FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

15822 Upper eyelid surgery Medicare reimbursement rates in Vermont

Upper eyelid blepharoplasty reshapes an upper lid when the operation does not meet the separate criterion for excess skin weighing down the lid. Compare 15822 office and facility rates across CMS payment localities in Vermont.

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 15822 in Vermont?

Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

$460.49

1 of 1 localities have a supported rate.

Payment area: Vermont

One mapped payment locality.

Facility setting

$345.74

1 of 1 localities have a supported rate.

Payment area: Vermont

One mapped payment locality.

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.

Find 15822 in your payment locality →

Oculoplastic surgery

About 15822: Upper eyelid blepharoplasty

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

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.

CMS billing rules for 15822

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
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU4.50 · 32%
  • Practice expense (office) RVU9.13 · 65%
  • Malpractice RVU0.49 · 3%

3K

Medicare services in 2024 · #2184 by national volume

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 compared with similar codes

Office rates for Vermont, from the same CMS release.

15823

Upper eyelid surgery

Excess skin affects lid function

$619.46

Both address the upper eyelid. Choose 15823 when excess skin weighs down the lid and the procedure meets its specific criterion; otherwise consider 15822.

15820

Lower eyelid surgery

Lower eyelid

$576.59

15820 is for lower-lid blepharoplasty without the extensive herniated fat distinction. 15822 is for the upper eyelid.

15821

Lower eyelid surgery

Prominent fat-pad prolapse

$619.66

15821 is for lower-lid blepharoplasty involving extensive herniated fat. 15822 addresses the upper eyelid.

Compare 15822 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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

Need rates for a whole code list?

Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.

Explore fee-sheet early access →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 15822 in Vermont.

PPRRVU2026_Oct_nonQPP.csv

1,563

Code
15822
Physician work
4.50
Practice expense
9.13
Malpractice
0.49

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office / nonfacility calculation for 15822 in Vermont
ComponentRVULocality factorAdjusted
Physician work4.50× 1.0004.5000
Practice expense9.13× 0.9909.0387
Malpractice0.49× 0.5060.2479
Total RVUs13.7866
Conversion factor× 33.4009

Office / nonfacility rate, Vermont$460.49

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.51
Practice expense9.130.99
Malpractice0.490.506

(4.5 × 1 + 9.13 × 0.99 + 0.49 × 0.506) × $33.4009 = $460.49

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.51
Practice expense5.660.99
Malpractice0.490.506

(4.5 × 1 + 5.66 × 0.99 + 0.49 × 0.506) × $33.4009 = $345.74

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

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 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.

RVUs for 15822PPRRVU2026_Oct_nonQPP.csv, line 1,563 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet