No office rate
Use 67413 for removal of a foreign object. Use 67412 when the orbital target is a lesion.
On this page
CMS RVU26D · Effective 2026-10-01
67413 Orbital surgery Medicare reimbursement rates in New York
Surgical orbital exposure and extraction of a retained foreign object are reported when removal requires an orbitotomy rather than a superficial eye procedure. Compare 67413 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 67413 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
$814.76–$983.32
5 of 5 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.
Where 67413 pays more and less in New York
Ophthalmic surgery
About 67413: Orbital foreign body removal through orbitotomy
Surgical orbital exposure and extraction of a retained foreign object are reported when removal requires an orbitotomy rather than a superficial eye procedure.
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.
CMS billing rules for 67413
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.98 · 39%
- Practice expense (office) RVU14.58 · 57%
- Malpractice RVU0.80 · 3%
120
Medicare services in 2024 · #4741 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.
67413 compared with similar codes
Office rates for New York, from the same CMS release.
No office rate
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.
No office rate
67400 describes orbital exploration, with or without biopsy. Report 67413 when the documented procedure removes a foreign object.
Compare 67413 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
Manhattan →
Office / nonfacility
Unavailable
Facility
$962.93
Nyc Suburbs/Long Island →
Office / nonfacility
Unavailable
Facility
$983.32
Poughkpsie/N Nyc Suburbs →
Office / nonfacility
Unavailable
Facility
$913.92
Queens →
Office / nonfacility
Unavailable
Facility
$968.82
Rest Of New York →
Office / nonfacility
Unavailable
Facility
$814.76
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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 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.
7,46867400,,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
7,47267414,,Explr/decompress eye socket,A,,17.49,18.35,NA,18.35,,1.56,37.40,37.40,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47367415,,Aspiration orbital contents,A,,1.72,0.60,NA,0.60,,0.14,2.46,2.46,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47467420,,Explore/treat eye socket,A,,21.32,21.66,NA,21.66,,2.05,45.03,45.03,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00