CPT code 67440: Orbital drainage2026 Medicare rate & RVUs in Nebraska
Reports surgical drainage of an orbital collection through a lateral orbitotomy that uses a bone flap or window to access the eye socket.
CMS doesn’t publish an office rate for 67440 in Nebraska.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 67440 covers
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.
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 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $1,101.59 |
How the 67440 rate is calculated
Each of 67440’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 67440
RVUs × geographic indexes × conversion factor
Work14.47
14.47 RVUs× 1.000 GPCI
Practice expense19.58
19.58 RVUs× 1.000 GPCI
Malpractice1.16
1.16 RVUs× 1.000 GPCI
Adjusted RVUs
35.2100
Conversion factor
$33.4009
Medicare rate
$1,176.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67440
67440 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67440
Orbital drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 67440
Orbital drainage
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67440 without 50 · national facility
$1,176.05
Orbital drainage
67440-50 · Bilateral: 150%
$1,764.08
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
67440 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67405Orbital drainage
- 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.
- 67430Orbital exploration
- 67430 is for lateral orbitotomy exploration, with or without biopsy. Use 67440 when the operative service includes drainage through the lateral bony approach.
- 67415Orbital aspiration
- 67415 describes aspiration of orbital contents. 67440 is for surgical drainage through a lateral orbitotomy with a bone flap or window.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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