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CMS RVU26D · Effective 2026-10-01

61330 Orbital decompression Medicare reimbursement rates in New York

Reports surgical expansion of the orbit through a transcranial route to relieve orbital pressure, such as compression associated with severe proptosis or optic neuropathy. Compare 61330 office and facility rates across CMS payment localities in New York.

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 61330 in New York?

New York has 5 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 5 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$1630.54–$2226.59

5 of 5 localities have a supported rate.

Lowest: Rest Of New York

Highest: Nyc Suburbs/Long Island

A spread of $596.05 per service.

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.

Find 61330 in your payment locality →

Where 61330 pays more and less in New York

Neurosurgery

About 61330: Transcranial orbital decompression

Reports surgical expansion of the orbit through a transcranial route to relieve orbital pressure, such as compression associated with severe proptosis or optic neuropathy.

This procedure relieves pressure within the orbit by removing bone through a cranial approach, creating more space for the orbital contents. It may be performed for severe proptosis or optic nerve compression, including in patients with thyroid-associated orbitopathy. Neurosurgeons and oculoplastic surgeons may perform it in a hospital operating room. The operative report should establish that the route was transcranial and that the work was orbital decompression rather than treatment of an intracranial lesion.

Report the code for the transcranial orbital decompression itself, with documentation of the indication, side, approach, and operative work. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 61330

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 RVU24.67 · 47%
  • Practice expense (office) RVU17.70 · 34%
  • Malpractice RVU10.43 · 20%

29

Medicare services in 2024 · #5693 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.

61330 compared with similar codes

Office rates for New York, from the same CMS release.

67414

Orbital decompression

Without bone flap

No office rate

Use this code for orbital decompression through a transcranial approach. Code 67414 describes decompression through a lateral orbitotomy.

61322

Cranial decompression

Without lobectomy

No office rate

This code targets the orbit. Code 61322 describes cranial decompression without lobectomy, not orbital decompression.

61323

Cranial decompression

With lobectomy

No office rate

This code targets the orbit. Code 61323 describes cranial decompression with lobectomy, not orbital decompression.

Compare 61330 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.

5 of 5 payment localities

Office and facility base rates · shared scale starting at $0

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61330 billing questions

How does this differ from orbital decompression through a lateral orbitotomy?

This code identifies decompression performed through a transcranial route. A lateral orbitotomy code, such as 67414, describes a different surgical approach.

What documentation supports reporting this code?

The operative report should identify the transcranial approach, the orbit decompressed, laterality, the reason for decompression, and the work performed.

How should bilateral decompression be reported?

Report bilateral surgery with modifier 50; CMS pays the bilateral procedure at 150%.

Does the code include postoperative care?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, while team surgery is 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.

RVUs for 61330PPRRVU2026_Oct_nonQPP.csv, line 6,768 (RVU26D)