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CPT code 67903: Ptosis repair, internal approach2026 Medicare rate & RVUs in Virginia

Corrects upper eyelid ptosis through an internal approach by adjusting the levator mechanism when that technique is performed.

CMS RVU26DEffective Oct 1, 2026One payment locality9.7K Medicare services in 2024

In Virginia, Medicare pays $594.90 for 67903 in the office and $400.53 when it’s performed in a hospital or facility.

$594.90Office (non-facility)
$400.53Hospital or facility
−1.9%vs the national office rate ($606.23)

Check a contract rate as a % of Medicare · 67903 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 67903 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 67903 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 67903 covers

This operation elevates a drooping upper eyelid by shortening or advancing the levator mechanism through an incision on the inner eyelid surface. Ophthalmologists and oculoplastic surgeons use it for upper eyelid ptosis, including cases in which the lid obstructs the patient’s superior visual field. The operative approach distinguishes this service from ptosis repairs performed through an external skin incision or by frontalis suspension.

Report 67903 when the surgeon performs the internal levator approach; the operative note should identify the approach and the tissue adjusted. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. With modifier 50, bilateral performance is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with supporting documentation, and team surgery is 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 Virginia compares for 67903

Across 109 of 109 payment localities, the office rate for 67903 runs from $544.91 in Arkansas to $788.63 in San Benito County, CA. Virginia pays $594.90. The RVUs are the same everywhere; the geographic indexes change the dollars.

67903 in Virginia vs other payment areas
  1. Virginia · this page$594.90
  2. Los Angeles, CA · California$678.38+$83.48
  3. Washington, DC area · District of Columbia$686.75+$91.85
  4. Miami, FL · Florida$647.24+$52.34
  5. Chicago, IL · Illinois$631.23+$36.33
  6. Manhattan, NY · New York$690.73+$95.83
  7. Alaska · Alaska$729.31+$134.41

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

Every other payment area

67903 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$551.80$378.78
ArkansasArkansas$544.91$375.06
ArizonaArizona$592.12$400.52
Bakersfield, CACalifornia$639.96$423.24
Chico, CACalifornia$638.32$421.60
El Centro, CACalifornia$638.40$421.68
Fresno, CACalifornia$638.32$421.60
Hanford, CACalifornia$638.32$421.60

67903 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.

$544.91

$729.31

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

View every state and territory as a table
67903 office rate range by state
State / territoryOffice rate rangeLocalities
AK$729.311
AL$551.801
AR$544.911
AZ$592.121
CA$638.32–$788.6329
CO$629.271
CT$643.041
DC$686.751
DE$601.071
FL$598.02–$647.243
GA$568.67–$616.262
GU$650.901
HI$650.901
IA$564.071
ID$567.231
IL$582.79–$631.234
IN$570.091
KS$561.711
KY$562.911
LA$562.12–$586.232
MA$626.23–$686.312
MD$611.51–$686.753
ME$569.72–$596.672
MI$575.54–$604.472
MN$605.411
MO$553.71–$588.143
MS$549.401
MT$606.191
NC$574.911
ND$596.311
NE$566.781
NH$619.611
NJ$651.05–$681.112
NM$578.261
NV$603.811
NY$582.39–$705.455
OH$573.521
OK$562.121
OR$599.76–$647.242
PA$574.36–$628.742
PR$610.131
RI$620.911
SC$575.041
SD$595.141
TN$564.151
TX$571.07–$626.648
UT$581.881
VA$594.90–$686.752
VI$610.131
VT$594.201
WA$625.00–$699.452
WI$578.821
WV$563.981
WY$601.881

See 67903 in every payment locality

How the 67903 rate is calculated

Each of 67903’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 · 67903

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.35

6.35 RVUs× 1.000 GPCI

Practice expense11.30

11.30 RVUs× 1.000 GPCI

Malpractice0.50

0.50 RVUs× 1.000 GPCI

Adjusted RVUs

18.1500

Conversion factor

$33.4009

Medicare rate

$606.23

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

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,507

Code
67903
Physician work
6.35
Practice expense
11.30
Malpractice
0.50

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 67903 in Virginia
ComponentRVULocality factorAdjusted
Physician work6.35× 1.0006.3500
Practice expense11.30× 0.98311.1079
Malpractice0.50× 0.7060.3530
Total RVUs17.8109
Conversion factor× 33.4009

Office rate, Virginia$594.90

Office: (6.35 × 1 + 11.3 × 0.983 + 0.5 × 0.706) × $33.4009 = $594.90

Facility: (6.35 × 1 + 5.38 × 0.983 + 0.5 × 0.706) × $33.4009 = $400.53

Open 67903 in the RVU calculator

Payment rules and modifiers for 67903

67903 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67903

Ptosis repair, internal approach

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 67903

Ptosis repair, internal approach

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

67903 without 50 · national office

$606.23

Ptosis repair, internal approach

67903-50 · Bilateral: 150%

$909.35

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 67903

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

Codes related to 67903
CodeHow it relatesOffice range, Virginia
Same family
67904Ptosis repair, external levator approachPtosis repair using an external rather than internal approach.$730.58
67901Ptosis repair, frontalis sling, nonautologous materialPtosis repair using a frontalis technique with suture or other material.$778.58
67902Ptosis repair, frontalis sling with fasciaPtosis repair using a frontalis technique with autologous fascia lata.No office rate
67906Ptosis repair, superior rectus slingPtosis repair using a conjunctival and muscle resection technique.No office rate
67908Ptosis repair, müller muscle-conjunctival resectionPtosis repair associated with excessive eyelid skin.$536.20

How 67903 has changed in Virginia

67903 · Office / nonfacility

$594.90

Effective 2026-10-01

The base rate is $25.54 higher than on 2025-10-01, moving from $569.36 to $594.90 (4.5%).

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

    $569.36changed to$594.90

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.51 changed to 6.35
    • Practice expense RVU 10.86 changed to 11.30
    • Malpractice RVU 0.52 changed to 0.50
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $590.51changed to$569.36

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.00 changed to 10.86

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $580.87changed to$590.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $600.56changed to$580.87

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.90 changed to 11.00
    • Malpractice RVU 0.51 changed to 0.52
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $611.17changed to$600.56

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.72 changed to 10.90
    • Malpractice RVU 0.54 changed to 0.51
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $615.99changed to$611.17

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.74 changed to 10.72
    • Malpractice RVU 0.51 changed to 0.54

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $608.46changed to$615.99

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.97 changed to 10.74
    • Malpractice RVU 0.52 changed to 0.51
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $605.26changed to$608.46

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.50 changed to 0.52
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $602.46changed to$605.26

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.91 changed to 9.97

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $594.51changed to$602.46

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.76 changed to 9.91
    • Malpractice RVU 0.51 changed to 0.50
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $590.88changed to$594.51

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.73 changed to 9.76
    • Malpractice RVU 0.52 changed to 0.51
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $592.01changed to$590.88

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.71 changed to 9.73
    • Malpractice RVU 0.51 changed to 0.52

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $589.06changed to$592.01

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $607.81changed to$589.06

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 1.21 changed to 0.51
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $606.75changed to$607.81

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.64 changed to 9.71
    • Malpractice RVU 1.27 changed to 1.21
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $606.75

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$594.90$400.53RVU26D
2026-07-01$594.90$400.53RVU26C
2026-04-01$594.90$400.53RVU26B
2026-01-01$594.90$400.53RVU26A
2025-10-01$569.36$454.77RVU25D
2025-07-01$569.36$454.77RVU25C
2025-04-01$569.36$454.77RVU25B
2025-01-01$569.36$454.77RVU25A
2024-10-01$590.51$467.02RVU24D
2024-07-01$590.51$467.02RVU24C
2024-04-01$590.51$467.02RVU24B
2024-03-09$590.51$467.02RVU24AR
2024-01-01$580.87$459.40RVU24A
2023-10-01$600.56$472.74RVU23D
2023-07-01$600.56$472.74RVU23C
2023-04-01$600.56$472.74RVU23B
2023-01-01$600.56$472.74RVU23A
2022-10-01$611.17$478.26RVU22D
2022-07-01$611.17$478.26RVU22C
2022-04-01$611.17$478.26RVU22B
2022-01-01$611.17$478.26RVU22A
2021-10-01$615.99$480.94RVU21D
2021-07-01$615.99$480.94RVU21C
2021-04-01$615.99$480.94RVU21B
2021-01-01$615.99$480.94RVU21A
2020-10-01$608.46$489.01RVU20D
2020-07-01$608.46$489.01RVU20C
2020-04-01$608.46$489.01RVU20B
2020-01-01$608.46$489.01RVU20A
2019-10-01$605.26$490.12RVU19D
2019-07-01$605.26$490.12RVU19C
2019-04-01$605.26$490.12RVU19B
2019-01-01$605.26$490.12RVU19A
2018-10-01$602.46$491.36RVU18D
2018-07-01$602.46$491.36RVU18C
2018-04-01$602.46$491.36RVU18B
2018-01-01$602.46$491.36RVU18AR1
2017-10-01$594.51$486.69RVU17D
2017-07-01$594.51$486.69RVU17C
2017-04-01$594.51$486.69RVU17B
2017-01-01$594.51$486.69RVU17A
2016-10-01$590.88$483.53RVU16D
2016-07-01$590.88$483.53RVU16C
2016-04-01$590.88$483.53RVU16B
2016-01-01$590.88$483.53RVU16A
2015-10-01$592.01$483.92RVU15D
2015-07-01$592.01$483.92RVU15C
2015-04-01$589.06$481.52RVU15B
2015-01-01$589.06$481.52RVU15A
2014-10-01$607.81$502.14RVU14D
2014-07-01$607.81$502.14RVU14C
2014-04-01$607.81$502.14RVU14B
2014-01-01$607.81$502.14RVU14A
2013-10-01$606.75$494.73RVU13D
2013-07-01$606.75$494.73RVU13C
2013-04-01$606.75$494.73RVU13B
2013-01-01$606.75$494.73RVU13AR

Price 67903 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

67903 billing questions

How does 67903 differ from 67904?

67903 is for an internal approach to the levator mechanism. 67904 is used when the repair is performed through an external approach.

When is 67903 preferred over a frontalis suspension code?

Use 67903 when the surgeon adjusts the levator mechanism internally. Codes 67901 and 67902 describe frontalis muscle techniques instead.

What documentation supports reporting 67903?

The operative report should establish upper eyelid ptosis and describe the internal approach and the levator tissue adjusted. Documenting the effect of the drooping lid, such as superior visual field obstruction, supports the clinical context.

How is bilateral 67903 reported?

Report bilateral performance with modifier 50. CMS pays the bilateral procedure at 150%.

Are the preoperative visit and postoperative checks separately included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be paid for 67903?

Assistant-at-surgery payment is restricted. Co-surgeons are paid only when supporting documentation is provided; team surgery is 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
RVUs for 67903PPRRVU2026_Oct_nonQPP.csv, line 7,507 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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