Billing code 67320: Muscle transpositionMedicare rate & RVUs in Washington
Reports an extraocular muscle transposition performed with a primary strabismus operation to redirect muscle pull and address ocular misalignment.
CMS doesn’t publish an office rate for 67320 in Washington.
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 9 sections
What 67320 covers
An extraocular muscle transposition changes the direction of a muscle’s pull to help correct ocular misalignment. An ophthalmologist, often a strabismus surgeon, may perform this maneuver when the surgical plan requires repositioning a muscle or its tendon rather than relying only on a conventional recession or resection. It is performed as part of operative strabismus care, commonly in a facility setting.
Report 67320 only with a primary procedure; it is not a stand-alone service. The operative report should identify the muscle involved, the transposition performed, the clinical reason for changing its pull, and the primary strabismus procedure performed at the encounter. CMS treats this as an add-on paid within the primary procedure’s global period. The record should make clear that a transposition was performed, rather than only a standard muscle recession or resection.
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.
Where 67320 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $140.96 |
| Seattle (King Cnty) | Unavailable | $150.97 |
How the 67320 rate is calculated
Each of 67320’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 · 67320
RVUs × geographic indexes × conversion factor
Work2.93
2.93 RVUs× 1.000 GPCI
Practice expense1.03
1.03 RVUs× 1.000 GPCI
Malpractice0.22
0.22 RVUs× 1.000 GPCI
Adjusted RVUs
4.1800
Conversion factor
$33.4009
Medicare rate
$139.62
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67320
The CMS indicators that decide how 67320 is paid alongside other services.
CMS payment indicators · 67320
Muscle transposition
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
67320 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67311Eye muscle surgery
- 67311 describes recession or resection of one horizontal muscle. Choose 67320 for a transposition maneuver reported with a primary procedure.
- 67314Eye muscle surgery
- 67314 describes recession or resection of one vertical muscle. It does not describe redirecting a muscle’s pull by transposition.
- 67318Eye muscle surgery
- 67318 describes recession or resection of one oblique muscle. Use 67320 for the transposition add-on, not for that standard muscle adjustment.
67320 billing questions
Can 67320 be reported by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure.
How is a transposition different from a recession or resection?
A transposition redirects the muscle’s pull by changing its position or course. Recession and resection instead adjust the muscle’s effective strength or tension.
What should the operative note document?
Document the muscle treated, the transposition maneuver, its purpose, and the primary strabismus procedure performed during the encounter.
How does the global period affect payment?
CMS includes payment for this add-on within the primary procedure’s global period. Submit it with the primary procedure, not as a separate stand-alone service.
Is 67320 the right choice for routine muscle recession or resection?
No. Use the applicable recession or resection code when that is the procedure performed; 67320 describes an additional transposition maneuver.
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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