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CPT code 67850: Eyelid lesion destruction, margin lesion under 1 cm2026 Medicare rate & RVUs in Kentucky

Destruction treats a lesion smaller than 1 cm at the eyelid margin, typically when an ophthalmologist eradicates it without excisional removal.

CMS RVU26DEffective Oct 1, 2026One payment locality7.8K Medicare services in 2024

In Kentucky, Medicare pays $192.91 for 67850 in the office and $106.50 when it’s performed in a hospital or facility.

$192.91Office (non-facility)
$106.50Hospital or facility
−8.0%vs the national office rate ($209.76)

Check a contract rate as a % of Medicare · 67850 nationwide

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

We’ll open 67850 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kentucky
  2. What 67850 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 67850 covers

An ophthalmologist or other qualified eye-care professional uses a destructive method, such as cryotherapy or electrosurgery, to treat a lesion located at the eyelid margin and measuring less than 1 cm. The method destroys the targeted tissue rather than removing the lesion by excision. This may be selected for a small lesion when treatment, rather than obtaining tissue for diagnosis, is the goal.

Report the service for a lesion at the lid margin that meets the size criterion; do not select it for a larger lesion or a lesion treated by excision. Document the exact site, lesion size, treatment method, and medical reason for treatment. The code has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. For bilateral reporting with modifier 50, payment is 150%. Assistant-at-surgery payment is restricted; 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.

How Kentucky compares for 67850

Across 109 of 109 payment localities, the office rate for 67850 runs from $186.46 in Arkansas to $279.08 in San Benito County, CA. Kentucky pays $192.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

67850 in Kentucky vs other payment areas
  1. Kentucky · this page$192.91
  2. Los Angeles, CA · California$237.48+$44.57
  3. Washington, DC area · District of Columbia$239.73+$46.82
  4. Miami, FL · Florida$223.48+$30.57
  5. Chicago, IL · Illinois$217.38+$24.47
  6. Manhattan, NY · New York$240.30+$47.39
  7. Alaska · Alaska$245.52+$52.61

Other areas in Kentucky first, then benchmark localities. Bars start at $0.

Every other payment area

67850 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$189.09$104.04
ArkansasArkansas$186.46$102.97
ArizonaArizona$204.45$110.27
Bakersfield, CACalifornia$223.08$116.55
Chico, CACalifornia$222.60$116.08
El Centro, CACalifornia$222.63$116.10
Fresno, CACalifornia$222.60$116.08
Hanford, CACalifornia$222.60$116.08

67850 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$186.46

$250.84

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

View every state and territory as a table
67850 office rate range by state
State / territoryOffice rate rangeLocalities
AK$245.521
AL$189.091
AR$186.461
AZ$204.451
CA$222.60–$279.0829
CO$218.811
CT$223.341
DC$239.731
DE$207.761
FL$205.77–$223.483
GA$194.74–$213.302
GU$227.921
HI$227.921
IA$194.161
ID$195.281
IL$199.71–$218.024
IN$196.381
KS$193.071
KY$192.911
LA$192.53–$201.712
MA$217.49–$240.242
MD$211.69–$239.733
ME$196.03–$206.582
MI$197.53–$208.022
MN$210.521
MO$189.21–$202.673
MS$187.881
MT$209.751
NC$198.041
ND$206.781
NE$195.251
NH$215.201
NJ$226.13–$237.352
NM$198.481
NV$209.071
NY$200.87–$245.655
OH$196.921
OK$192.811
OR$207.68–$225.812
PA$197.35–$217.812
PR$211.311
RI$215.181
SC$197.761
SD$206.431
TN$193.971
TX$196.08–$217.888
UT$200.371
VA$205.77–$239.732
VI$211.311
VT$205.801
WA$217.14–$245.272
WI$200.081
WV$192.531
WY$208.461

See 67850 in every payment locality

How the 67850 rate is calculated

Each of 67850’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 · 67850

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.70

1.70 RVUs× 1.000 GPCI

Practice expense4.43

4.43 RVUs× 1.000 GPCI

Malpractice0.15

0.15 RVUs× 1.000 GPCI

Adjusted RVUs

6.2800

Conversion factor

$33.4009

Medicare rate

$209.76

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

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,500

Code
67850
Physician work
1.70
Practice expense
4.43
Malpractice
0.15

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for 67850 in Kentucky
ComponentRVULocality factorAdjusted
Physician work1.70× 1.0001.7000
Practice expense4.43× 0.8893.9383
Malpractice0.15× 0.9150.1373
Total RVUs5.7755
Conversion factor× 33.4009

Office rate, Kentucky$192.91

Office: (1.7 × 1 + 4.43 × 0.889 + 0.15 × 0.915) × $33.4009 = $192.91

Facility: (1.7 × 1 + 1.52 × 0.889 + 0.15 × 0.915) × $33.4009 = $106.50

Open 67850 in the RVU calculator

Payment rules and modifiers for 67850

67850 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67850

Eyelid lesion destruction, margin lesion under 1 cm

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are 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.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 67850

Eyelid lesion destruction, margin lesion under 1 cm

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

67850 without 50 · national office

$209.76

Eyelid lesion destruction, margin lesion under 1 cm

67850-50 · Bilateral: 150%

$314.64

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

Codes related to 67850

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 67850
CodeHow it relatesOffice range, Kentucky
Used instead
67840Eyelid lesion excision, excludes chalazionExcisional treatment of an eyelid lesion instead of destruction.$254.76
67810Eyelid biopsy, eyelid skin or marginBiopsy for diagnostic tissue sampling rather than lesion destruction.$165.30
17110Benign lesion destruction, up to 14 lesionsDestruction of qualifying benign lesions at sites other than the eyelid margin.$101.46

How 67850 has changed in Kentucky

67850 · Office / nonfacility

$192.91

Effective 2026-10-01

The base rate is $3.96 higher than on 2025-10-01, moving from $188.95 to $192.91 (2.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $188.95changed to$192.91

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.74 changed to 1.70
    • Practice expense RVU 4.51 changed to 4.43
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $196.20changed to$188.95

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.57 changed to 4.51

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $192.99changed to$196.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $200.06changed to$192.99

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.60 changed to 4.57
    • Malpractice RVU 0.17 changed to 0.16
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913

  5. January 1, 2023

    RVU23A

    $200.48changed to$200.06

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.55 changed to 4.60
    • Malpractice RVU 0.12 changed to 0.17
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $205.45changed to$200.48

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.64 changed to 4.55
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $200.71changed to$205.45

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.25 changed to 4.64
    • Malpractice RVU 0.13 changed to 0.14
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $201.54changed to$200.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.21 changed to 4.25
    • Malpractice RVU 0.18 changed to 0.13
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $200.98changed to$201.54

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.19 changed to 4.21
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $198.42changed to$200.98

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.15 changed to 4.19
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $196.65changed to$198.42

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.13 changed to 4.15
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $196.76changed to$196.65

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.12 changed to 4.13
    • Malpractice RVU 0.18 changed to 0.19

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $195.78changed to$196.76

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $195.85changed to$195.78

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.07 changed to 4.12
    • Malpractice RVU 0.23 changed to 0.18
    • Malpractice GPCI 0.774 changed to 0.795

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $200.18changed to$195.85

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.55 changed to 4.07
    • Malpractice RVU 0.24 changed to 0.23
    • Practice expense GPCI 0.871 changed to 0.872
    • Malpractice GPCI 0.752 changed to 0.774

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $200.18

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$192.91$106.50RVU26D
2026-07-01$192.91$106.50RVU26C
2026-04-01$192.91$106.50RVU26B
2026-01-01$192.91$106.50RVU26A
2025-10-01$188.95$118.88RVU25D
2025-07-01$188.95$118.88RVU25C
2025-04-01$188.95$118.88RVU25B
2025-01-01$188.95$118.88RVU25A
2024-10-01$196.20$121.46RVU24D
2024-07-01$196.20$121.46RVU24C
2024-04-01$196.20$121.46RVU24B
2024-03-09$196.20$121.46RVU24AR
2024-01-01$192.99$119.48RVU24A
2023-10-01$200.06$122.55RVU23D
2023-07-01$200.06$122.55RVU23C
2023-04-01$200.06$122.55RVU23B
2023-01-01$200.06$122.55RVU23A
2022-10-01$200.48$120.79RVU22D
2022-07-01$200.48$120.79RVU22C
2022-04-01$200.48$120.79RVU22B
2022-01-01$200.48$120.79RVU22A
2021-10-01$205.45$122.37RVU21D
2021-07-01$205.45$122.37RVU21C
2021-04-01$205.45$122.37RVU21B
2021-01-01$205.45$122.37RVU21A
2020-10-01$200.71$125.96RVU20D
2020-07-01$200.71$125.96RVU20C
2020-04-01$200.71$125.96RVU20B
2020-01-01$200.71$125.96RVU20A
2019-10-01$201.54$128.91RVU19D
2019-07-01$201.54$128.91RVU19C
2019-04-01$201.54$128.91RVU19B
2019-01-01$201.54$128.91RVU19A
2018-10-01$200.98$130.02RVU18D
2018-07-01$200.98$130.02RVU18C
2018-04-01$200.98$130.02RVU18B
2018-01-01$200.98$130.02RVU18AR1
2017-10-01$198.42$128.94RVU17D
2017-07-01$198.42$128.94RVU17C
2017-04-01$198.42$128.94RVU17B
2017-01-01$198.42$128.94RVU17A
2016-10-01$196.65$128.28RVU16D
2016-07-01$196.65$128.28RVU16C
2016-04-01$196.65$128.28RVU16B
2016-01-01$196.65$128.28RVU16A
2015-10-01$196.76$128.45RVU15D
2015-07-01$196.76$128.45RVU15C
2015-04-01$195.78$127.82RVU15B
2015-01-01$195.78$127.82RVU15A
2014-10-01$195.85$128.37RVU14D
2014-07-01$195.85$128.37RVU14C
2014-04-01$195.85$128.37RVU14B
2014-01-01$195.85$128.37RVU14A
2013-10-01$200.18$127.87RVU13D
2013-07-01$200.18$127.87RVU13C
2013-04-01$200.18$127.87RVU13B
2013-01-01$200.18$127.87RVU13AR

Price 67850 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

67850 billing questions

When should this code be chosen instead of 67840?

Use 67850 for destruction of a lesion under 1 cm at the eyelid margin. Code 67840 describes excisional removal of an eyelid lesion.

Can a biopsy be reported for the same lesion?

This code represents destructive treatment, not tissue sampling. If the service is a diagnostic eyelid biopsy, consider 67810 instead; report services separately only when each was actually performed and independently reportable.

What documentation supports the code?

Record the lesion's eyelid-margin location, size under 1 cm, treatment method, and clinical reason for destruction.

How is bilateral treatment reported?

For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.

Are related postoperative visits separately payable during the global period?

Related postoperative visits during the 10-day global period are included in this minor procedure's payment.

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

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.

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 67850PPRRVU2026_Oct_nonQPP.csv, line 7,500 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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