.50,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93421267,,Revise eye sockets,A,,20.17,19.99,NA,19.99,,3.75,43.91,43.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93521268,,Revise eye sockets,A,,26.39,23.25,NA,23.25,,4.89,54.53,54.53,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93621270,,Augmentation cheek bone,A,,10.36,20.78,,7.94,,1.92,33.06,20.22,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93721275,,Revision orbitofacial bones,A,,11.47,9.28,NA,9.28,,2.13,22.88,22.88,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00