FeeBase
Log inGet started
Menu

Billing code 67415: Orbital aspirationMedicare rate & RVUs

Needle aspiration of an orbital mass or localized collection for diagnostic sampling or evacuation when the service is performed without an open orbitotomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities187 Medicare services in 2024

Medicare pays $82.17 for 67415 nationally in a facility.

Medicare rate · 67415

Orbital aspiration

Swap in your local Medicare rate.

Work RVUs
1.72
Total RVUs
2.46
Global days
000

National rate · 2026

$82.17

Facility setting, before claim adjustments.

See every locality for 67415 → · 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 67415 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 67415 covers

67415 represents needle-based sampling or evacuation of material from within the orbit, rather than an incision-based orbitotomy. Ophthalmologists, especially oculoplastic or orbital surgeons, may use it to obtain cells or fluid from an orbital mass or localized collection when needle aspiration is the service performed. The record should identify the side and target, the reason for aspiration, the technique, and whether material was collected for analysis.

Report the service supported by the procedure note. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. For bilateral aspiration, modifier 50 is paid at 150%. An assistant at surgery is paid only when medical necessity is documented; 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 67415 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

67415 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$77.63
Alaska*Unavailable$110.09
ArizonaUnavailable$80.87
ArkansasUnavailable$77.07
AtlantaUnavailable$83.60
AustinUnavailable$82.91
BakersfieldUnavailable$83.35
Baltimore/Surr. CntysUnavailable$85.66
BeaumontUnavailable$80.03
BrazoriaUnavailable$81.42

67415 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
67415 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 67415 rate is calculated

Each of 67415’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 · 67415

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.72Practice expense 0.60Malpractice 0.14

2.4600 adjusted RVUs×$33.4009 conversion factor=$82.17

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 67415

The CMS indicators that decide how 67415 is paid alongside other services.

CMS payment indicators · 67415

Orbital aspiration

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

67415 without 50 · national facility

$82.17

Orbital aspiration

67415-50 · Bilateral: 150%

$123.26

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

67415 compared with similar codes

Compare codes

67415 vs 67400 vs 67405 vs 67440: national Medicare rates

Swap in your local Medicare rate.

  • 67415
    Orbital aspiration · 1.72 wRVU
    —
  • 67400
    Orbitotomy · 10.92 wRVU
    —
  • 67405
    Orbital drainage · 8.97 wRVU
    —
  • 67440
    Orbital drainage · 14.47 wRVU
    —

How to choose

67400Orbitotomy
67400 describes open exploration of the orbit, with or without biopsy. Choose 67415 when the documented procedure is needle aspiration rather than open exploration.
67405Orbital drainage
67405 is an orbitotomy-based drainage service. 67415 is for needle aspiration, not drainage performed through an open orbital approach.
67440Orbital drainage
67440 describes drainage through an orbitotomy approach; 67415 describes needle aspiration of orbital contents.

Codes related to 67415

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

Codes related to 67415
CodeHow it relatesNational office range
Used instead
67400OrbitotomyOpen orbital exploration, with or without biopsy, is a different approach from needle aspiration.No office rate
67405Orbital drainageOrbitotomy-based drainage is distinct from needle aspiration of orbital contents.No office rate
67440Orbital drainageAn orbitotomy drainage approach differs from the needle aspiration reported with 67415.No office rate

67415 billing questions

When should 67415 be chosen over an orbitotomy code?

Use 67415 when the documented service is needle aspiration of orbital contents. An incision-based exploration or drainage is represented by the applicable orbitotomy code.

How is bilateral orbital aspiration reported?

For aspiration performed on both orbits, report modifier 50. CMS pays the bilateral procedure at 150%.

What care is included in the global period?

The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant at surgery be reported?

CMS pays an assistant at surgery only when the record documents medical necessity.

What documentation supports 67415?

Document the orbit and target, the clinical reason for aspiration, the needle-based technique, and the material obtained or evacuated.

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 67415PPRRVU2026_Oct_nonQPP.csv, line 7,473 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 67415 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 67415 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →