Billing code 67445: Orbital decompressionMedicare rate & RVUs in Kansas
Report orbital bone removal for decompression when surgery enlarges the orbital space to relieve pressure associated with thyroid eye disease or other orbital conditions.
CMS doesn’t publish an office rate for 67445 in Kansas.
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 67445 covers
This operation removes orbital bone to create additional space around the eye and relieve pressure on orbital contents. It is commonly performed by an ophthalmologist, often an oculoplastic or orbital surgeon, for proptosis or optic nerve compression associated with thyroid eye disease. The procedure is generally performed in an operating-room setting; CMS reported facility-setting utilization for this code in 2024.
Report 67445 when the operative service removes orbital bone for decompression, rather than exploring the orbit or removing a lesion. The operative report should identify the indication, side, bone removal, and decompressive purpose. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. With multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires 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.
67445 in Kansas
| Payment locality | Office | Facility |
|---|---|---|
| Kansas | Unavailable | $1,224.39 |
How the 67445 rate is calculated
Each of 67445’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 · 67445
RVUs × geographic indexes × conversion factor
Work18.64
18.64 RVUs× 1.000 GPCI
Practice expense19.05
19.05 RVUs× 1.000 GPCI
Malpractice1.58
1.58 RVUs× 1.000 GPCI
Adjusted RVUs
39.2700
Conversion factor
$33.4009
Medicare rate
$1,311.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67445
67445 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67445
Orbital decompression
| 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) | 2 | Paid. |
| 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 · 67445
Orbital decompression
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
67445 without 50 · national facility
$1,311.65
Orbital decompression
67445-50 · Bilateral: 150%
$1,967.48
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).
67445 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67414Orbital decompression
- Choose 67445 for orbital bone removal to decompress. Choose 67414 when the bone-flap or window orbitotomy is performed to remove an orbital lesion.
- 67440Orbital drainage
- 67440 describes lateral orbitotomy for exploration. 67445 is the decompression service involving orbital bone removal.
- 67412Orbital surgery
- 67412 is for orbitotomy with lesion removal through a non-bone-flap approach; 67445 is selected for decompression through bone removal.
67445 billing questions
How is 67445 different from orbital exploration or lesion removal?
Use 67445 when orbital bone is removed to decompress the orbit. Exploration or removal of an orbital lesion describes a different operative purpose.
What should the operative report document?
Document the clinical reason for decompression, the side treated, the bone removal performed, and how the work relieved pressure in the orbit.
How is bilateral decompression reported?
When both orbits are treated, report modifier 50; CMS pays bilateral procedures at 150%.
How does the 90-day global period affect follow-up?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only when supporting documentation is provided.
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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