Billing code 15821: Lower eyelid surgeryMedicare rate & RVUs in Delaware
Reports lower-eyelid blepharoplasty that addresses pronounced protrusion of orbital fat pads, with the operative work and findings supporting the selected level.
Medicare pays $628.53 for 15821 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 9 sections
What 15821 covers
This procedure reshapes the lower eyelid when prominent orbital fat pads create under-eye bulging. The surgeon may remove or reposition protruding fat and address redundant skin as part of the lid contouring. Oculoplastic, plastic, or facial plastic surgeons commonly perform it in an ambulatory surgery center or hospital, and sometimes in an office-based operating setting. The operative note should identify the lower lid treated, describe the extent of fat prolapse, and document the work performed and the clinical indication.
Select this code when the lower-lid operation involves substantial fat-pad prolapse; use 15820 for lower-lid blepharoplasty without that extent of fat involvement. For both eyelids, CMS pays modifier 50 at 150% of the unilateral payment. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. Assistant-at-surgery payment requires documented medical necessity; 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.
15821 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $628.53 | $479.70 |
How the 15821 rate is calculated
Each of 15821’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 · 15821
RVUs × geographic indexes × conversion factor
Work6.67
6.67 RVUs× 1.000 GPCI
Practice expense11.67
11.67 RVUs× 1.000 GPCI
Malpractice0.65
0.65 RVUs× 1.000 GPCI
Adjusted RVUs
18.9900
Conversion factor
$33.4009
Medicare rate
$634.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15821
15821 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15821
Lower eyelid surgery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 15821
Lower eyelid surgery
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
15821 without 50 · national office
$634.28
Lower eyelid surgery
15821-50 · Bilateral: 150%
$951.42
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).
15821 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15820Lower eyelid surgery
- Both address lower-lid blepharoplasty, but 15821 is selected when the operation addresses pronounced orbital fat-pad prolapse; 15820 is for the lower-lid procedure without that extent of fat involvement.
- 15822Upper eyelid surgery
- 15822 describes upper-eyelid blepharoplasty. Use 15821 for the lower eyelid with prominent orbital fat-pad prolapse.
- 15823Upper eyelid surgery
- 15823 concerns upper-lid blepharoplasty with excess skin. It is not the code for lower-lid fat-pad contouring.
15821 billing questions
How does 15821 differ from 15820?
Use 15821 when the lower-lid blepharoplasty addresses pronounced prolapse of orbital fat pads. Use 15820 for lower-lid blepharoplasty without that degree of fat-pad involvement.
Can 15820 also be reported for the same lower eyelid?
Do not separately report 15820 for the same lower-lid blepharoplasty represented by 15821. Document the fat-pad findings and the operative work supporting 15821.
How should bilateral lower-lid surgery be reported?
Report the bilateral procedure with modifier 50. CMS pays it at 150% of the unilateral payment.
What happens when another procedure is performed in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction.
What postoperative care is included in the global period?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
When is assistant-at-surgery payment allowed?
CMS pays an assistant at surgery only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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
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