No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
21267 Orbital repositioning Medicare reimbursement rates in Pennsylvania
Reports surgical repositioning of one orbit using periorbital osteotomies to correct an orbital position or craniofacial skeletal deformity. Compare 21267 office and facility rates across CMS payment localities in Pennsylvania.
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 21267 in Pennsylvania?
Pennsylvania 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
$1404.99–$1530.31
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.
Craniofacial surgery
About 21267: Unilateral orbital repositioning with osteotomies
Reports surgical repositioning of one orbit using periorbital osteotomies to correct an orbital position or craniofacial skeletal deformity.
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.
CMS billing rules for 21267
- 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 RVU20.17 · 46%
- Practice expense (office) RVU19.99 · 46%
- Malpractice RVU3.75 · 9%
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.
21267 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
This code is for orbital repositioning through periorbital osteotomies. Code 21275 is considered for revision of orbitofacial bones when that is the service performed.
No office rate
Code 21280 addresses medial canthal support. It is not a substitute for repositioning the bony orbit with osteotomies.
No office rate
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.
Compare 21267 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1530.31
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1404.99
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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 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.
1,93121260,,Revise eye sockets,A,,17.45,16.80,NA,16.80,,3.23,37.48,37.48,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93221261,,Revise eye sockets,A,,33.22,25.75,NA,25.75,,6.17,65.14,65.14,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93321263,,Revise eye sockets,A,,30.23,24.66,NA,24.66,,5.61,60.50,60.50,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93421267,,Revise eye sockets,A,,20.17,19.99,NA,19.99,,3.75,43.91,43.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93521268,,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