CPT code 67901: Ptosis repair, frontalis sling, nonautologous material2026 Medicare rate & RVUs in California
Corrects upper eyelid drooping by suspending the lid from the frontalis muscle with suture or other nonautologous material.
Medicare pays $838.67–$1,043.56 for 67901 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 67901 covers
This operation treats blepharoptosis, or a drooping upper eyelid, by linking the eyelid to the frontalis muscle so brow movement helps elevate it. An ophthalmologist, commonly an oculoplastic surgeon, may use a suture or another nonautologous sling material. The technique is distinct from harvesting the patient’s own fascia for the suspension and from shortening or advancing the eyelid elevator muscle.
Report the code for the frontalis suspension technique, with the operative note identifying the method and material used, the treated eyelid, and the ptosis being corrected. The code has a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed 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 67901 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$838.67 to $1043.56
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $840.67 | $521.46 |
| Chico, CA | $838.67 | $519.45 |
| El Centro, CA | $838.77 | $519.56 |
| Fresno, CA | $838.67 | $519.45 |
| Hanford, CA | $838.67 | $519.45 |
| Los Angeles, CA | $892.99 | $548.43 |
| Madera, CA | $838.67 | $519.45 |
| Marin County, CA | $1,021.43 | $610.76 |
| Merced, CA | $838.67 | $519.45 |
| Modesto, CA | $838.67 | $519.45 |
| Napa, CA | $966.17 | $582.30 |
| Oxnard, CA | $888.40 | $544.14 |
| Redding, CA | $838.67 | $519.45 |
| Rest of California | $838.67 | $519.45 |
| Riverside, CA | $845.48 | $526.26 |
| Sacramento, CA | $878.59 | $539.86 |
| Salinas, CA | $875.25 | $537.68 |
| San Benito County, CA | $1,043.56 | $623.57 |
| San Diego, CA | $894.58 | $546.24 |
| San Francisco, CA | $1,020.73 | $610.06 |
| San Luis Obispo, CA | $861.27 | $529.53 |
| Santa Clara County, CA | $1,040.68 | $620.69 |
| Santa Cruz, CA | $902.22 | $548.34 |
| Santa Maria, CA | $878.19 | $538.58 |
| Santa Rosa, CA | $911.28 | $553.62 |
| Stockton, CA | $838.67 | $519.45 |
| Vallejo, CA | $965.16 | $581.28 |
| Visalia, CA | $838.67 | $519.45 |
| Yuba City, CA | $838.67 | $519.45 |
How the 67901 rate is calculated
Each of 67901’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 · 67901
RVUs × geographic indexes × conversion factor
Work7.40
7.40 RVUs× 1.000 GPCI
Practice expense15.74
15.74 RVUs× 1.000 GPCI
Malpractice0.62
0.62 RVUs× 1.000 GPCI
Adjusted RVUs
23.7600
Conversion factor
$33.4009
Medicare rate
$793.61
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67901
67901 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67901
Ptosis repair, frontalis sling, nonautologous material
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 67901
Ptosis repair, frontalis sling, nonautologous material
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67901 without 50 · national office
$793.61
Ptosis repair, frontalis sling, nonautologous material
67901-50 · Bilateral: 150%
$1,190.42
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).
67901 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 67902Ptosis repairFrontalis sling with fascia
- Both use a frontalis suspension approach, but 67902 is for a sling made from the patient’s own fascia; 67901 uses suture or other nonautologous material.
- 67903Ptosis repairInternal approach
- 67903 repairs ptosis by external levator resection or advancement. Choose 67901 when the operative technique suspends the eyelid from the frontalis muscle.
- 67904Ptosis repairExternal levator approach
- 67904 is an internal levator resection or advancement, rather than a frontalis suspension.
- 67900Brow repairBrow ptosis
- 67900 addresses a brow defect. Code 67901 corrects upper eyelid ptosis with a frontalis suspension.
67901 billing questions
When is 67901 selected instead of 67902?
Use 67901 for a frontalis suspension using suture or other nonautologous material. Code 67902 describes the frontalis technique using the patient’s own fascia.
How does this differ from levator repair?
This code represents a sling connecting the eyelid to the frontalis muscle. Codes 67903 and 67904 describe levator resection or advancement by external and internal approaches, respectively.
What should the operative note identify?
Document the ptosis treated, eyelid laterality, frontalis suspension technique, and material used. The note should make clear that the repair is not an autologous fascia sling or a levator procedure.
How is bilateral surgery reported?
Report bilateral surgery with modifier 50; CMS pays the procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. Services unrelated to the operation should be distinguished from care related to the repair.
Can an assistant or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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
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