$80.90–$87.43
This code describes an orbital injection. Choose 67570 when the service is surgical decompression of the optic nerve.
On this page
CMS RVU26D · Effective 2026-10-01
67570 Optic nerve surgery Medicare reimbursement rates in Massachusetts
Reports surgical decompression of the optic nerve, including optic nerve sheath fenestration, for vision-threatening pressure-related optic neuropathy. Compare 67570 office and facility rates across CMS payment localities in Massachusetts.
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 67570 in Massachusetts?
Massachusetts 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
$1140.05–$1240.12
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 67570: Optic nerve decompression surgery
Reports surgical decompression of the optic nerve, including optic nerve sheath fenestration, for vision-threatening pressure-related optic neuropathy.
This code covers an operation to relieve pressure affecting the optic nerve, commonly by opening the nerve’s surrounding sheath. It may be considered for vision-threatening optic nerve injury associated with elevated pressure, including papilledema. The service is performed in an operating room by an ophthalmic or neurosurgical specialist; the operative report should identify the indication, treated side, surgical method, and findings supporting decompression.
Report the code for the decompression operation itself, not for an orbital injection or an orbital implant procedure. The documented work should establish that the optic nerve was surgically decompressed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 67570
- 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 RVU14.04 · 42%
- Practice expense (office) RVU18.02 · 54%
- Malpractice RVU1.12 · 3%
50
Medicare services in 2024 · #5360 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.
67570 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
67550 concerns placement of an orbital implant; it is not the code for pressure-relieving surgery on the optic nerve.
67599
No office rateUnlisted procedure orbit
67599 is for an orbital procedure without a specific listed code. Use 67570 when the documented service is the specified optic nerve decompression operation.
Compare 67570 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
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$1240.12
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$1140.05
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67570 billing questions
When is 67570 different from an orbital injection code?
67570 describes an operation to decompress the optic nerve. Codes 67500, 67505, and 67515 describe orbital injections, not surgical decompression.
Does the 90-day global period include postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral decompression reported?
For a bilateral procedure, modifier 50 is paid at 150% under the CMS facts for this code.
How does CMS handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What should the operative note establish?
Document the clinical reason for decompression, the side treated, the surgical method, and operative findings showing that optic nerve decompression was performed.
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.
7,48267516,,Sprchoroidal spc njx rx agt,A,,1.49,2.02,,0.78,,0.12,3.63,2.39,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48367550,,Insert eye socket implant,A,,11.48,16.16,NA,16.16,,0.98,28.62,28.62,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48467560,,Revise eye socket implant,A,,11.88,16.27,NA,16.27,,1.06,29.21,29.21,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48567570,,Decompress optic nerve,A,,14.04,18.02,NA,18.02,,1.12,33.18,33.18,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48667599,,Unlisted procedure orbit,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48767700,,Blepharotomy drg absc eyelid,A,,1.37,6.92,,1.59,,0.11,8.40,3.07,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48867710,,Severing tarsorrhaphy,A,,1.04,6.05,,1.48,,0.08,7.17,2.60,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00