Billing code 67412: Orbital surgeryMedicare rate & RVUs in Guam
Report this orbital operation when a surgeon removes a foreign body through a transconjunctival approach without creating a bone flap.
CMS doesn’t publish an office rate for 67412 in Guam.
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 67412 covers
An ophthalmologist or oculoplastic surgeon uses a transconjunctival route to reach the orbit and remove a foreign body without creating a bone flap. A typical case involves a retained fragment within the eye socket, rather than an object on the ocular surface or inside the globe. The service may occur in a hospital or ambulatory surgical setting, depending on the patient and operative plan.
Select this code when the operative note supports both the orbital location and the transconjunctival approach, and describes removal of the foreign body. The code includes the operative exploration needed to locate and extract it. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, Medicare pays 150%. Assistant-at-surgery services are not paid; co-surgeons require supporting documentation, and team surgery is 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.
67412 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $931.88 |
How the 67412 rate is calculated
Each of 67412’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 · 67412
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.04Practice expense 15.28Malpractice 0.84
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67412
67412 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67412
Orbital 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) | 1 | Permitted with supporting documentation. |
| 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 · 67412
Orbital 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
67412 without 50 · national facility
$873.77
Orbital surgery
67412-50 · Bilateral: 150%
$1,310.66
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).
67412 compared with similar codes
Compare codes
67412 vs 67430 vs 67400 vs 67413 vs 67414: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67430Orbital exploration
- Use 67412 for transconjunctival access without a bone flap. Use 67430 when the surgeon uses a lateral approach with a bone flap or window to remove the orbital foreign body.
- 67400Orbitotomy
- Use 67400 for transconjunctival orbital exploration, with or without biopsy, when the service is not foreign-body removal. Use 67412 when the operation removes an orbital foreign body.
- 67413Orbital surgery
- Use 67413 for transconjunctival removal of an orbital tumor. Use 67412 when the target is a foreign body rather than a tumor.
- 67414Orbital decompression
- Use 67414 for transconjunctival orbital decompression. Use 67412 when the operative objective is removal of a foreign body.
67412 billing questions
How does this differ from 67430?
Both involve orbital foreign-body removal. This code describes a transconjunctival route without a bone flap; 67430 describes a lateral approach using a bone flap or window.
Can orbital exploration be billed separately?
The exploration needed to locate and remove the foreign body is part of this operation. The operative report should establish the orbital site, approach, and removal.
Does the 90-day global period include postoperative care?
Yes. Related postoperative care for 90 days and the day-before preoperative visit are included in the global period.
How is bilateral surgery reported?
For bilateral surgery, report modifier 50; Medicare pays 150% under the CMS bilateral rule for this code.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeon payment requires supporting documentation, and team surgery is 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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