No office rate
67400 describes open exploration of the orbit, with or without biopsy. Choose 67415 when the documented procedure is needle aspiration rather than open exploration.
On this page
CMS RVU26D · Effective 2026-10-01
67415 Orbital aspiration Medicare reimbursement rates in Maine
Needle aspiration of an orbital mass or localized collection for diagnostic sampling or evacuation when the service is performed without an open orbitotomy. Compare 67415 office and facility rates across CMS payment localities in Maine.
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 67415 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$78.80–$80.26
2 of 2 localities have a supported rate.
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.
Ophthalmic surgery
About 67415: Orbital needle aspiration
Needle aspiration of an orbital mass or localized collection for diagnostic sampling or evacuation when the service is performed without an open orbitotomy.
67415 represents needle-based sampling or evacuation of material from within the orbit, rather than an incision-based orbitotomy. Ophthalmologists, especially oculoplastic or orbital surgeons, may use it to obtain cells or fluid from an orbital mass or localized collection when needle aspiration is the service performed. The record should identify the side and target, the reason for aspiration, the technique, and whether material was collected for analysis.
Report the service supported by the procedure note. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. For bilateral aspiration, modifier 50 is paid at 150%. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 67415
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.72 · 70%
- Practice expense (office) RVU0.60 · 24%
- Malpractice RVU0.14 · 6%
187
Medicare services in 2024 · #4377 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.
67415 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
67405 is an orbitotomy-based drainage service. 67415 is for needle aspiration, not drainage performed through an open orbital approach.
No office rate
67440 describes drainage through an orbitotomy approach; 67415 describes needle aspiration of orbital contents.
Compare 67415 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$78.80
Southern Maine →
Office / nonfacility
Unavailable
Facility
$80.26
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67415 billing questions
When should 67415 be chosen over an orbitotomy code?
Use 67415 when the documented service is needle aspiration of orbital contents. An incision-based exploration or drainage is represented by the applicable orbitotomy code.
How is bilateral orbital aspiration reported?
For aspiration performed on both orbits, report modifier 50. CMS pays the bilateral procedure at 150%.
What care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant at surgery be reported?
CMS pays an assistant at surgery only when the record documents medical necessity.
What documentation supports 67415?
Document the orbit and target, the clinical reason for aspiration, the needle-based technique, and the material obtained or evacuated.
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.
7,47067412,,Explore/treat eye socket,A,,10.04,15.28,NA,15.28,,0.84,26.16,26.16,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47167413,,Explore/treat eye socket,A,,9.98,14.58,NA,14.58,,0.80,25.36,25.36,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47267414,,Explr/decompress eye socket,A,,17.49,18.35,NA,18.35,,1.56,37.40,37.40,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47367415,,Aspiration orbital contents,A,,1.72,0.60,NA,0.60,,0.14,2.46,2.46,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47467420,,Explore/treat eye socket,A,,21.32,21.66,NA,21.66,,2.05,45.03,45.03,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47567430,,Explore/treat eye socket,A,,14.91,20.20,NA,20.20,,1.20,36.31,36.31,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47667440,,Explore/drain eye socket,A,,14.47,19.58,NA,19.58,,1.16,35.21,35.21,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00