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CPT code 67906: Ptosis repair, superior rectus sling2026 Medicare rate & RVUs

Surgical correction of upper eyelid ptosis using a superior rectus-based fascial sling, reported when the operative technique matches this specific repair.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $427.53 for 67906 nationally in a facility.

Medicare rate · 67906

Ptosis repair, superior rectus sling

Office or facility?

Work RVUs
6.76
Total RVUs
12.80
Global days
090

National rate · 2026

$427.53

Facility setting, before claim adjustments.

See every locality for 67906 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 67906 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 67906 covers

CPT 67906 reports surgical correction of blepharoptosis using a superior rectus-based technique with a fascial sling to elevate the upper eyelid. An ophthalmologist, commonly an oculoplastic surgeon, performs this operation when the selected repair uses this specific muscle-and-sling approach. The code is selected by the technique documented, not simply because ptosis is severe or congenital.

The operative report should identify the affected eyelid, describe the superior rectus and sling technique, and support the medical need for repair. This major surgery has 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 are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. 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.

Where 67906 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

67906 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$396.84
AlaskaUnavailable$544.44
ArizonaUnavailable$419.28
ArkansasUnavailable$393.00
Atlanta, GAUnavailable$434.71
Austin, TXUnavailable$436.64
Bakersfield, CAUnavailable$442.57
Baltimore area, MDUnavailable$448.77
Beaumont, TXUnavailable$409.71
Brazoria, TXUnavailable$423.79

67906 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
67906 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 67906 rate is calculated

Each of 67906’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 · 67906

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.76

6.76 RVUs× 1.000 GPCI

Practice expense5.51

5.51 RVUs× 1.000 GPCI

Malpractice0.53

0.53 RVUs× 1.000 GPCI

Adjusted RVUs

12.8000

Conversion factor

$33.4009

Medicare rate

$427.53

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

Payment rules and modifiers for 67906

67906 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67906

Ptosis repair, superior rectus sling

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)0Not permitted.
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 · 67906

Ptosis repair, superior rectus sling

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

67906 without 50 · national facility

$427.53

Ptosis repair, superior rectus sling

67906-50 · Bilateral: 150%

$641.30

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

67906 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 67906

    Ptosis repair, superior rectus sling6.76 wRVU

    Not priced

  • 67901

    Ptosis repair, frontalis sling, nonautologous material7.4 wRVU

    $793.61

  • 67902

    Ptosis repair, frontalis sling with fascia9.57 wRVU

    Not priced

  • 67903

    Ptosis repair, internal approach6.35 wRVU

    $606.23

  • 67904

    Ptosis repair, external levator approach7.77 wRVU

    $744.84

How to choose

67901Ptosis repairFrontalis sling, nonautologous material
Use 67901 for a frontalis muscle technique with suture or other material. Use 67906 when the operative method is a superior rectus-based fascial sling.
67902Ptosis repairFrontalis sling with fascia
67902 describes frontalis suspension using an autologous fascial sling; 67906 identifies the superior rectus-based sling approach.
67903Ptosis repairInternal approach
67903 is an internal ptosis repair approach. 67906 is selected for the superior rectus-based fascial sling technique.
67904Ptosis repairExternal levator approach
67904 is an external levator-based ptosis repair. 67906 applies when the surgeon uses the superior rectus and a fascial sling.

Codes related to 67906

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

Codes related to 67906
CodeHow it relatesNational office range
Same family
67901Ptosis repair, frontalis sling, nonautologous materialPtosis repair using a frontalis technique with suture or other material.$709.43–$1,043.56
67902Ptosis repair, frontalis sling with fasciaPtosis repair using a frontalis technique with an autologous fascial sling.No office rate
67903Ptosis repair, internal approachPtosis repair using an internal approach rather than the superior rectus sling technique.$544.91–$788.63
67904Ptosis repair, external levator approachPtosis repair using an external levator-based approach.$668.94–$968.23
Used instead
67900Brow repair, brow ptosisRepairs brow ptosis rather than blepharoptosis of the upper eyelid.$589.36–$856.45

67906 billing questions

How is 67906 distinguished from other ptosis repairs?

Choose 67906 when the operative report documents the superior rectus-based fascial sling technique. Frontalis suspension or levator-based repairs belong to different codes.

What documentation supports reporting 67906?

Document the ptosis, the eyelid treated, the medical reason for repair, and the superior rectus-and-sling technique performed.

Does the 90-day global period include postoperative visits?

Yes. The day-before preoperative visit and 90 days of related postoperative care are included.

How is bilateral 67906 handled?

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

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 other procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is restricted 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
RVUs for 67906PPRRVU2026_Oct_nonQPP.csv, line 7,509 (RVU26D)

Open CMS sourceHow we calculate rates

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