CPT 15822
Global 090 ActiveBlepharoplasty upper eyelid
CPT 15822 Billing & Documentation Guide
CPT code 15822 (Blepharoplasty upper eyelid) is classified under Anesthesia with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 4.5, a non-facility practice expense RVU of 9.13, and a malpractice RVU of 0.49, a total non-facility RVU of 14.12 and facility RVU of 10.65. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $485.64, though rates vary from $420.69 to $615.35 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 15822, 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 15822 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 15822 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 15822
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 4.5 | 4.5 |
| Practice Expense RVU | 9.13 | 5.66 |
| Malpractice RVU | 0.49 | 0.49 |
| Total RVU | 14.12 | 10.65 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 15822
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 | $525.41 | $388.26 | $495.86 - $615.35 | 29 |
| Florida | $488.13 | $371.84 | $466.44 - $509.15 | 3 |
| Georgia | $461.03 | $350.46 | $441.83 - $480.24 | 2 |
| Illinois | $476.76 | $364.78 | $454.3 - $495.39 | 4 |
| Michigan | $459.69 | $350.86 | $447.2 - $472.17 | 2 |
| North Carolina | $445.28 | $337.15 | $445.28 - $445.28 | 1 |
| New York | $519.88 | $390.59 | $451.51 - $552.9 | 5 |
| Ohio | $445.22 | $339.4 | $445.22 - $445.22 | 1 |
| Pennsylvania | $467.85 | $354.33 | $445.71 - $489.99 | 2 |
| Texas | $466.55 | $352.45 | $443.01 - $487.74 | 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 15822
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 15822 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 15822
What does CPT code 15822 mean? +
CPT code 15822 represents: Blepharoplasty upper eyelid. It's in the Anesthesia category with a global period of 090.
What is the Medicare reimbursement for CPT 15822? +
The 2026 Medicare national average non-facility payment for CPT 15822 is $485.64. Rates range from $420.69 to $615.35 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 15822? +
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 15822? +
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 May 31, 2026.
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