$591.39
Both address the upper eyelid. Choose 15823 when excess skin weighs down the lid and the procedure meets its specific criterion; otherwise consider 15822.
On this page
CMS RVU26D · Effective 2026-10-01
15822 Upper eyelid surgery Medicare reimbursement rates in Idaho
Upper eyelid blepharoplasty reshapes an upper lid when the operation does not meet the separate criterion for excess skin weighing down the lid. Compare 15822 office and facility rates across CMS payment localities in Idaho.
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 15822 in Idaho?
Idaho 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
$438.60
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
$331.97
1 of 1 localities have a supported rate.
Payment area: Idaho
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.
Oculoplastic surgery
About 15822: Upper eyelid blepharoplasty
Upper eyelid blepharoplasty reshapes an upper lid when the operation does not meet the separate criterion for excess skin weighing down the lid.
This operation reshapes an upper eyelid, typically through an incision in the lid crease to remove or adjust tissue. Ophthalmic plastic surgeons, ophthalmologists, and plastic surgeons perform it for upper-lid contour or functional concerns. It may be done on one or both upper eyelids in an outpatient operating room or, in selected cases, an office-based setting.
Report 15822 when the upper-lid service does not meet the distinct 15823 criterion for excess skin weighing down the lid. Document the treated eyelid or eyelids, the clinical reason, relevant findings, and the procedure performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued is paid in full and the others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 15822
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.50 · 32%
- Practice expense (office) RVU9.13 · 65%
- Malpractice RVU0.49 · 3%
3K
Medicare services in 2024 · #2184 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.
15822 compared with similar codes
Office rates for Idaho, from the same CMS release.
$550.29
15820 is for lower-lid blepharoplasty without the extensive herniated fat distinction. 15822 is for the upper eyelid.
$591.66
15821 is for lower-lid blepharoplasty involving extensive herniated fat. 15822 addresses the upper eyelid.
Compare 15822 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
Idaho →
Office / nonfacility
$438.60
Facility
$331.97
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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 15822 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
1,563
- Code
- 15822
- Physician work
- 4.50
- Practice expense
- 9.13
- Malpractice
- 0.49
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.50 | × 1.000 | 4.5000 |
| Practice expense | 9.13 | × 0.920 | 8.3996 |
| Malpractice | 0.49 | × 0.473 | 0.2318 |
| Total RVUs | 13.1314 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$438.60
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.5 | 1 |
| Practice expense | 9.13 | 0.92 |
| Malpractice | 0.49 | 0.473 |
(4.5 × 1 + 9.13 × 0.92 + 0.49 × 0.473) × $33.4009 = $438.60
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.5 | 1 |
| Practice expense | 5.66 | 0.92 |
| Malpractice | 0.49 | 0.473 |
(4.5 × 1 + 5.66 × 0.92 + 0.49 × 0.473) × $33.4009 = $331.97
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.
15822 billing questions
When should 15823 be reported instead?
Use 15823 when excess upper-lid skin weighs down the lid and the procedure meets that code’s criterion. Use 15822 for upper-lid blepharoplasty that does not meet that distinction.
Can 15822 be reported for both upper eyelids?
Yes. CMS lists bilateral payment with modifier 50 at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can 15822 be reported with a lower-lid blepharoplasty?
It may be reported with a lower-lid procedure when both upper and lower lids are operated on during the same session. Choose the lower-lid code based on the service performed there.
How does Medicare handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and the other procedures are paid at 50% under the standard multiple procedure reduction.
Is an assistant surgeon payable for 15822?
CMS lists a statutory restriction on assistant-at-surgery payment 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 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.
1,56015793,,Chemical peel nonfacial drm,A,,3.86,9.78,,5.21,,0.45,14.09,9.52,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,56115820,,Blepharoplasty lower eyelid,A,,6.11,11.02,,6.90,,0.48,17.61,13.49,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,56215821,,Blepharp lwr eyelid fat pad,A,,6.67,11.67,,7.16,,0.65,18.99,14.48,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,56315822,,Blepharoplasty upper eyelid,A,,4.50,9.13,,5.66,,0.49,14.12,10.65,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,56415823,,Blepharp upr eyelid xcsv skn,A,,6.64,11.73,,7.20,,0.58,18.95,14.42,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,56515824,,Rhytidectomy forehead,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,56615825,,Rhytdct nck pltysml tghtg,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772