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

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 South Dakota, Medicare pays $206.43 for 67850 in the office and $109.23 when it’s performed in a hospital or facility.

$206.43Office (non-facility)
$109.23Hospital or facility
−1.6%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 South Dakota
  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 South Dakota 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. South Dakota pays $206.43. The RVUs are the same everywhere; the geographic indexes change the dollars.

67850 in South Dakota vs other payment areas
  1. South Dakota · this page$206.43
  2. Los Angeles, CA · California$237.48+$31.05
  3. Washington, DC area · District of Columbia$239.73+$33.30
  4. Miami, FL · Florida$223.48+$17.05
  5. Chicago, IL · Illinois$217.38+$10.95
  6. Manhattan, NY · New York$240.30+$33.87
  7. Alaska · Alaska$245.52+$39.09

Other areas in South Dakota 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.

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 South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 67850 in South Dakota
ComponentRVULocality factorAdjusted
Physician work1.70× 1.0001.7000
Practice expense4.43× 1.0004.4300
Malpractice0.15× 0.3360.0504
Total RVUs6.1804
Conversion factor× 33.4009

Office rate, South Dakota$206.43

Office: (1.7 × 1 + 4.43 × 1 + 0.15 × 0.336) × $33.4009 = $206.43

Facility: (1.7 × 1 + 1.52 × 1 + 0.15 × 0.336) × $33.4009 = $109.23

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

How 67850 has changed in South Dakota

67850 · Office / nonfacility

$206.43

Effective 2026-10-01

The base rate is $2.29 higher than on 2025-10-01, moving from $204.14 to $206.43 (1.1%).

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

    $204.14changed to$206.43

    • 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
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $212.08changed to$204.14

    • 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

    $208.62changed to$212.08

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $216.94changed to$208.62

    • 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
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $219.11changed to$216.94

    • 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
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $224.31changed to$219.11

    • 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

    $217.90changed to$224.31

    • 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
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $216.96changed to$217.90

    • 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
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $216.14changed to$216.96

    • 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

    $214.08changed to$216.14

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.15 changed to 4.19
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $212.89changed to$214.08

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.13 changed to 4.15
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $213.16changed to$212.89

    • 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

    $212.10changed to$213.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $211.56changed to$212.10

    • 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 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $217.53changed to$211.56

    • 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
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $217.53

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$206.43$109.23RVU26D
2026-07-01$206.43$109.23RVU26C
2026-04-01$206.43$109.23RVU26B
2026-01-01$206.43$109.23RVU26A
2025-10-01$204.14$124.25RVU25D
2025-07-01$204.14$124.25RVU25C
2025-04-01$204.14$124.25RVU25B
2025-01-01$204.14$124.25RVU25A
2024-10-01$212.08$126.86RVU24D
2024-07-01$212.08$126.86RVU24C
2024-04-01$212.08$126.86RVU24B
2024-03-09$212.08$126.86RVU24AR
2024-01-01$208.62$124.79RVU24A
2023-10-01$216.94$128.16RVU23D
2023-07-01$216.94$128.16RVU23C
2023-04-01$216.94$128.16RVU23B
2023-01-01$216.94$128.16RVU23A
2022-10-01$219.11$127.41RVU22D
2022-07-01$219.11$127.41RVU22C
2022-04-01$219.11$127.41RVU22B
2022-01-01$219.11$127.41RVU22A
2021-10-01$224.31$128.71RVU21D
2021-07-01$224.31$128.71RVU21C
2021-04-01$224.31$128.71RVU21B
2021-01-01$224.31$128.71RVU21A
2020-10-01$217.90$132.37RVU20D
2020-07-01$217.90$132.37RVU20C
2020-04-01$217.90$132.37RVU20B
2020-01-01$217.90$132.37RVU20A
2019-10-01$216.96$134.43RVU19D
2019-07-01$216.96$134.43RVU19C
2019-04-01$216.96$134.43RVU19B
2019-01-01$216.96$134.43RVU19A
2018-10-01$216.14$135.50RVU18D
2018-07-01$216.14$135.50RVU18C
2018-04-01$216.14$135.50RVU18B
2018-01-01$216.14$135.50RVU18AR1
2017-10-01$214.08$134.76RVU17D
2017-07-01$214.08$134.76RVU17C
2017-04-01$214.08$134.76RVU17B
2017-01-01$214.08$134.76RVU17A
2016-10-01$212.89$134.48RVU16D
2016-07-01$212.89$134.48RVU16C
2016-04-01$212.89$134.48RVU16B
2016-01-01$212.89$134.48RVU16A
2015-10-01$213.16$134.82RVU15D
2015-07-01$213.16$134.82RVU15C
2015-04-01$212.10$134.15RVU15B
2015-01-01$212.10$134.15RVU15A
2014-10-01$211.56$134.18RVU14D
2014-07-01$211.56$134.18RVU14C
2014-04-01$211.56$134.18RVU14B
2014-01-01$211.56$134.18RVU14A
2013-10-01$217.53$134.52RVU13D
2013-07-01$217.53$134.52RVU13C
2013-04-01$217.53$134.52RVU13B
2013-01-01$217.53$134.52RVU13AR

Price 67850 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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 South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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