No office rate
67311 is for surgical recession or resection of one horizontal muscle. Choose 67345 when the treatment is chemodenervation injection rather than muscle surgery.
On this page
CMS RVU26D · Effective 2026-10-01
67345 Eye muscle injection Medicare reimbursement rates in Virginia
Reports injection of a chemodenervating agent into an extraocular muscle to temporarily weaken it, commonly to manage strabismus or diplopia. Compare 67345 office and facility rates across CMS payment localities in Virginia.
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 67345 in Virginia?
Virginia 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
$243.66–$282.60
2 of 2 localities have a supported rate.
Facility setting
$184.24–$211.38
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.
Ophthalmology
About 67345: Extraocular muscle chemodenervation
Reports injection of a chemodenervating agent into an extraocular muscle to temporarily weaken it, commonly to manage strabismus or diplopia.
An ophthalmologist, often a strabismus specialist, injects a chemodenervating agent into a selected extraocular muscle to reduce its activity temporarily. The treatment may be used for strabismus or diplopia when weakening a particular muscle is clinically appropriate. It is performed in an outpatient setting, including an office or procedure room, or in a facility setting.
Report 67345 for the chemodenervation procedure, rather than for surgical recession or resection of an eye muscle. The operative or procedure note should identify the treated muscle and eye, the indication, and the agent and dose administered. When the practice supplies the drug, report it separately under the applicable drug code when supported. CMS assigns a 10-day global period, so related postoperative visits during that period are included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 67345
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU2.93 · 39%
- Practice expense (office) RVU4.06 · 54%
- Malpractice RVU0.53 · 7%
391
Medicare services in 2024 · #3757 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.
67345 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
67312 describes surgical recession or resection involving two horizontal muscles. It is not the code for weakening a muscle by injection.
No office rate
67314 is for surgical recession or resection of one vertical muscle. 67345 describes chemodenervation, regardless of whether the selected muscle is horizontal or vertical.
Compare 67345 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
Dc + Md/Va Suburbs →
Office / nonfacility
$282.60
Facility
$211.38
Virginia →
Office / nonfacility
$243.66
Facility
$184.24
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67345 billing questions
When should 67345 be selected instead of an eye muscle surgery code?
Use 67345 when treatment is by chemodenervation injection to weaken an extraocular muscle. Use a recession or resection code when the surgeon surgically changes muscle position or length.
Can the supplied drug be billed separately?
The code reports the chemodenervation procedure. When the practice supplies the drug, report the applicable drug code separately when supported by the record.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Are postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in 67345.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery for this procedure. Co-surgeons and team surgery are not permitted.
What happens if another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.
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.
7,46267335,,Eye suture during surgery,A,,3.15,1.09,NA,1.09,,0.24,4.48,4.48,0,ZZZ,0.00,0.00,0.00,0,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46367340,,Revise eye muscle add-on,A,,4.88,1.72,NA,1.72,,0.39,6.99,6.99,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46467343,,Release eye tissue,A,,8.26,8.52,NA,8.52,,0.67,17.45,17.45,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46567345,,Destroy nerve of eye muscle,A,,2.93,4.06,,2.25,,0.53,7.52,5.71,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46667346,,Biopsy eye muscle,A,,2.80,1.81,NA,1.81,,0.21,4.82,4.82,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46767399,,Unlisted px extraocular musc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46867400,,Explore/biopsy eye socket,A,,10.92,15.47,NA,15.47,,0.89,27.28,27.28,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00