Billing code 15822: Upper eyelid surgeryMedicare rate & RVUs in Utah

Upper eyelid blepharoplasty reshapes an upper lid when the operation does not meet the separate criterion for excess skin weighing down the lid.

CMS RVU26DEffective Oct 1, 20261 payment locality3K Medicare services in 2024

Medicare pays $451.65 for 15822 in the office in Utah (Utah). Which amount applies depends on the service address.

$451.65Office (non-facility)
$342.71Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 15822 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 15822 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 15822 covers

This operation reshapes an upper eyelid, typically through an incision in the lid crease to remove or adjust tissue. Ophthalmic plastic surgeons, ophthalmologists, and plastic surgeons perform it for upper-lid contour or functional concerns. It may be done on one or both upper eyelids in an outpatient operating room or, in selected cases, an office-based setting.

Report 15822 when the upper-lid service does not meet the distinct 15823 criterion for excess skin weighing down the lid. Document the treated eyelid or eyelids, the clinical reason, relevant findings, and the procedure performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued is paid in full and the others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are 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.

15822 in Utah

15822 office and facility rates by payment locality
Payment localityOfficeFacility
Utah$451.65$342.71

How the 15822 rate is calculated

Each of 15822’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 · 15822

RVUs × geographic indexes × conversion factor

Work4.50

4.50 RVUs× 1.000 GPCI

Practice expense9.13

9.13 RVUs× 1.000 GPCI

Malpractice0.49

0.49 RVUs× 1.000 GPCI

Adjusted RVUs

14.1200

Conversion factor

$33.4009

Medicare rate

$471.62

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 15822

15822 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15822

Upper eyelid surgery

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 15822

Upper eyelid surgery

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

15822 without 50 · national office

$471.62

Upper eyelid surgery

15822-50 · Bilateral: 150%

$707.43

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).

When to use modifier 50

15822 compared with similar codes

Compare codes · National

4 codes, side by side

  • 15822

    Upper eyelid surgery4.5 wRVU

    $471.62

  • 15823

    Upper eyelid surgery6.64 wRVU

    $632.95+$161.33

  • 15820

    Lower eyelid surgery6.11 wRVU

    $588.19+$116.57

  • 15821

    Lower eyelid surgery6.67 wRVU

    $634.28+$162.66

How to choose

15823Upper eyelid surgery
Both address the upper eyelid. Choose 15823 when excess skin weighs down the lid and the procedure meets its specific criterion; otherwise consider 15822.
15820Lower eyelid surgery
15820 is for lower-lid blepharoplasty without the extensive herniated fat distinction. 15822 is for the upper eyelid.
15821Lower eyelid surgery
15821 is for lower-lid blepharoplasty involving extensive herniated fat. 15822 addresses the upper eyelid.

15822 billing questions

When should 15823 be reported instead?

Use 15823 when excess upper-lid skin weighs down the lid and the procedure meets that code’s criterion. Use 15822 for upper-lid blepharoplasty that does not meet that distinction.

Can 15822 be reported for both upper eyelids?

Yes. CMS lists bilateral payment with modifier 50 at 150%.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can 15822 be reported with a lower-lid blepharoplasty?

It may be reported with a lower-lid procedure when both upper and lower lids are operated on during the same session. Choose the lower-lid code based on the service performed there.

How does Medicare handle multiple procedures in the same session?

The highest-valued procedure is paid in full, and the other procedures are paid at 50% under the standard multiple procedure reduction.

Is an assistant surgeon payable for 15822?

CMS lists a statutory restriction on assistant-at-surgery payment for this code.

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
RVUs for 15822PPRRVU2026_Oct_nonQPP.csv, line 1,563 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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