No office rate
21280 stabilizes the medial canthus at the inner eye corner; 21282 addresses the lateral canthus at the outer corner.
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CMS RVU26D · Effective 2026-10-01
21280 Canthopexy Medicare reimbursement rates in New Jersey
Medial canthopexy tightens or repositions support at the inner corner of the eyelid for documented medial canthal laxity or malposition. Compare 21280 office and facility rates across CMS payment localities in New Jersey.
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 21280 in New Jersey?
New Jersey 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
$560.69–$583.60
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.
Oculoplastic surgery
About 21280: Medial canthal tendon support
Medial canthopexy tightens or repositions support at the inner corner of the eyelid for documented medial canthal laxity or malposition.
Medial canthopexy stabilizes or repositions the medial canthal tendon, which supports the eyelids at the inner corner of the eye. Oculoplastic, plastic, or facial plastic surgeons may perform it for medial canthal laxity or malposition, including in reconstructive settings. The operative report should identify the affected side, the clinical problem, and the tendon-support maneuver performed.
Select this code for work directed at the medial canthus; lateral canthal support is a different service. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral work reported with modifier 50, CMS pays 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21280
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.95 · 44%
- Practice expense (office) RVU8.04 · 51%
- Malpractice RVU0.71 · 5%
193
Medicare services in 2024 · #4351 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.
21280 compared with similar codes
Office rates for New Jersey, from the same CMS release.
$632.97–$662.62
67950 describes canthal reconstruction. Choose 21280 when the documented procedure is medial canthal tendon tightening or repositioning rather than broader reconstruction.
$673.20–$705.49
67917 is for extensive ectropion repair, such as a tarsal strip operation. Choose 21280 when the documented work specifically supports or repositions the medial canthal tendon.
Compare 21280 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$583.60
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$560.69
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21280 billing questions
How does medial canthopexy differ from lateral canthopexy?
Code 21280 addresses support at the inner corner of the eyelid. Use 21282 for support at the outer corner.
Can this be reported with an ectropion repair?
The operative note should distinguish medial tendon stabilization from the eyelid-position repair. Do not separately report a maneuver that is integral to the other operation.
How is bilateral work reported?
Report bilateral work with modifier 50 when appropriate; CMS pays the bilateral procedure at 150%. Document the procedure on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When may an assistant at surgery be paid?
CMS allows assistant-at-surgery payment only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
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.
1,93521268,,Revise eye sockets,A,,26.39,23.25,NA,23.25,,4.89,54.53,54.53,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93621270,,Augmentation cheek bone,A,,10.36,20.78,,7.94,,1.92,33.06,20.22,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93721275,,Revision orbitofacial bones,A,,11.47,9.28,NA,9.28,,2.13,22.88,22.88,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93821280,,Medial canthopexy,A,,6.95,8.04,NA,8.04,,0.71,15.70,15.70,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93921282,,Lateral canthopexy,A,,4.16,6.39,NA,6.39,,0.51,11.06,11.06,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94021295,,Revision of jaw muscle/bone,A,,1.85,3.43,NA,3.43,,0.26,5.54,5.54,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94121296,,Revision of jaw muscle/bone,A,,4.66,5.74,NA,5.74,,0.67,11.07,11.07,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00