CPT 15821
Global 090 ActiveBlepharp lwr eyelid fat pad
CPT 15821 Billing & Documentation Guide
CPT code 15821 (Blepharp lwr eyelid fat pad) is classified under Anesthesia with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 6.67, a non-facility practice expense RVU of 11.67, and a malpractice RVU of 0.65, a total non-facility RVU of 18.99 and facility RVU of 14.48. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $652.72, though rates vary from $568.79 to $821 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 15821, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 15821 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 15821 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 15821
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 6.67 | 6.67 |
| Practice Expense RVU | 11.67 | 7.16 |
| Malpractice RVU | 0.65 | 0.65 |
| Total RVU | 18.99 | 14.48 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 15821
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $703.77 | $525.52 | $665.42 - $821 | 29 |
| Florida | $656.13 | $505 | $628.05 - $683.46 | 3 |
| Georgia | $620.95 | $477.25 | $596.35 - $645.55 | 2 |
| Illinois | $641.69 | $496.13 | $612.59 - $665.91 | 4 |
| Michigan | $619.35 | $477.91 | $603.17 - $635.53 | 2 |
| North Carolina | $600.33 | $459.78 | $600.33 - $600.33 | 1 |
| New York | $697.71 | $529.66 | $608.35 - $740.82 | 5 |
| Ohio | $600.55 | $463.01 | $600.55 - $600.55 | 1 |
| Pennsylvania | $629.8 | $482.25 | $601.13 - $658.46 | 2 |
| Texas | $627.92 | $479.62 | $597.66 - $654.86 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 15821
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 15821 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 15821
What does CPT code 15821 mean? +
CPT code 15821 represents: Blepharp lwr eyelid fat pad. It's in the Anesthesia category with a global period of 090.
What is the Medicare reimbursement for CPT 15821? +
The 2026 Medicare national average non-facility payment for CPT 15821 is $652.72. Rates range from $568.79 to $821 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 15821? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 15821? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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