No office rate
Choose 67405 when the orbitotomy is performed to drain an orbital collection. Choose 67400 for exploration, with or without biopsy, when drainage is not the service performed.
On this page
CMS RVU26D · Effective 2026-10-01
67405 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$794.98
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Ophthalmic surgery
About 67405: Orbital drainage without bone flap
Reports open orbital drainage through an orbitotomy without a bone flap, such as drainage of an orbital abscess when drainage is the operative objective.
An ophthalmic or oculoplastic surgeon uses an orbitotomy without a bone flap to reach and drain an orbital collection, commonly an abscess. The service is generally performed in an operating room, often in a hospital facility, when operative access and drainage are needed rather than needle aspiration alone. The drainage is the defining purpose; exploration may provide access, but removal of a lesion or foreign body is a different operative objective.
Report 67405 when the operative documentation supports orbital drainage without a bone flap and identifies the site and collection treated. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. For bilateral surgery reported with modifier 50, CMS pays 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 67405
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.97 · 37%
- Practice expense (office) RVU14.32 · 60%
- Malpractice RVU0.71 · 3%
90
Medicare services in 2024 · #4962 by national volume
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.
67405 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Both describe orbital drainage, but 67440 uses a bone flap or window through a lateral approach; 67405 is drainage without a bone flap.
No office rate
67415 describes aspiration of orbital contents. 67405 describes open drainage through an orbitotomy.
No office rate
67412 is used when orbitotomy treatment includes removal of a lesion. 67405 is for drainage as the operative objective.
The same code, a different location
How does Delaware compare?
67405 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 67405
Office
Unavailable
Facility
$731.54
No comparable office rate is available.
Arkansas
Arkansas · 67405
Office
Unavailable
Facility
$722.68
No comparable office rate is available.
Arizona
Arizona · 67405
Office
Unavailable
Facility
$783.38
No comparable office rate is available.
Bakersfield
California · 67405
Office
Unavailable
Facility
$843.96
No comparable office rate is available.
Chico
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
El Centro
California · 67405
Office
Unavailable
Facility
$841.75
No comparable office rate is available.
Fresno
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Hanford-Corcoran
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Madera
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Merced
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Modesto
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Napa
California · 67405
Office
Unavailable
Facility
$960.93
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 67405
Office
Unavailable
Facility
$888.12
No comparable office rate is available.
Redding
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Rest Of California
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 67405
Office
Unavailable
Facility
$849.45
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 67405
Office
Unavailable
Facility
$879.37
No comparable office rate is available.
Salinas
California · 67405
Office
Unavailable
Facility
$875.96
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 67405
Office
Unavailable
Facility
$893.50
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 67405
Office
Unavailable
Facility
$1013.36
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 67405
Office
Unavailable
Facility
$1012.55
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 67405
Office
Unavailable
Facility
$1034.98
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 67405
Office
Unavailable
Facility
$1031.69
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 67405
Office
Unavailable
Facility
$862.20
No comparable office rate is available.
Santa Cruz-Watsonville
California · 67405
Office
Unavailable
Facility
$899.74
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 67405
Office
Unavailable
Facility
$878.40
No comparable office rate is available.
Santa Rosa-Petaluma
California · 67405
Office
Unavailable
Facility
$908.66
No comparable office rate is available.
Stockton
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Vallejo
California · 67405
Office
Unavailable
Facility
$959.77
No comparable office rate is available.
Visalia
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Yuba City
California · 67405
Office
Unavailable
Facility
$841.63
No comparable office rate is available.
Colorado
Colorado · 67405
Office
Unavailable
Facility
$830.63
No comparable office rate is available.
Connecticut
Connecticut · 67405
Office
Unavailable
Facility
$849.42
No comparable office rate is available.
Fort Lauderdale
Florida · 67405
Office
Unavailable
Facility
$827.00
No comparable office rate is available.
Rest Of Florida
Florida · 67405
Office
Unavailable
Facility
$792.50
No comparable office rate is available.
Atlanta
Georgia · 67405
Office
Unavailable
Facility
$814.94
No comparable office rate is available.
Rest Of Georgia
Georgia · 67405
Office
Unavailable
Facility
$754.52
No comparable office rate is available.
Hawaii, Guam
Hawaii · 67405
Office
Unavailable
Facility
$857.16
No comparable office rate is available.
Iowa
Iowa · 67405
Office
Unavailable
Facility
$746.67
No comparable office rate is available.
Idaho
Idaho · 67405
Office
Unavailable
Facility
$750.86
No comparable office rate is available.
East St. Louis
Illinois · 67405
Office
Unavailable
Facility
$787.40
No comparable office rate is available.
Rest Of Illinois
Illinois · 67405
Office
Unavailable
Facility
$773.36
No comparable office rate is available.
Suburban Chicago
Illinois · 67405
Office
Unavailable
Facility
$834.94
No comparable office rate is available.
Indiana
Indiana · 67405
Office
Unavailable
Facility
$754.52
No comparable office rate is available.
Kansas
Kansas · 67405
Office
Unavailable
Facility
$743.94
No comparable office rate is available.
Kentucky
Kentucky · 67405
Office
Unavailable
Facility
$746.51
No comparable office rate is available.
New Orleans
Louisiana · 67405
Office
Unavailable
Facility
$776.63
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 67405
Office
Unavailable
Facility
$745.62
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 67405
Office
Unavailable
Facility
$904.09
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 67405
Office
Unavailable
Facility
$826.95
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 67405
Office
Unavailable
Facility
$846.95
No comparable office rate is available.
Rest Of Maryland
Maryland · 67405
Office
Unavailable
Facility
$808.41
No comparable office rate is available.
Rest Of Maine
Maine · 67405
Office
Unavailable
Facility
$754.39
No comparable office rate is available.
Southern Maine
Maine · 67405
Office
Unavailable
Facility
$788.57
No comparable office rate is available.
Detroit
Michigan · 67405
Office
Unavailable
Facility
$801.15
No comparable office rate is available.
Rest Of Michigan
Michigan · 67405
Office
Unavailable
Facility
$763.07
No comparable office rate is available.
Minnesota
Minnesota · 67405
Office
Unavailable
Facility
$798.80
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 67405
Office
Unavailable
Facility
$771.90
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 67405
Office
Unavailable
Facility
$778.71
No comparable office rate is available.
Rest Of Missouri
Missouri · 67405
Office
Unavailable
Facility
$735.00
No comparable office rate is available.
Mississippi
Mississippi · 67405
Office
Unavailable
Facility
$728.95
No comparable office rate is available.
Montana**
Montana · 67405
Office
Unavailable
Facility
$801.57
No comparable office rate is available.
North Carolina
North Carolina · 67405
Office
Unavailable
Facility
$761.01
No comparable office rate is available.
North Dakota**
North Dakota · 67405
Office
Unavailable
Facility
$787.54
No comparable office rate is available.
Nebraska
Nebraska · 67405
Office
Unavailable
Facility
$750.04
No comparable office rate is available.
New Hampshire
New Hampshire · 67405
Office
Unavailable
Facility
$818.27
No comparable office rate is available.
Northern Nj
New Jersey · 67405
Office
Unavailable
Facility
$898.64
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 67405
Office
Unavailable
Facility
$859.91
No comparable office rate is available.
New Mexico
New Mexico · 67405
Office
Unavailable
Facility
$766.69
No comparable office rate is available.
Nevada**
Nevada · 67405
Office
Unavailable
Facility
$798.14
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 67405
Office
Unavailable
Facility
$931.52
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 67405
Office
Unavailable
Facility
$865.52
No comparable office rate is available.
Queens
New York · 67405
Office
Unavailable
Facility
$918.33
No comparable office rate is available.
Rest Of New York
New York · 67405
Office
Unavailable
Facility
$770.66
No comparable office rate is available.
Ohio
Ohio · 67405
Office
Unavailable
Facility
$760.20
No comparable office rate is available.
Oklahoma
Oklahoma · 67405
Office
Unavailable
Facility
$745.16
No comparable office rate is available.
Portland
Oregon · 67405
Office
Unavailable
Facility
$853.44
No comparable office rate is available.
Rest Of Oregon
Oregon · 67405
Office
Unavailable
Facility
$792.67
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 67405
Office
Unavailable
Facility
$831.20
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 67405
Office
Unavailable
Facility
$761.10
No comparable office rate is available.
Puerto Rico
Puerto Rico · 67405
Office
Unavailable
Facility
$806.53
No comparable office rate is available.
Rhode Island
Rhode Island · 67405
Office
Unavailable
Facility
$820.54
No comparable office rate is available.
South Carolina
South Carolina · 67405
Office
Unavailable
Facility
$761.71
No comparable office rate is available.
South Dakota**
South Dakota · 67405
Office
Unavailable
Facility
$785.88
No comparable office rate is available.
Tennessee
Tennessee · 67405
Office
Unavailable
Facility
$747.12
No comparable office rate is available.
Austin
Texas · 67405
Office
Unavailable
Facility
$827.26
No comparable office rate is available.
Beaumont
Texas · 67405
Office
Unavailable
Facility
$756.89
No comparable office rate is available.
Brazoria
Texas · 67405
Office
Unavailable
Facility
$794.50
No comparable office rate is available.
Dallas
Texas · 67405
Office
Unavailable
Facility
$799.04
No comparable office rate is available.
Fort Worth
Texas · 67405
Office
Unavailable
Facility
$794.56
No comparable office rate is available.
Galveston
Texas · 67405
Office
Unavailable
Facility
$796.59
No comparable office rate is available.
Houston
Texas · 67405
Office
Unavailable
Facility
$809.59
No comparable office rate is available.
Rest Of Texas
Texas · 67405
Office
Unavailable
Facility
$774.93
No comparable office rate is available.
Utah
Utah · 67405
Office
Unavailable
Facility
$770.50
No comparable office rate is available.
Virginia
Virginia · 67405
Office
Unavailable
Facility
$786.52
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 67405
Office
Unavailable
Facility
$806.53
No comparable office rate is available.
Vermont
Vermont · 67405
Office
Unavailable
Facility
$785.12
No comparable office rate is available.
Rest Of Washington
Washington · 67405
Office
Unavailable
Facility
$825.20
No comparable office rate is available.
Seattle (King Cnty)
Washington · 67405
Office
Unavailable
Facility
$920.84
No comparable office rate is available.
Wisconsin
Wisconsin · 67405
Office
Unavailable
Facility
$765.12
No comparable office rate is available.
West Virginia
West Virginia · 67405
Office
Unavailable
Facility
$749.19
No comparable office rate is available.
Wyoming**
Wyoming · 67405
Office
Unavailable
Facility
$795.46
No comparable office rate is available.
See how rates vary across the country
67405 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 67405 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$874.48
$794.98 × 110% = $874.48
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 67405 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
7,469
- Code
- 67405
- Physician work
- 8.97
- Practice expense
- 14.32
- Malpractice
- 0.71
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.97 | × 1.005 | 9.0148 |
| Practice expense | 14.32 | × 0.988 | 14.1482 |
| Malpractice | 0.71 | × 0.899 | 0.6383 |
| Total RVUs | 23.8013 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$794.98
Open 67405 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.97 | 1.005 |
| Practice expense | 14.32 | 0.988 |
| Malpractice | 0.71 | 0.899 |
(8.97 × 1.005 + 14.32 × 0.988 + 0.71 × 0.899) × $33.4009 = $794.98
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
67405 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $794.98 | RVU26D |
| 2026-07-01 | Not available in this setting | $794.98 | RVU26C |
| 2026-04-01 | Not available in this setting | $794.98 | RVU26B |
| 2026-01-01 | Not available in this setting | $794.98 | RVU26A |
| 2025-10-01 | Not available in this setting | $858.57 | RVU25D |
| 2025-07-01 | Not available in this setting | $858.57 | RVU25C |
| 2025-04-01 | Not available in this setting | $858.57 | RVU25B |
| 2025-01-01 | Not available in this setting | $858.57 | RVU25A |
67405 billing questions
When is 67405 appropriate instead of orbital aspiration?
Use 67405 for operative drainage through an orbitotomy without a bone flap. Orbital-content aspiration, rather than open surgical drainage, is described by 67415.
How does 67405 differ from 67400?
67405 identifies drainage as the operative objective. 67400 describes orbitotomy for exploration, with or without biopsy, when drainage is not the service performed.
Can 67405 be reported when a lesion is removed?
67405 is for drainage only. If the operative objective is removal of an orbital lesion, select the code that describes that procedure rather than reporting drainage for the same work.
What documentation supports 67405?
Document the orbital collection and its location, the orbitotomy approach, and the drainage performed. The operative report should make clear that drainage, rather than aspiration or lesion removal, was the objective.
How are bilateral procedures and other same-session procedures paid?
CMS pays bilateral surgery reported with modifier 50 at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard reduction.
Is postoperative care separately reported during the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care through 90 days after surgery.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,46667346,,Biopsy eye muscle,A,,2.80,1.81,NA,1.81,,0.21,4.82,4.82,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46767399,,Unlisted px extraocular musc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46867400,,Explore/biopsy eye socket,A,,10.92,15.47,NA,15.47,,0.89,27.28,27.28,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46967405,,Explore/drain eye socket,A,,8.97,14.32,NA,14.32,,0.71,24.00,24.00,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47067412,,Explore/treat eye socket,A,,10.04,15.28,NA,15.28,,0.84,26.16,26.16,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47167413,,Explore/treat eye socket,A,,9.98,14.58,NA,14.58,,0.80,25.36,25.36,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47267414,,Explr/decompress eye socket,A,,17.49,18.35,NA,18.35,,1.56,37.40,37.40,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503