Billing code 67413: Orbital surgeryMedicare rate & RVUs

Medicare pays $847.05 for 67413 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 67413 covers

This service involves surgically opening the orbit to locate and remove a retained foreign object, without creating a bone flap. It is typically performed by an ophthalmic surgeon, often an oculoplastic surgeon, in an operating room. The procedure is distinct from removing an object accessible at the eye surface or from aspirating orbital contents.

Report the code when the operative documentation supports orbital exploration and extraction of a foreign body, rather than removal of a lesion, drainage, or decompression. The record should identify the foreign object, the orbital approach, and the work performed to retrieve it. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 67413 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

67413 rates by state

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

How the 67413 rate is calculated

Each of 67413’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 67413

67413 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

67413 compared with similar codes

How to choose

67412Orbital surgery

Use 67413 for removal of a foreign object. Use 67412 when the orbital target is a lesion.

67430Orbital exploration

Both address orbital foreign body removal, but 67430 uses a lateral approach with a bone flap or window; 67413 is performed without a bone flap.

67400Orbitotomy

67400 describes orbital exploration, with or without biopsy. Report 67413 when the documented procedure removes a foreign object.

Codes related to 67413

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