CPT code 67810: Eyelid biopsy, eyelid skin or margin2026 Medicare rate & RVUs

Ophthalmologists report this incisional eyelid biopsy to sample suspicious eyelid skin or lid-margin tissue when diagnosis is needed without complete lesion excision.

CMS RVU26DEffective Oct 1, 2026109 payment localities16.9K Medicare services in 2024

Medicare pays $181.03 for 67810 nationally in the office and $55.11 in a hospital or facility. Local office rates run $159.66–$244.97.

Medicare rate · 67810

Eyelid biopsy, eyelid skin or margin

Office or facility?

Work RVUs
1.15
Total RVUs
5.42
Global days
000

National rate · 2026

$181.03

Office setting, before claim adjustments.

See every locality for 67810 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 67810 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 67810 covers

An ophthalmologist, often an oculoplastic surgeon, takes a tissue sample from eyelid skin or the lid margin for diagnostic evaluation. Typical situations include a suspicious, changing, ulcerated, or nonhealing eyelid growth. The service may be performed in an office or facility setting, and the sample is submitted for tissue examination. This code describes obtaining a biopsy sample, not removing the entire lesion as treatment.

Report 67810 when the procedure is an incisional biopsy of eyelid skin or margin; document the sampled site, the lesion’s clinical appearance, and that tissue was obtained for diagnosis. The CMS global period is 0 days, so same-day preoperative and postoperative care is included. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

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 67810 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$159.66 to $244.97

$159.66$202.31$244.97
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

67810 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$162.07$51.89
Alaska$207.62$73.51
Arizona$176.20$54.18
Arkansas$159.66$51.49
Atlanta, GA$184.11$56.17
Austin, TX$188.75$55.52
Bakersfield, CA$193.67$55.66
Baltimore area, MD$192.66$57.55
Beaumont, TX$168.27$53.68
Brazoria, TX$179.28$54.49

67810 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$159.66

$219.14

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
67810 office rate range by state
State / territoryOffice rate rangeLocalities
AK$207.621
AL$162.071
AR$159.661
AZ$176.201
CA$193.32–$244.9729
CO$189.581
CT$193.271
DC$208.251
DE$179.191
FL$176.77–$192.353
GA$166.73–$184.112
GU$198.521
HI$198.521
IA$167.011
ID$167.981
IL$171.01–$187.894
IN$169.001
KS$165.871
KY$165.301
LA$164.90–$173.332
MA$188.27–$209.162
MD$182.78–$208.253
ME$168.53–$178.432
MI$169.42–$178.692
MN$182.481
MO$161.76–$174.373
MS$160.761
MT$181.031
NC$170.401
ND$178.851
NE$168.051
NH$186.271
NJ$195.71–$205.932
NM$170.241
NV$180.561
NY$172.99–$212.905
OH$168.971
OK$165.351
OR$179.39–$196.132
PA$169.44–$188.132
PR$182.511
RI$185.951
SC$169.921
SD$178.591
TN$166.691
TX$168.27–$188.758
UT$172.321
VA$177.59–$208.252
VI$182.511
VT$177.831
WA$188.02–$213.822
WI$172.651
WV$164.411
WY$180.081

How the 67810 rate is calculated

Each of 67810’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 · 67810

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.15

1.15 RVUs× 1.000 GPCI

Practice expense4.16

4.16 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

5.4200

Conversion factor

$33.4009

Medicare rate

$181.03

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 67810

The CMS indicators that decide how 67810 is paid alongside other services.

CMS payment indicators · 67810

Eyelid biopsy, eyelid skin or margin

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

67810 without 50 · national office

$181.03

Eyelid biopsy, eyelid skin or margin

67810-50 · Bilateral: 150%

$271.55

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

67810 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 67810

    Eyelid biopsy, eyelid skin or margin1.15 wRVU

    $181.03

  • 67840

    Eyelid lesion excision, excludes chalazion2.04 wRVU

    $277.90+$96.87

  • 68100

    Conjunctival biopsy, diagnostic tissue sampling1.32 wRVU

    $179.70−$1.33

  • 11102

    Tangential skin biopsy, first or only lesion0.64 wRVU

    $95.53−$85.50

How to choose

67840Eyelid lesion excisionExcludes chalazion
67810 samples eyelid tissue for diagnosis. 67840 is used when the eyelid lesion is excised rather than biopsied.
68100Conjunctival biopsyDiagnostic tissue sampling
67810 applies to eyelid skin or lid-margin tissue; 68100 applies when the sampled tissue is conjunctiva.
11102Tangential skin biopsyFirst or only lesion
11102 describes a tangential skin biopsy for a different site and method. 67810 is specific to an incisional biopsy of eyelid skin or margin.

67810 billing questions

When should 67810 be chosen instead of 67840?

Use 67810 when tissue is sampled for diagnosis. Use 67840 when the eyelid lesion is excised rather than sampled.

Does 67810 include removal of the whole lesion?

No. It represents an incisional biopsy sample; document a complete excision separately when that is the service performed.

How is a bilateral eyelid biopsy reported?

CMS recognizes modifier 50 for bilateral reporting and pays the procedure at 150%. Document the eyelid sites sampled.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and the others at 50%.

Is same-day postoperative care separately included?

No. The 0-day global period includes same-day preoperative and postoperative care.

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
RVUs for 67810PPRRVU2026_Oct_nonQPP.csv, line 7,494 (RVU26D)

Open CMS sourceHow we calculate rates

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