Billing code 67414: Orbital decompressionMedicare rate & RVUs

Medicare pays $1,249.19 for 67414 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 67414 covers

An ophthalmic or oculoplastic surgeon performs an orbitotomy without raising a bone flap to create additional orbital space. A common setting is treatment of thyroid eye disease when proptosis or pressure on the optic nerve calls for orbital decompression. The operative approach and tissue work distinguish this service from decompression performed through a lateral bone flap or window.

Report the code when the operative note supports decompression without a bone flap, including the indication, approach, and work performed. It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. 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. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires 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 67414 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

67414 rates by state

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

How the 67414 rate is calculated

Each of 67414’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 67414

67414 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

67414 compared with similar codes

How to choose

67445Orbital decompression

Both describe orbital decompression, but 67445 uses a lateral bone flap or window. This code is for decompression without a bone flap.

67400Orbitotomy

Code 67400 describes orbitotomy for exploration, with or without biopsy. Choose this code when the operative service is decompression without a bone flap.

67420Orbitotomy

Code 67420 describes lateral orbitotomy with a bone flap or window for exploration. It is not the decompression service represented by this code.

67405Orbital drainage

Code 67405 is for orbitotomy with drainage. This code is for orbital decompression without a bone flap, not drainage of an orbital collection.

Codes related to 67414

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