Billing code 67415: Orbital aspirationMedicare rate & RVUs in Delaware
Needle aspiration of an orbital mass or localized collection for diagnostic sampling or evacuation when the service is performed without an open orbitotomy.
CMS doesn’t publish an office rate for 67415 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 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.
67415 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $81.74 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
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).
67415 compared with similar codes
Compare codes
67415 vs 67400 vs 67405 vs 67440: national Medicare rates
Swap in your local Medicare rate.
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.
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
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