No office rate
Choose 67400 for orbital exploration or biopsy. Choose 67405 when the orbitotomy includes drainage.
On this page
CMS RVU26D · Effective 2026-10-01
67400 Orbitotomy Medicare reimbursement rates in Nebraska
Open orbital exploration or biopsy through an orbitotomy without a bone flap, typically to evaluate an orbital mass or obtain tissue for diagnosis. Compare 67400 office and facility rates across CMS payment localities in Nebraska.
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 67400 in Nebraska?
Nebraska 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
$852.90
1 of 1 localities have a supported rate.
Payment area: Nebraska
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.
Ophthalmic surgery
About 67400: Orbitotomy for exploration or biopsy
Open orbital exploration or biopsy through an orbitotomy without a bone flap, typically to evaluate an orbital mass or obtain tissue for diagnosis.
This procedure opens the orbit without removing a bone flap, using a transconjunctival or transcutaneous approach to inspect orbital structures or obtain tissue. Ophthalmologists, commonly oculoplastic or orbital surgeons, may perform it in an operating room when imaging or examination identifies an orbital mass or other abnormality requiring direct evaluation or biopsy. The approach allows access to orbital contents without the bone-flap approach used in other orbitotomy codes.
Report 67400 when the operative service is exploration or biopsy, not when the defining work is drainage, lesion removal, foreign-body removal, or decompression. The operative report should support the indication, approach, and exploration or tissue sampling performed. CMS assigns a 90-day global period, including 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 67400
- 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 RVU10.92 · 40%
- Practice expense (office) RVU15.47 · 57%
- Malpractice RVU0.89 · 3%
3.2K
Medicare services in 2024 · #2120 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.
67400 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Choose 67400 for exploration or tissue sampling. Choose 67412 when the orbitotomy includes removal of a lesion.
No office rate
67415 describes aspiration of orbital contents; 67400 describes open exploration or biopsy through an orbitotomy without a bone flap.
No office rate
Both codes describe exploration or biopsy, but 67420 uses a lateral bone-flap or bone-window approach; 67400 does not involve a bone flap.
Compare 67400 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$852.90
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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 67400 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
7,468
- Code
- 67400
- Physician work
- 10.92
- Practice expense
- 15.47
- Malpractice
- 0.89
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.92 | × 1.000 | 10.9200 |
| Practice expense | 15.47 | × 0.923 | 14.2788 |
| Malpractice | 0.89 | × 0.378 | 0.3364 |
| Total RVUs | 25.5352 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$852.90
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.92 | 1 |
| Practice expense | 15.47 | 0.923 |
| Malpractice | 0.89 | 0.378 |
(10.92 × 1 + 15.47 × 0.923 + 0.89 × 0.378) × $33.4009 = $852.90
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.
67400 billing questions
When should 67400 be chosen instead of an orbitotomy code for drainage or lesion removal?
Use 67400 when the orbit is opened for exploration or biopsy. When drainage or removal of a lesion is the defining service, the corresponding orbitotomy code describes that work instead.
How does 67400 differ from 67420 or 67450?
67400 is an orbitotomy without a bone flap. Codes 67420 and 67450 describe exploration or biopsy using a bone-flap or bone-window approach, with the approach distinguishing those codes.
What postoperative 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.
How is bilateral 67400 reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
Can an assistant surgeon or co-surgeon be paid for 67400?
CMS lists a statutory restriction on assistant-at-surgery payment. Co-surgeons are paid only when supporting documentation is provided.
What happens when 67400 is performed with another procedure in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
7,46567345,,Destroy nerve of eye muscle,A,,2.93,4.06,,2.25,,0.53,7.52,5.71,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46667346,,Biopsy eye muscle,A,,2.80,1.81,NA,1.81,,0.21,4.82,4.82,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46767399,,Unlisted px extraocular musc,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
7,46867400,,Explore/biopsy eye socket,A,,10.92,15.47,NA,15.47,,0.89,27.28,27.28,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46967405,,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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068