Billing code 67412: Orbital surgeryMedicare rate & RVUs

Medicare pays $873.77 for 67412 nationally in a facility.

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

What 67412 covers

An ophthalmologist or oculoplastic surgeon uses a transconjunctival route to reach the orbit and remove a foreign body without creating a bone flap. A typical case involves a retained fragment within the eye socket, rather than an object on the ocular surface or inside the globe. The service may occur in a hospital or ambulatory surgical setting, depending on the patient and operative plan.

Select this code when the operative note supports both the orbital location and the transconjunctival approach, and describes removal of the foreign body. The code includes the operative exploration needed to locate and extract it. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, Medicare pays 150%. Assistant-at-surgery services are not paid; co-surgeons require supporting documentation, and team surgery is 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 67412 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

67412 rates by state

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

How the 67412 rate is calculated

Each of 67412’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 67412

67412 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

67412 compared with similar codes

How to choose

67430Orbital exploration

Use 67412 for transconjunctival access without a bone flap. Use 67430 when the surgeon uses a lateral approach with a bone flap or window to remove the orbital foreign body.

67400Orbitotomy

Use 67400 for transconjunctival orbital exploration, with or without biopsy, when the service is not foreign-body removal. Use 67412 when the operation removes an orbital foreign body.

67413Orbital surgery

Use 67413 for transconjunctival removal of an orbital tumor. Use 67412 when the target is a foreign body rather than a tumor.

67414Orbital decompression

Use 67414 for transconjunctival orbital decompression. Use 67412 when the operative objective is removal of a foreign body.

Codes related to 67412

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