Billing code 67221Medicare rate & RVUs in Texas
Compare 67221 physician payment amounts across CMS localities, including office and facility settings.
Medicare pays $268.93–$292.95 for 67221 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
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 5 sections
Where 67221 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$268.93 to $292.95
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $292.95 | $170.33 |
| Beaumont | $268.93 | $163.46 |
| Brazoria | $281.76 | $166.90 |
| Dallas | $283.37 | $167.93 |
| Fort Worth | $281.84 | $167.57 |
| Galveston | $282.50 | $167.41 |
| Houston | $287.26 | $172.17 |
| Rest Of Texas | $275.07 | $165.08 |
How the 67221 rate is calculated
Each of 67221’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 · 67221
RVUs × geographic indexes × conversion factor
Work3.36
3.36 RVUs× 1.000 GPCI
Practice expense4.89
4.89 RVUs× 1.000 GPCI
Malpractice0.26
0.26 RVUs× 1.000 GPCI
Adjusted RVUs
8.5100
Conversion factor
$33.4009
Medicare rate
$284.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67221
The CMS indicators that decide how 67221 is paid alongside other services.
CMS payment indicators · 67221
Code 67221
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
67221 without 51 · national office
$284.24
67221-51 · Second procedure: 50%
$142.12
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
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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