No office rate
Use 67311 when one horizontal muscle is treated with recession or resection. Use 67312 when two horizontal muscles are treated.
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CMS RVU26D · Effective 2026-10-01
67312 Strabismus surgery Medicare reimbursement rates in Kentucky
Reports strabismus surgery using recession or resection on two horizontal eye muscles to correct ocular misalignment. Compare 67312 office and facility rates across CMS payment localities in Kentucky.
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 67312 in Kentucky?
Kentucky 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
$531.14
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Ophthalmology surgery
About 67312: Two-horizontal-muscle strabismus surgery
Reports strabismus surgery using recession or resection on two horizontal eye muscles to correct ocular misalignment.
An ophthalmic surgeon uses recession, which moves a muscle’s attachment to weaken its pull, or resection, which shortens the muscle to strengthen its pull. This code covers work on two horizontal extraocular muscles for strabismus, or misalignment of the eyes. The service is commonly performed in an operating room, with the operative report identifying the muscles treated and the eye or eyes involved.
Choose the code by the number and orientation of the muscles treated, not by the degree of misalignment. Documentation should support the two horizontal muscles and the recession or resection performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 indicates bilateral surgery, paid at 150%. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 67312
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.26 · 55%
- Practice expense (office) RVU6.72 · 40%
- Malpractice RVU0.73 · 4%
1.9K
Medicare services in 2024 · #2513 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.
67312 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
67314 covers one vertical muscle; 67312 covers two horizontal muscles. The muscle orientation distinguishes these codes.
No office rate
67316 is for two or more vertical muscles, while 67312 is for two horizontal muscles.
No office rate
67318 applies to recession or resection of oblique muscle or muscles; 67312 applies to two horizontal muscles.
Compare 67312 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$531.14
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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 67312 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,454
- Code
- 67312
- Physician work
- 9.26
- Practice expense
- 6.72
- Malpractice
- 0.73
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.26 | × 1.000 | 9.2600 |
| Practice expense | 6.72 | × 0.889 | 5.9741 |
| Malpractice | 0.73 | × 0.915 | 0.6680 |
| Total RVUs | 15.9020 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$531.14
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.26 | 1 |
| Practice expense | 6.72 | 0.889 |
| Malpractice | 0.73 | 0.915 |
(9.26 × 1 + 6.72 × 0.889 + 0.73 × 0.915) × $33.4009 = $531.14
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.
67312 billing questions
How does this differ from 67311?
67312 is for recession or resection of two horizontal muscles; 67311 is for one horizontal muscle. Base code selection on the muscles actually treated.
Can this code describe surgery on vertical muscles?
No. This code is for two horizontal muscles. Codes 67314 and 67316 describe recession or resection involving vertical muscles, with selection based on the number treated.
What should the operative report document?
Document the two horizontal muscles treated, the eye or eyes involved, and whether each muscle underwent recession or resection.
How does Medicare handle bilateral surgery?
When the procedure is performed bilaterally, CMS lists modifier 50 payment at 150%. The operative documentation should identify the muscles and sides treated.
Are assistant or co-surgeon services payable?
Medicare does not pay an assistant at surgery for this code. Co-surgeon payment is limited to cases with supporting documentation.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
7,45167255,,Reinforce/graft eye wall,A,,8.17,9.04,NA,9.04,,0.65,17.86,17.86,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45267299,,Unlisted px posterior segmnt,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45367311,,Revise eye muscle,A,,5.78,5.48,NA,5.48,,0.45,11.71,11.71,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45467312,,Revise two eye muscles,A,,9.26,6.72,NA,6.72,,0.73,16.71,16.71,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,45567314,,Revise eye muscle,A,,5.78,5.48,NA,5.48,,0.45,11.71,11.71,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631