No office rate
Both describe orbital decompression, but 67445 uses a lateral bone flap or window. This code is for decompression without a bone flap.
On this page
CMS RVU26D · Effective 2026-10-01
67414 Orbital decompression Medicare reimbursement rates in Missouri
Reports orbital decompression through an orbitotomy without a bone flap, commonly to relieve proptosis or pressure related to thyroid eye disease. Compare 67414 office and facility rates across CMS payment localities in Missouri.
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 67414 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1163.26–$1219.88
3 of 3 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.
Where 67414 pays more and less in Missouri
Ophthalmic surgery
About 67414: Orbital decompression without bone flap
Reports orbital decompression through an orbitotomy without a bone flap, commonly to relieve proptosis or pressure related to thyroid eye disease.
An ophthalmic or oculoplastic surgeon performs an orbitotomy without raising a bone flap to create additional orbital space. A common setting is treatment of thyroid eye disease when proptosis or pressure on the optic nerve calls for orbital decompression. The operative approach and tissue work distinguish this service from decompression performed through a lateral bone flap or window.
Report the code when the operative note supports decompression without a bone flap, including the indication, approach, and work performed. It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. 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.
CMS billing rules for 67414
- 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 RVU17.49 · 47%
- Practice expense (office) RVU18.35 · 49%
- Malpractice RVU1.56 · 4%
239
Medicare services in 2024 · #4168 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.
67414 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Code 67400 describes orbitotomy for exploration, with or without biopsy. Choose this code when the operative service is decompression without a bone flap.
No office rate
Code 67420 describes lateral orbitotomy with a bone flap or window for exploration. It is not the decompression service represented by this code.
No office rate
Code 67405 is for orbitotomy with drainage. This code is for orbital decompression without a bone flap, not drainage of an orbital collection.
Compare 67414 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$1210.61
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$1219.88
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$1163.26
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67414 billing questions
How does this differ from 67445?
This code describes orbital decompression without a bone flap. Code 67445 is the related decompression service using a lateral bone flap or window.
What documentation supports reporting this code?
The operative note should identify the decompression indication, the approach, and the work performed, with enough detail to show that decompression was done without a bone flap.
How is bilateral surgery reported?
CMS pays bilateral reporting with modifier 50 at 150%. The record should support decompression on both sides.
How does the multiple-procedure reduction affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What care is included in the global period?
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.
7,46967405,,Explore/drain eye socket,A,,8.97,14.32,NA,14.32,,0.71,24.00,24.00,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47067412,,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