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CMS RVU26D · Effective 2026-10-01

67440 Orbital drainage Medicare reimbursement rates in Kentucky

Reports surgical drainage of an orbital collection through a lateral orbitotomy that uses a bone flap or window to access the eye socket. Compare 67440 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 67440 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

$1100.16

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.

Find 67440 in your payment locality →

Ophthalmic surgery

About 67440: Lateral orbitotomy with drainage

Reports surgical drainage of an orbital collection through a lateral orbitotomy that uses a bone flap or window to access the eye socket.

An ophthalmic or orbital surgeon uses a lateral approach to open the orbit through a bone flap or window and drain an orbital collection, such as an abscess. The procedure is generally performed in an operating room when the collection requires surgical access rather than aspiration alone. The defining features are the lateral bony approach and drainage, not simply exploration or removal of a lesion.

Report the code when the operative documentation supports both the lateral orbitotomy and drainage. Include the indication, side, approach, and the collection treated. This is major surgery with 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 other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

CMS billing rules for 67440

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
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU14.47 · 41%
  • Practice expense (office) RVU19.58 · 56%
  • Malpractice RVU1.16 · 3%

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.

67440 compared with similar codes

Office rates for Kentucky, from the same CMS release.

67405

Orbital drainage

Drainage only

No office rate

Both codes describe orbital drainage. Choose 67440 when the surgeon uses a lateral orbitotomy with a bone flap or window; 67405 describes drainage without that approach.

67430

Orbital exploration

Transcranial, bone flap or window

No office rate

67430 is for lateral orbitotomy exploration, with or without biopsy. Use 67440 when the operative service includes drainage through the lateral bony approach.

67415

Orbital aspiration

Needle sampling or evacuation

No office rate

67415 describes aspiration of orbital contents. 67440 is for surgical drainage through a lateral orbitotomy with a bone flap or window.

Compare 67440 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

Office and facility base rates · shared scale starting at $0

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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 67440 in Kentucky.

PPRRVU2026_Oct_nonQPP.csv

7,476

Code
67440
Physician work
14.47
Practice expense
19.58
Malpractice
1.16

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Facility calculation for 67440 in Kentucky
ComponentRVULocality factorAdjusted
Physician work14.47× 1.00014.4700
Practice expense19.58× 0.88917.4066
Malpractice1.16× 0.9151.0614
Total RVUs32.9380
Conversion factor× 33.4009

Facility rate, Kentucky$1100.16

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work14.471
Practice expense19.580.889
Malpractice1.160.915

(14.47 × 1 + 19.58 × 0.889 + 1.16 × 0.915) × $33.4009 = $1100.16

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.

67440 billing questions

How is 67440 different from 67405?

67440 describes drainage through a lateral orbitotomy using a bone flap or window. 67405 is the drainage code for an orbitotomy without that lateral bony approach.

Can orbital aspiration be reported instead?

Use 67415 when the service is aspiration of orbital contents. 67440 describes surgical drainage through a lateral orbitotomy, not aspiration alone.

What documentation supports 67440?

The operative report should establish the lateral approach, use of a bone flap or window, the orbital collection, and the drainage performed. Document the side treated.

How is bilateral drainage reported?

For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.

What payment rules apply when other procedures are performed?

In the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.

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.

RVUs for 67440PPRRVU2026_Oct_nonQPP.csv, line 7,476 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet