No office rate
67311 reports the primary recession or resection procedure for one horizontal muscle. Add 67331 only when the prior-surgery or restrictive-myopathy circumstance also applies.
On this page
CMS RVU26D · Effective 2026-10-01
67331 Strabismus surgery Medicare reimbursement rates in Guam
This add-on reports added complexity during strabismus surgery when prior eye surgery or restrictive myopathy affects one or more extraocular muscles. Compare 67331 office and facility rates across CMS payment localities in Guam.
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.
What does Medicare pay for 67331 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$102.78
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Ophthalmic surgery
About 67331: Complex strabismus surgery add-on
This add-on reports added complexity during strabismus surgery when prior eye surgery or restrictive myopathy affects one or more extraocular muscles.
An ophthalmologist reports this add-on with a primary strabismus procedure when prior eye surgery or restrictive myopathy, such as thyroid-related restriction, makes surgery on one or more extraocular muscles more complex. It represents added work during the muscle operation, not a separate postoperative examination. These cases are generally managed in an operating room, with the surgeon addressing the alignment problem and the effects of prior surgery or muscle restriction.
Report 67331 only with the primary procedure; it is paid within that procedure’s global period. The operative report should support the underlying strabismus procedure and document the prior eye surgery or restrictive myopathy affecting the surgical work. CMS lists bilateral reporting with modifier 50 as paid at 150%. The primary procedure identifies the muscle surgery performed; this add-on identifies the qualifying complexity.
CMS billing rules for 67331
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
Where the value comes from
- Work RVU1.95 · 65%
- Practice expense (office) RVU0.91 · 30%
- Malpractice RVU0.16 · 5%
1K
Medicare services in 2024 · #2971 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.
67331 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
67314 reports the primary procedure for one vertical muscle. It does not by itself represent the added complexity captured by 67331.
No office rate
Both are strabismus-surgery add-ons, but 67332 is associated with reoperation. Use 67331 for the prior-eye-surgery or restrictive-myopathy circumstance described for that code.
Compare 67331 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$102.78
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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 67331 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
7,459
- Code
- 67331
- Physician work
- 1.95
- Practice expense
- 0.91
- Malpractice
- 0.16
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.95 | × 1.000 | 1.9500 |
| Practice expense | 0.91 | × 1.137 | 1.0347 |
| Malpractice | 0.16 | × 0.579 | 0.0926 |
| Total RVUs | 3.0773 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$102.78
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.95 | 1 |
| Practice expense | 0.91 | 1.137 |
| Malpractice | 0.16 | 0.579 |
(1.95 × 1 + 0.91 × 1.137 + 0.16 × 0.579) × $33.4009 = $102.78
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.
67331 billing questions
When is 67331 reported with strabismus surgery?
Report it with a primary strabismus procedure when prior eye surgery or restrictive myopathy affects the work on one or more extraocular muscles. It is an add-on, not a standalone follow-up service.
What documentation supports 67331?
The operative report should identify the primary muscle procedure and describe the prior eye surgery or restrictive myopathy that affected the surgical work.
Can 67331 be billed by itself?
No. CMS identifies it as an add-on that must be billed with a primary procedure, and payment is within that procedure’s global period.
How is bilateral 67331 reported?
CMS lists bilateral reporting with modifier 50, paid at 150%.
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.
7,45667316,,Revise two eye muscles,A,,10.05,6.99,NA,6.99,,0.81,17.85,17.85,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45767318,,Revise eye muscle(s),A,,9.56,7.01,NA,7.01,,0.76,17.33,17.33,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45867320,,Revise eye muscle(s) add-on,A,,2.93,1.03,NA,1.03,,0.22,4.18,4.18,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45967331,,Eye surgery follow-up add-on,A,,1.95,0.91,NA,0.91,,0.16,3.02,3.02,0,ZZZ,0.00,0.00,0.00,0,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46067332,,Rerevise eye muscles add-on,A,,3.41,1.19,NA,1.19,,0.26,4.86,4.86,0,ZZZ,0.00,0.00,0.00,0,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46167334,,Revise eye muscle w/suture,A,,2.01,0.81,NA,0.81,,0.16,2.98,2.98,0,ZZZ,0.00,0.00,0.00,0,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46267335,,Eye suture during surgery,A,,3.15,1.09,NA,1.09,,0.24,4.48,4.48,0,ZZZ,0.00,0.00,0.00,0,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014