No office rate
Choose 67445 for orbital bone removal to decompress. Choose 67414 when the bone-flap or window orbitotomy is performed to remove an orbital lesion.
On this page
CMS RVU26D · Effective 2026-10-01
67445 Orbital decompression Medicare reimbursement rates in Wyoming
Report orbital bone removal for decompression when surgery enlarges the orbital space to relieve pressure associated with thyroid eye disease or other orbital conditions. Compare 67445 office and facility rates across CMS payment localities in Wyoming.
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 67445 in Wyoming?
Wyoming 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
No supported rate
Facility setting
$1297.93
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Ophthalmic surgery
About 67445: Orbital bone removal for decompression
Report orbital bone removal for decompression when surgery enlarges the orbital space to relieve pressure associated with thyroid eye disease or other orbital conditions.
This operation removes orbital bone to create additional space around the eye and relieve pressure on orbital contents. It is commonly performed by an ophthalmologist, often an oculoplastic or orbital surgeon, for proptosis or optic nerve compression associated with thyroid eye disease. The procedure is generally performed in an operating-room setting; CMS reported facility-setting utilization for this code in 2024.
Report 67445 when the operative service removes orbital bone for decompression, rather than exploring the orbit or removing a lesion. The operative report should identify the indication, side, bone removal, and decompressive purpose. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. With multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 67445
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU18.64 · 47%
- Practice expense (office) RVU19.05 · 49%
- Malpractice RVU1.58 · 4%
133
Medicare services in 2024 · #4649 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.
67445 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
67440 describes lateral orbitotomy for exploration. 67445 is the decompression service involving orbital bone removal.
No office rate
67412 is for orbitotomy with lesion removal through a non-bone-flap approach; 67445 is selected for decompression through bone removal.
Compare 67445 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$1297.93
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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 67445 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,477
- Code
- 67445
- Physician work
- 18.64
- Practice expense
- 19.05
- Malpractice
- 1.58
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.64 | × 1.000 | 18.6400 |
| Practice expense | 19.05 | × 1.000 | 19.0500 |
| Malpractice | 1.58 | × 0.740 | 1.1692 |
| Total RVUs | 38.8592 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1297.93
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.64 | 1 |
| Practice expense | 19.05 | 1 |
| Malpractice | 1.58 | 0.74 |
(18.64 × 1 + 19.05 × 1 + 1.58 × 0.74) × $33.4009 = $1297.93
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.
67445 billing questions
How is 67445 different from orbital exploration or lesion removal?
Use 67445 when orbital bone is removed to decompress the orbit. Exploration or removal of an orbital lesion describes a different operative purpose.
What should the operative report document?
Document the clinical reason for decompression, the side treated, the bone removal performed, and how the work relieved pressure in the orbit.
How is bilateral decompression reported?
When both orbits are treated, report modifier 50; CMS pays bilateral procedures at 150%.
How does the 90-day global period affect follow-up?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only when supporting documentation is provided.
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.
7,47467420,,Explore/treat eye socket,A,,21.32,21.66,NA,21.66,,2.05,45.03,45.03,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47567430,,Explore/treat eye socket,A,,14.91,20.20,NA,20.20,,1.20,36.31,36.31,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47667440,,Explore/drain eye socket,A,,14.47,19.58,NA,19.58,,1.16,35.21,35.21,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47767445,,Explr/decompress eye socket,A,,18.64,19.05,NA,19.05,,1.58,39.27,39.27,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47867450,,Explore/biopsy eye socket,A,,15.02,20.24,NA,20.24,,1.21,36.47,36.47,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,47967500,,Inject/treat eye socket,A,,1.15,1.13,,0.42,,0.08,2.36,1.65,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48067505,,Inject/treat eye socket,A,,1.15,1.31,,0.51,,0.08,2.54,1.74,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,