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Billing code 67440: Orbital drainageMedicare rate & RVUs

Reports surgical drainage of an orbital collection through a lateral orbitotomy that uses a bone flap or window to access the eye socket.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,176.05 for 67440 nationally in a facility.

Medicare rate · 67440

Orbital drainage

Swap in your local Medicare rate.

Work RVUs
14.47
Total RVUs
35.21
Global days
090

National rate · 2026

$1,176.05

Facility setting, before claim adjustments.

See every locality for 67440 → · 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 67440 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 67440 covers

An ophthalmic or orbital surgeon uses a lateral approach to open the orbit through a bone flap or window and drain an orbital collection, such as an abscess. The procedure is generally performed in an operating room when the collection requires surgical access rather than aspiration alone. The defining features are the lateral bony approach and drainage, not simply exploration or removal of a lesion.

Report the code when the operative documentation supports both the lateral orbitotomy and drainage. Include the indication, side, approach, and the collection treated. This is major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; co-surgeons are paid only with 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 67440 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

67440 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,077.48
Alaska*Unavailable$1,442.81
ArizonaUnavailable$1,150.19
ArkansasUnavailable$1,065.04
AtlantaUnavailable$1,195.75
AustinUnavailable$1,210.53
BakersfieldUnavailable$1,232.86
Baltimore/Surr. CntysUnavailable$1,240.70
BeaumontUnavailable$1,114.44
BrazoriaUnavailable$1,165.50

67440 rates by state

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

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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
67440 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 67440 rate is calculated

Each of 67440’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 · 67440

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.47Practice expense 19.58Malpractice 1.16

35.2100 adjusted RVUs×$33.4009 conversion factor=$1,176.05

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

Payment rules and modifiers for 67440

67440 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67440

Orbital drainage

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 67440

Orbital drainage

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

67440 without 50 · national facility

$1,176.05

Orbital drainage

67440-50 · Bilateral: 150%

$1,764.08

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

67440 compared with similar codes

Compare codes

67440 vs 67405 vs 67430 vs 67415: national Medicare rates

Swap in your local Medicare rate.

  • 67440
    Orbital drainage · 14.47 wRVU
    —
  • 67405
    Orbital drainage · 8.97 wRVU
    —
  • 67430
    Orbital exploration · 14.91 wRVU
    —
  • 67415
    Orbital aspiration · 1.72 wRVU
    —

How to choose

67405Orbital drainage
Both codes describe orbital drainage. Choose 67440 when the surgeon uses a lateral orbitotomy with a bone flap or window; 67405 describes drainage without that approach.
67430Orbital exploration
67430 is for lateral orbitotomy exploration, with or without biopsy. Use 67440 when the operative service includes drainage through the lateral bony approach.
67415Orbital aspiration
67415 describes aspiration of orbital contents. 67440 is for surgical drainage through a lateral orbitotomy with a bone flap or window.

Codes related to 67440

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

Codes related to 67440
CodeHow it relatesNational office range
Used instead
67405Orbital drainageDrainage through an orbitotomy without the lateral bone-flap or window approach.No office rate
67415Orbital aspirationAspiration of orbital contents rather than surgical drainage through a lateral orbitotomy.No office rate
Same family
67430Orbital explorationLateral orbitotomy for exploration, with or without biopsy, rather than drainage.No office rate
67400OrbitotomyExploration through a non-lateral orbitotomy approach, with or without biopsy.No office rate

67440 billing questions

How is 67440 different from 67405?

67440 describes drainage through a lateral orbitotomy using a bone flap or window. 67405 is the drainage code for an orbitotomy without that lateral bony approach.

Can orbital aspiration be reported instead?

Use 67415 when the service is aspiration of orbital contents. 67440 describes surgical drainage through a lateral orbitotomy, not aspiration alone.

What documentation supports 67440?

The operative report should establish the lateral approach, use of a bone flap or window, the orbital collection, and the drainage performed. Document the side treated.

How is bilateral drainage reported?

For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.

What payment rules apply when other procedures are performed?

In the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.

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 67440PPRRVU2026_Oct_nonQPP.csv, line 7,476 (RVU26D)

Open CMS sourceHow we calculate rates

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