Billing code 67311: Eye muscle surgeryMedicare rate & RVUs in Delaware
Reports strabismus surgery involving recession or resection of one horizontal eye muscle to correct misalignment such as esotropia or exotropia.
CMS doesn’t publish an office rate for 67311 in Delaware.
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 67311 covers
An ophthalmologist, often one specializing in strabismus, uses this code for surgery on one horizontal extraocular muscle to change its pull and improve eye alignment. The operation may recess or resect a medial or lateral rectus muscle. It is typically performed in an operating room or ambulatory surgery center for conditions such as esotropia or exotropia.
Select the code by the number and orientation of muscles treated: one horizontal muscle is reported here; two horizontal muscles are represented by 67312. Document the eye, the specific muscle, the procedure performed, and the strabismus being treated. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery reported with modifier 50, CMS pays 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; 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.
67311 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $388.38 |
How the 67311 rate is calculated
Each of 67311’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 · 67311
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.78Practice expense 5.48Malpractice 0.45
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67311
67311 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67311
Eye muscle 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) | 1 | Not paid (statutory restriction). |
| 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) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 67311
Eye muscle 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
67311 without 50 · national facility
$391.12
Eye muscle surgery
67311-50 · Bilateral: 150%
$586.68
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).
67311 compared with similar codes
Compare codes
67311 vs 67312 vs 67314 vs 67316: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67312Strabismus surgery
- Choose 67312 when two horizontal muscles are treated; 67311 represents one horizontal muscle.
- 67314Eye muscle surgery
- Choose 67314 for one vertical muscle. 67311 is for one horizontal muscle.
- 67316Strabismus surgery
- 67316 represents two vertical muscles, while 67311 represents one horizontal muscle.
67311 billing questions
When should I use 67311 rather than 67312?
Use 67311 for surgery on one horizontal muscle. Use 67312 when two horizontal muscles are treated.
How does 67311 differ from 67314?
67311 represents one horizontal muscle, such as a medial or lateral rectus. 67314 represents one vertical muscle.
How is bilateral surgery reported?
CMS pays bilateral surgery at 150% when reported with modifier 50. The operative documentation should identify the muscle treated in each eye.
Are related postoperative visits separately included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What happens when another procedure is performed in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50%. The operative record should support each separately reported procedure.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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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