Billing code 67414: Orbital decompressionMedicare rate & RVUs in Ohio
Reports orbital decompression through an orbitotomy without a bone flap, commonly to relieve proptosis or pressure related to thyroid eye disease.
CMS doesn’t publish an office rate for 67414 in Ohio.
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 67414 covers
An ophthalmic or oculoplastic surgeon performs an orbitotomy without raising a bone flap to create additional orbital space. A common setting is treatment of thyroid eye disease when proptosis or pressure on the optic nerve calls for orbital decompression. The operative approach and tissue work distinguish this service from decompression performed through a lateral bone flap or window.
Report the code when the operative note supports decompression without a bone flap, including the indication, approach, and work performed. It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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%. Assistant-at-surgery payment may be available; co-surgeon payment requires 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.
67414 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,196.29 |
How the 67414 rate is calculated
Each of 67414’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 · 67414
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.49Practice expense 18.35Malpractice 1.56
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67414
67414 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67414
Orbital decompression
| 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 · 67414
Orbital decompression
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
67414 without 50 · national facility
$1,249.19
Orbital decompression
67414-50 · Bilateral: 150%
$1,873.79
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).
67414 compared with similar codes
Compare codes
67414 vs 67445 vs 67400 vs 67420 vs 67405: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67445Orbital decompression
- Both describe orbital decompression, but 67445 uses a lateral bone flap or window. This code is for decompression without a bone flap.
- 67400Orbitotomy
- Code 67400 describes orbitotomy for exploration, with or without biopsy. Choose this code when the operative service is decompression without a bone flap.
- 67420Orbitotomy
- Code 67420 describes lateral orbitotomy with a bone flap or window for exploration. It is not the decompression service represented by this code.
- 67405Orbital drainage
- Code 67405 is for orbitotomy with drainage. This code is for orbital decompression without a bone flap, not drainage of an orbital collection.
67414 billing questions
How does this differ from 67445?
This code describes orbital decompression without a bone flap. Code 67445 is the related decompression service using a lateral bone flap or window.
What documentation supports reporting this code?
The operative note should identify the decompression indication, the approach, and the work performed, with enough detail to show that decompression was done without a bone flap.
How is bilateral surgery reported?
CMS pays bilateral reporting with modifier 50 at 150%. The record should support decompression on both sides.
How does the multiple-procedure reduction affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What care is included in the global period?
The 90-day 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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