CPT code 67904: Ptosis repair, external levator approach2026 Medicare rate & RVUs in Iowa
Reports surgical correction of upper-eyelid ptosis through an external approach that resects or advances the levator mechanism to improve eyelid position.
In Iowa, Medicare pays $692.34 for 67904 in the office and $475.66 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 67904 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 67904 covers
This operation corrects upper-eyelid ptosis by reaching the levator mechanism through an external incision, typically in the eyelid crease, then shortening or advancing it to raise the lid. Ophthalmologists, including oculoplastic surgeons, perform it when the levator mechanism can be repaired and the eyelid droop warrants surgical correction. The surgeon assesses lid position and function and adjusts the repair to achieve appropriate eyelid height.
Report 67904 for the external levator approach, not a frontalis sling or an internal approach. The record should support the ptosis diagnosis, affected side, clinical findings and functional impact, and the operative method. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons require 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 Iowa compares for 67904
Across 109 of 109 payment localities, the office rate for 67904 runs from $668.94 in Arkansas to $968.23 in San Benito County, CA. Iowa pays $692.34. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$692.34
- Los Angeles, CA · California$833.03+$140.69
- Washington, DC area · District of Columbia$843.83+$151.49
- Miami, FL · Florida$797.04+$104.70
- Chicago, IL · Illinois$777.09+$84.75
- Manhattan, NY · New York$849.28+$156.94
- Alaska · Alaska$894.99+$202.65
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $677.47 | $470.26 |
| ArkansasArkansas | $668.94 | $465.52 |
| ArizonaArizona | $727.34 | $497.87 |
| Bakersfield, CACalifornia | $785.79 | $526.24 |
| Chico, CACalifornia | $783.68 | $524.14 |
| El Centro, CACalifornia | $783.79 | $524.25 |
| Fresno, CACalifornia | $783.68 | $524.14 |
| Hanford, CACalifornia | $783.68 | $524.14 |
| Madera, CACalifornia | $783.68 | $524.14 |
| Merced, CACalifornia | $783.68 | $524.14 |
| Modesto, CACalifornia | $783.68 | $524.14 |
| Napa, CACalifornia | $897.93 | $585.82 |
| Oxnard, CACalifornia | $828.30 | $548.39 |
| Redding, CACalifornia | $783.68 | $524.14 |
| Rest of CaliforniaCalifornia | $783.68 | $524.14 |
| Riverside, CACalifornia | $790.83 | $531.28 |
| Sacramento, CACalifornia | $819.68 | $544.26 |
| Salinas, CACalifornia | $816.52 | $542.06 |
| San Diego, CACalifornia | $833.55 | $550.32 |
| Marin County, CACalifornia | $947.83 | $613.92 |
| San Francisco, CACalifornia | $947.09 | $613.18 |
| San Benito County, CACalifornia | $968.23 | $626.74 |
| Santa Clara County, CACalifornia | $965.21 | $623.73 |
| San Luis Obispo, CACalifornia | $803.62 | $533.89 |
| Santa Cruz, CACalifornia | $839.89 | $552.16 |
| Santa Maria, CACalifornia | $818.99 | $542.87 |
| Santa Rosa, CACalifornia | $848.25 | $557.45 |
| Stockton, CACalifornia | $783.68 | $524.14 |
| Vallejo, CACalifornia | $896.87 | $584.75 |
| Visalia, CACalifornia | $783.68 | $524.14 |
| Yuba City, CACalifornia | $783.68 | $524.14 |
| ColoradoColorado | $772.87 | $520.90 |
| ConnecticutConnecticut | $790.29 | $535.24 |
| DelawareDelaware | $738.38 | $504.41 |
| Fort Lauderdale, FLFlorida | $768.41 | $528.52 |
| Rest of FloridaFlorida | $735.36 | $508.97 |
| Atlanta, GAGeorgia | $757.40 | $516.80 |
| Rest of GeorgiaGeorgia | $698.94 | $487.70 |
| Hawaii, Guam, HIHawaii | $799.21 | $529.96 |
| IdahoIdaho | $696.31 | $478.44 |
| East St. Louis, ILIllinois | $729.77 | $511.90 |
| Rest of IllinoisIllinois | $716.73 | $500.52 |
| Suburban Chicago, ILIllinois | $775.93 | $532.73 |
| IndianaIndiana | $699.84 | $480.31 |
| KansasKansas | $689.57 | $475.49 |
| KentuckyKentucky | $691.53 | $481.01 |
| New Orleans, LALouisiana | $720.44 | $497.60 |
| Rest of LouisianaLouisiana | $690.61 | $481.03 |
| Metropolitan Boston, MAMassachusetts | $843.03 | $560.28 |
| Rest of MassachusettsMassachusetts | $769.16 | $519.79 |
| Baltimore area, MDMaryland | $787.98 | $533.88 |
| Rest of MarylandMaryland | $751.22 | $511.56 |
| Rest of MaineMaine | $699.55 | $481.68 |
| Southern Maine, MEMaine | $732.66 | $497.98 |
| Detroit, MIMichigan | $743.51 | $514.98 |
| Rest of MichiganMichigan | $707.31 | $491.10 |
| MinnesotaMinnesota | $743.00 | $499.32 |
| Metropolitan Kansas City, MOMissouri | $716.06 | $493.69 |
| Metropolitan St. Louis, MOMissouri | $722.63 | $497.19 |
| Rest of MissouriMissouri | $680.30 | $476.17 |
| MississippiMississippi | $674.73 | $470.84 |
| MontanaMontana | $744.80 | $507.98 |
| North CarolinaNorth Carolina | $705.94 | $485.00 |
| North DakotaNorth Dakota | $731.94 | $495.13 |
| NebraskaNebraska | $695.64 | $477.06 |
| New HampshireNew Hampshire | $761.13 | $514.61 |
| Northern New JerseyNew Jersey | $836.84 | $562.14 |
| Rest of New JerseyNew Jersey | $799.98 | $541.38 |
| New MexicoNew Mexico | $710.72 | $493.57 |
| NevadaNevada | $741.68 | $504.63 |
| NYC suburbs and Long Island, NYNew York | $867.68 | $586.11 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $805.12 | $545.81 |
| Queens, NYNew York | $855.42 | $575.51 |
| Rest of New YorkNew York | $715.21 | $490.24 |
| OhioOhio | $704.68 | $488.47 |
| OklahomaOklahoma | $690.39 | $478.92 |
| Portland, OROregon | $794.89 | $531.80 |
| Rest of OregonOregon | $736.54 | $500.67 |
| Metropolitan Philadelphia, PAPennsylvania | $772.71 | $526.19 |
| Rest of PennsylvaniaPennsylvania | $705.63 | $488.24 |
| Puerto RicoPuerto Rico | $749.61 | $510.20 |
| Rhode IslandRhode Island | $762.73 | $518.10 |
| South CarolinaSouth Carolina | $706.35 | $487.53 |
| South DakotaSouth Dakota | $730.42 | $493.61 |
| TennesseeTennessee | $692.60 | $477.34 |
| Austin, TXTexas | $769.77 | $519.23 |
| Beaumont, TXTexas | $701.57 | $486.07 |
| Brazoria, TXTexas | $737.97 | $503.29 |
| Dallas, TXTexas | $742.24 | $506.37 |
| Fort Worth, TXTexas | $737.88 | $504.39 |
| Galveston, TXTexas | $739.94 | $504.78 |
| Houston, TXTexas | $751.83 | $516.68 |
| Rest of TexasTexas | $719.09 | $494.36 |
| UtahUtah | $714.81 | $492.21 |
| VirginiaVirginia | $730.58 | $497.79 |
| Virgin Islands, VIUnited States Virgin Islands | $749.61 | $510.20 |
| VermontVermont | $729.48 | $495.03 |
| Rest of WashingtonWashington | $767.60 | $518.23 |
| King County, WAWashington | $859.08 | $568.51 |
| WisconsinWisconsin | $710.34 | $483.48 |
| West VirginiaWest Virginia | $693.47 | $487.68 |
| WyomingWyoming | $739.20 | $502.38 |
67904 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.
$668.94
$894.99
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $894.99 | 1 |
| AL | $677.47 | 1 |
| AR | $668.94 | 1 |
| AZ | $727.34 | 1 |
| CA | $783.68–$968.23 | 29 |
| CO | $772.87 | 1 |
| CT | $790.29 | 1 |
| DC | $843.83 | 1 |
| DE | $738.38 | 1 |
| FL | $735.36–$797.04 | 3 |
| GA | $698.94–$757.40 | 2 |
| GU | $799.21 | 1 |
| HI | $799.21 | 1 |
| IA | $692.34 | 1 |
| ID | $696.31 | 1 |
| IL | $716.73–$777.09 | 4 |
| IN | $699.84 | 1 |
| KS | $689.57 | 1 |
| KY | $691.53 | 1 |
| LA | $690.61–$720.44 | 2 |
| MA | $769.16–$843.03 | 2 |
| MD | $751.22–$843.83 | 3 |
| ME | $699.55–$732.66 | 2 |
| MI | $707.31–$743.51 | 2 |
| MN | $743.00 | 1 |
| MO | $680.30–$722.63 | 3 |
| MS | $674.73 | 1 |
| MT | $744.80 | 1 |
| NC | $705.94 | 1 |
| ND | $731.94 | 1 |
| NE | $695.64 | 1 |
| NH | $761.13 | 1 |
| NJ | $799.98–$836.84 | 2 |
| NM | $710.72 | 1 |
| NV | $741.68 | 1 |
| NY | $715.21–$867.68 | 5 |
| OH | $704.68 | 1 |
| OK | $690.39 | 1 |
| OR | $736.54–$794.89 | 2 |
| PA | $705.63–$772.71 | 2 |
| PR | $749.61 | 1 |
| RI | $762.73 | 1 |
| SC | $706.35 | 1 |
| SD | $730.42 | 1 |
| TN | $692.60 | 1 |
| TX | $701.57–$769.77 | 8 |
| UT | $714.81 | 1 |
| VA | $730.58–$843.83 | 2 |
| VI | $749.61 | 1 |
| VT | $729.48 | 1 |
| WA | $767.60–$859.08 | 2 |
| WI | $710.34 | 1 |
| WV | $693.47 | 1 |
| WY | $739.20 | 1 |
How the 67904 rate is calculated
Each of 67904’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 · 67904
RVUs × geographic indexes × conversion factor
Work7.77
7.77 RVUs× 1.000 GPCI
Practice expense13.88
13.88 RVUs× 1.000 GPCI
Malpractice0.65
0.65 RVUs× 1.000 GPCI
Adjusted RVUs
22.3000
Conversion factor
$33.4009
Medicare rate
$744.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,508
- Code
- 67904
- Physician work
- 7.77
- Practice expense
- 13.88
- Malpractice
- 0.65
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.77 | × 1.000 | 7.7700 |
| Practice expense | 13.88 | × 0.915 | 12.7002 |
| Malpractice | 0.65 | × 0.397 | 0.2581 |
| Total RVUs | 20.7282 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$692.34
Office: (7.77 × 1 + 13.88 × 0.915 + 0.65 × 0.397) × $33.4009 = $692.34
Facility: (7.77 × 1 + 6.79 × 0.915 + 0.65 × 0.397) × $33.4009 = $475.66
Payment rules and modifiers for 67904
67904 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67904
Ptosis repair, external levator approach
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 67904
Ptosis repair, external levator 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67904 without 50 · national office
$744.84
Ptosis repair, external levator approach
67904-50 · Bilateral: 150%
$1,117.26
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).
How 67904 has changed in Iowa
67904 · Office / nonfacility
$692.34
Effective 2026-10-01
The base rate is $32.00 higher than on 2025-10-01, moving from $660.34 to $692.34 (4.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$660.34changed to$692.34
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 7.97 changed to 7.77
- Practice expense RVU 13.30 changed to 13.88
- Malpractice RVU 0.66 changed to 0.65
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$685.02changed to$660.34
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 13.47 changed to 13.30
- Malpractice RVU 0.68 changed to 0.66
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$673.84changed to$685.02
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$692.24changed to$673.84
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 13.37 changed to 13.47
- Malpractice RVU 0.66 changed to 0.68
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$698.27changed to$692.24
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 13.15 changed to 13.37
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$705.34changed to$698.27
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 13.20 changed to 13.15
- Malpractice RVU 0.64 changed to 0.66
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$700.55changed to$705.34
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 12.32 changed to 13.20
- Malpractice RVU 0.63 changed to 0.64
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$700.20changed to$700.55
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 12.34 changed to 12.32
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$697.80changed to$700.20
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 12.29 changed to 12.34
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$688.41changed to$697.80
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 12.11 changed to 12.29
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$684.02changed to$688.41
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 12.08 changed to 12.11
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$686.16changed to$684.02
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 12.07 changed to 12.08
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$682.75changed to$686.16
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$695.23changed to$682.75
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 12.05 changed to 12.07
- Malpractice RVU 1.45 changed to 0.63
- Practice expense GPCI 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
January 1, 2014
RVU14A
$693.40changed to$695.23
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 13.21 changed to 12.05
- Malpractice RVU 1.52 changed to 1.45
- Practice expense GPCI 0.887 changed to 0.892
- Malpractice GPCI 0.456 changed to 0.475
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $693.40
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $692.34 | $475.66 | RVU26D |
| 2026-07-01 | $692.34 | $475.66 | RVU26C |
| 2026-04-01 | $692.34 | $475.66 | RVU26B |
| 2026-01-01 | $692.34 | $475.66 | RVU26A |
| 2025-10-01 | $660.34 | $535.42 | RVU25D |
| 2025-07-01 | $660.34 | $535.42 | RVU25C |
| 2025-04-01 | $660.34 | $535.42 | RVU25B |
| 2025-01-01 | $660.34 | $535.42 | RVU25A |
| 2024-10-01 | $685.02 | $550.38 | RVU24D |
| 2024-07-01 | $685.02 | $550.38 | RVU24C |
| 2024-04-01 | $685.02 | $550.38 | RVU24B |
| 2024-03-09 | $685.02 | $550.38 | RVU24AR |
| 2024-01-01 | $673.84 | $541.40 | RVU24A |
| 2023-10-01 | $692.24 | $553.47 | RVU23D |
| 2023-07-01 | $692.24 | $553.47 | RVU23C |
| 2023-04-01 | $692.24 | $553.47 | RVU23B |
| 2023-01-01 | $692.24 | $553.47 | RVU23A |
| 2022-10-01 | $698.27 | $555.14 | RVU22D |
| 2022-07-01 | $698.27 | $555.14 | RVU22C |
| 2022-04-01 | $698.27 | $555.14 | RVU22B |
| 2022-01-01 | $698.27 | $555.14 | RVU22A |
| 2021-10-01 | $705.34 | $558.81 | RVU21D |
| 2021-07-01 | $705.34 | $558.81 | RVU21C |
| 2021-04-01 | $705.34 | $558.81 | RVU21B |
| 2021-01-01 | $705.34 | $558.81 | RVU21A |
| 2020-10-01 | $700.55 | $568.31 | RVU20D |
| 2020-07-01 | $700.55 | $568.31 | RVU20C |
| 2020-04-01 | $700.55 | $568.31 | RVU20B |
| 2020-01-01 | $700.55 | $568.31 | RVU20A |
| 2019-10-01 | $700.20 | $571.08 | RVU19D |
| 2019-07-01 | $700.20 | $571.08 | RVU19C |
| 2019-04-01 | $700.20 | $571.08 | RVU19B |
| 2019-01-01 | $700.20 | $571.08 | RVU19A |
| 2018-10-01 | $697.80 | $572.42 | RVU18D |
| 2018-07-01 | $697.80 | $572.42 | RVU18C |
| 2018-04-01 | $697.80 | $572.42 | RVU18B |
| 2018-01-01 | $697.80 | $572.42 | RVU18AR1 |
| 2017-10-01 | $688.41 | $567.01 | RVU17D |
| 2017-07-01 | $688.41 | $567.01 | RVU17C |
| 2017-04-01 | $688.41 | $567.01 | RVU17B |
| 2017-01-01 | $688.41 | $567.01 | RVU17A |
| 2016-10-01 | $684.02 | $563.71 | RVU16D |
| 2016-07-01 | $684.02 | $563.71 | RVU16C |
| 2016-04-01 | $684.02 | $563.71 | RVU16B |
| 2016-01-01 | $684.02 | $563.71 | RVU16A |
| 2015-10-01 | $686.16 | $565.10 | RVU15D |
| 2015-07-01 | $686.16 | $565.10 | RVU15C |
| 2015-04-01 | $682.75 | $562.29 | RVU15B |
| 2015-01-01 | $682.75 | $562.29 | RVU15A |
| 2014-10-01 | $695.23 | $577.00 | RVU14D |
| 2014-07-01 | $695.23 | $577.00 | RVU14C |
| 2014-04-01 | $695.23 | $577.00 | RVU14B |
| 2014-01-01 | $695.23 | $577.00 | RVU14A |
| 2013-10-01 | $693.40 | $568.16 | RVU13D |
| 2013-07-01 | $693.40 | $568.16 | RVU13C |
| 2013-04-01 | $693.40 | $568.16 | RVU13B |
| 2013-01-01 | $693.40 | $568.16 | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
67904 billing questions
When should 67904 be selected instead of a frontalis sling code?
Use 67904 when the surgeon corrects ptosis by externally resecting or advancing the levator mechanism. Frontalis suspension codes describe a different operative technique.
How does 67904 differ from an internal ptosis repair?
67904 uses an external approach to the levator mechanism. Select an internal-approach code when the operative report documents correction through the inside of the eyelid.
Does the 90-day global period include routine postoperative visits?
Yes. Related postoperative care for 90 days and the preoperative visit on the day before surgery are included in the global period.
How is bilateral 67904 paid?
CMS pays bilateral surgery reported with modifier 50 at 150%.
Can an assistant or co-surgeon be reported for 67904?
Assistant-at-surgery payment is restricted. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
What happens when 67904 is performed with another procedure in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other 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
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