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Billing code 67320: Muscle transpositionMedicare rate & RVUs

Reports an extraocular muscle transposition performed with a primary strabismus operation to redirect muscle pull and address ocular misalignment.

CMS RVU26DEffective Oct 1, 2026109 payment localities339 Medicare services in 2024

Medicare pays $139.62 for 67320 nationally in a facility.

Medicare rate · 67320

Muscle transposition

Work RVUs
2.93
Total RVUs
4.18
Global days
ZZZ

National rate · 2026

$139.62

Facility setting, before claim adjustments.

See every locality for 67320 →Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 67320 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 67320 covers

An extraocular muscle transposition changes the direction of a muscle’s pull to help correct ocular misalignment. An ophthalmologist, often a strabismus surgeon, may perform this maneuver when the surgical plan requires repositioning a muscle or its tendon rather than relying only on a conventional recession or resection. It is performed as part of operative strabismus care, commonly in a facility setting.

Report 67320 only with a primary procedure; it is not a stand-alone service. The operative report should identify the muscle involved, the transposition performed, the clinical reason for changing its pull, and the primary strabismus procedure performed at the encounter. CMS treats this as an add-on paid within the primary procedure’s global period. The record should make clear that a transposition was performed, rather than only a standard muscle recession or resection.

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 67320 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

67320 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$132.13
Alaska*Unavailable$187.48
ArizonaUnavailable$137.49
ArkansasUnavailable$131.20
AtlantaUnavailable$141.94
AustinUnavailable$140.97
BakersfieldUnavailable$141.90
Baltimore/Surr. CntysUnavailable$145.43
BeaumontUnavailable$136.00
BrazoriaUnavailable$138.47

67320 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 every state and territory as a table
67320 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 67320 rate is calculated

Each of 67320’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 · 67320

RVUs × geographic indexes × conversion factor

Work2.93

2.93 RVUs× 1.000 GPCI

Practice expense1.03

1.03 RVUs× 1.000 GPCI

Malpractice0.22

0.22 RVUs× 1.000 GPCI

Adjusted RVUs

4.1800

Conversion factor

$33.4009

Medicare rate

$139.62

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

Payment rules and modifiers for 67320

The CMS indicators that decide how 67320 is paid alongside other services.

CMS payment indicators · 67320

Muscle transposition

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

67320 compared with similar codes

Compare codes · National

4 codes, side by side

  • 67320

    Muscle transposition2.93 wRVU

    Not priced

  • 67311

    Eye muscle surgery5.78 wRVU

    Not priced

  • 67314

    Eye muscle surgery5.78 wRVU

    Not priced

  • 67318

    Eye muscle surgery9.56 wRVU

    Not priced

How to choose

67311Eye muscle surgery
67311 describes recession or resection of one horizontal muscle. Choose 67320 for a transposition maneuver reported with a primary procedure.
67314Eye muscle surgery
67314 describes recession or resection of one vertical muscle. It does not describe redirecting a muscle’s pull by transposition.
67318Eye muscle surgery
67318 describes recession or resection of one oblique muscle. Use 67320 for the transposition add-on, not for that standard muscle adjustment.

Codes related to 67320

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

Codes related to 67320
CodeHow it relatesNational office range
Primary code
67311Eye muscle surgeryPrimary code for recession or resection of one horizontal muscle when performed with the transposition.No office rate
67314Eye muscle surgeryPrimary code for recession or resection of one vertical muscle when performed with the transposition.No office rate
67318Eye muscle surgeryPrimary code for recession or resection of one oblique muscle when performed with the transposition.No office rate
67312Strabismus surgeryPrimary code for recession or resection of two horizontal muscles when performed with the transposition.No office rate
67316Strabismus surgeryPrimary code for recession or resection of two vertical muscles when performed with the transposition.No office rate

67320 billing questions

Can 67320 be reported by itself?

No. CMS identifies it as an add-on code that must be billed with a primary procedure.

How is a transposition different from a recession or resection?

A transposition redirects the muscle’s pull by changing its position or course. Recession and resection instead adjust the muscle’s effective strength or tension.

What should the operative note document?

Document the muscle treated, the transposition maneuver, its purpose, and the primary strabismus procedure performed during the encounter.

How does the global period affect payment?

CMS includes payment for this add-on within the primary procedure’s global period. Submit it with the primary procedure, not as a separate stand-alone service.

Is 67320 the right choice for routine muscle recession or resection?

No. Use the applicable recession or resection code when that is the procedure performed; 67320 describes an additional transposition maneuver.

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 67320PPRRVU2026_Oct_nonQPP.csv, line 7,458 (RVU26D)

Open CMS sourceHow we calculate rates

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