Billing code 21267: Orbital repositioningMedicare rate & RVUs in Oregon
Reports surgical repositioning of one orbit using periorbital osteotomies to correct an orbital position or craniofacial skeletal deformity.
CMS doesn’t publish an office rate for 21267 in Oregon.
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 21267 covers
This service repositions the bony orbit on one side by making osteotomies around the orbit and moving the orbital framework. Craniofacial, oculoplastic, or plastic surgeons may perform it for a structural orbital deformity, such as orbital dystopia, in a hospital operating room. The operative report should establish that the work involved orbital bone cuts and repositioning, rather than soft-tissue eyelid repair alone or a limited canthal procedure.
Report the unilateral service when the documented operation matches this extent and method; include the side, osteotomy sites, and movement achieved. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. 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. For bilateral work, modifier 50 is paid at 150%. An assistant at surgery may be paid; 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.
Where 21267 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,519.46 |
| Rest Of Oregon | Unavailable | $1,426.76 |
How the 21267 rate is calculated
Each of 21267’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 · 21267
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 20.17Practice expense 19.99Malpractice 3.75
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21267
21267 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21267
Orbital repositioning
| 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) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21267
Orbital repositioning
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
21267 without 50 · national facility
$1,466.63
Orbital repositioning
21267-50 · Bilateral: 150%
$2,199.95
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).
21267 compared with similar codes
Compare codes
21267 vs 21268 vs 21275 vs 21280 vs 21256: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21268Orbital reconstruction
- Both concern orbital reconstruction, but selection depends on the specific procedure documented. Compare the full operative work with the full descriptor rather than relying on the abbreviated CMS label.
- 21275Orbitofacial revision
- This code is for orbital repositioning through periorbital osteotomies. Code 21275 is considered for revision of orbitofacial bones when that is the service performed.
- 21280Canthopexy
- Code 21280 addresses medial canthal support. It is not a substitute for repositioning the bony orbit with osteotomies.
- 21256Orbital reconstruction
- Both involve orbital reconstruction, but the operative technique and extent determine which code applies. Use this code when the documented service is unilateral orbital repositioning with periorbital osteotomies.
21267 billing questions
When is this code a better fit than a canthopexy code?
Use this code for repositioning the bony orbit with periorbital osteotomies. Medial or lateral canthopexy codes describe work on the canthal support structures, not orbital bone repositioning.
What documentation supports reporting the service?
The operative report should identify the affected side, the periorbital osteotomies, and how the bony orbit was repositioned. A description limited to eyelid or canthal soft-tissue work does not establish this service.
How is bilateral work reported?
CMS identifies this as a bilateral procedure: modifier 50 is paid at 150%. Document the work performed on each side.
Does the service include related postoperative visits?
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?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
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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