CPT code 67413: Orbital surgery2026 Medicare rate & RVUs in Nevada
Surgical orbital exposure and extraction of a retained foreign object are reported when removal requires an orbitotomy rather than a superficial eye procedure.
CMS doesn’t publish an office rate for 67413 in Nevada.
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 67413 covers
This service involves surgically opening the orbit to locate and remove a retained foreign object, without creating a bone flap. It is typically performed by an ophthalmic surgeon, often an oculoplastic surgeon, in an operating room. The procedure is distinct from removing an object accessible at the eye surface or from aspirating orbital contents.
Report the code when the operative documentation supports orbital exploration and extraction of a foreign body, rather than removal of a lesion, drainage, or decompression. The record should identify the foreign object, the orbital approach, and the work performed to retrieve it. The major-surgery global period includes 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%. An assistant at surgery may be paid; co-surgeons and team surgery are 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.
67413 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $843.07 |
How the 67413 rate is calculated
Each of 67413’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 · 67413
RVUs × geographic indexes × conversion factor
Work9.98
9.98 RVUs× 1.000 GPCI
Practice expense14.58
14.58 RVUs× 1.000 GPCI
Malpractice0.80
0.80 RVUs× 1.000 GPCI
Adjusted RVUs
25.3600
Conversion factor
$33.4009
Medicare rate
$847.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67413
67413 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67413
Orbital surgery
| 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) | 0 | Not permitted. |
| 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 · 67413
Orbital surgery
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
67413 without 50 · national facility
$847.05
Orbital surgery
67413-50 · Bilateral: 150%
$1,270.58
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).
67413 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67412Orbital surgery
- Use 67413 for removal of a foreign object. Use 67412 when the orbital target is a lesion.
- 67430Orbital exploration
- Both address orbital foreign body removal, but 67430 uses a lateral approach with a bone flap or window; 67413 is performed without a bone flap.
- 67400Orbitotomy
- 67400 describes orbital exploration, with or without biopsy. Report 67413 when the documented procedure removes a foreign object.
67413 billing questions
How is this different from 67412?
67413 is for surgical removal of a foreign object from the orbit. Code 67412 is for removal of an orbital lesion, not a retained foreign body.
When would 67430 be considered instead?
67430 describes orbital foreign body removal using a lateral approach with a bone flap or window. This code describes removal without a bone flap.
What documentation supports reporting this code?
Document the retained foreign object, its orbital location, the approach, and the operative steps used to expose and remove it.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery for this procedure. Co-surgeons and team surgery are not permitted.
How does bilateral reporting work?
When the procedure is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The major-surgery 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 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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