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CPT code 67916: Ectropion repair, tarsal wedge excision2026 Medicare rate & RVUs in Los Angeles, CA

Reports surgical correction of ectropion by removing a tarsal wedge to shorten and reposition an outward-turning eyelid, typically the lower lid.

CMS RVU26DEffective Oct 1, 2026One payment locality1.4K Medicare services in 2024

In Los Angeles, CA, Medicare pays $690.36 for 67916 in the office and $406.65 when it’s performed in a hospital or facility.

$690.36Office (non-facility)
$406.65Hospital or facility
+12.9%vs the national office rate ($611.57)

Check a contract rate as a % of Medicare · 67916 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 67916 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Los Angeles, CA
  2. What 67916 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 67916 covers

An ophthalmic or oculoplastic surgeon uses this procedure to correct ectropion, in which the eyelid turns outward and may expose the ocular surface. The surgeon removes a wedge of tarsal tissue to shorten the lid and improve its position against the eye. It is commonly used for lower-lid laxity, including involutional ectropion, and may be performed in an operating room or an appropriately equipped office procedure setting.

Choose this code when the operative technique includes tarsal wedge excision, rather than a suture-only or thermocautery repair or a more extensive repair. The operative note should identify the affected eyelid, the ectropion being corrected, and the wedge excision and repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery reported with modifier 50, CMS pays 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. 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 Los Angeles, CA compares for 67916

Across 109 of 109 payment localities, the office rate for 67916 runs from $545.32 in Arkansas to $809.05 in San Benito County, CA. Los Angeles, CA pays $690.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

67916 in Los Angeles, CA vs other payment areas
  1. Los Angeles, CA · this page$690.36
  2. Bakersfield, CA · California$649.23−$41.13
  3. Chico, CA · California$647.77−$42.59
  4. El Centro, CA · California$647.85−$42.51
  5. Fresno, CA · California$647.77−$42.59
  6. Hanford, CA · California$647.77−$42.59
  7. Madera, CA · California$647.77−$42.59

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

Every other payment area

67916 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$647.77$384.93
Modesto, CACalifornia$647.77$384.93
Napa, CACalifornia$748.39$432.31
Oxnard, CACalifornia$687.01$403.54
Redding, CACalifornia$647.77$384.93
Rest of CaliforniaCalifornia$647.77$384.93
Riverside, CACalifornia$652.72$389.88
Sacramento, CACalifornia$679.18$400.27

67916 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.

$545.32

$728.41

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

View every state and territory as a table
67916 office rate range by state
State / territoryOffice rate rangeLocalities
AK$721.181
AL$552.771
AR$545.321
AZ$596.441
CA$647.77–$809.0529
CO$637.181
CT$650.491
DC$697.341
DE$605.931
FL$600.73–$651.703
GA$569.29–$621.822
GU$662.531
HI$662.531
IA$566.961
ID$570.201
IL$583.65–$635.714
IN$573.321
KS$563.971
KY$563.871
LA$562.85–$588.942
MA$633.54–$698.362
MD$617.14–$697.343
ME$572.43–$602.262
MI$577.13–$607.252
MN$613.121
MO$553.47–$591.533
MS$549.521
MT$611.541
NC$578.131
ND$602.641
NE$570.021
NH$626.841
NJ$658.64–$690.742
NM$579.881
NV$609.481
NY$586.20–$714.905
OH$575.311
OK$563.471
OR$605.43–$656.992
PA$576.45–$634.832
PR$615.941
RI$627.141
SC$577.531
SD$601.591
TN$566.561
TX$572.87–$634.478
UT$584.951
VA$600.04–$697.342
VI$615.941
VT$599.961
WA$632.46–$712.662
WI$583.611
WV$563.271
WY$607.661

See 67916 in every payment locality

How the 67916 rate is calculated

Each of 67916’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 · 67916

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.34

5.34 RVUs× 1.000 GPCI

Practice expense12.52

12.52 RVUs× 1.000 GPCI

Malpractice0.45

0.45 RVUs× 1.000 GPCI

Adjusted RVUs

18.3100

Conversion factor

$33.4009

Medicare rate

$611.57

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

The exact Los Angeles, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,516

Code
67916
Physician work
5.34
Practice expense
12.52
Malpractice
0.45

GPCI2026.csv

13

Locality
Los Angeles, CA
Physician work
1.041
Practice expense
1.183
Malpractice
0.664
Office calculation for 67916 in Los Angeles, CA
ComponentRVULocality factorAdjusted
Physician work5.34× 1.0415.5589
Practice expense12.52× 1.18314.8112
Malpractice0.45× 0.6640.2988
Total RVUs20.6689
Conversion factor× 33.4009

Office rate, Los Angeles, CA$690.36

Office: (5.34 × 1.041 + 12.52 × 1.183 + 0.45 × 0.664) × $33.4009 = $690.36

Facility: (5.34 × 1.041 + 5.34 × 1.183 + 0.45 × 0.664) × $33.4009 = $406.65

Open 67916 in the RVU calculator

Payment rules and modifiers for 67916

67916 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67916

Ectropion repair, tarsal wedge excision

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 · 67916

Ectropion repair, tarsal wedge excision

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

67916 without 50 · national office

$611.57

Ectropion repair, tarsal wedge excision

67916-50 · Bilateral: 150%

$917.36

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 67916

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

Codes related to 67916
CodeHow it relatesOffice range, Los Angeles, CA
Same family
67914Ectropion repair, suture techniqueEctropion repair by suture technique rather than tarsal wedge excision.$556.41
67915Ectropion repair, thermocautery techniqueEctropion repair by thermocautery rather than tarsal wedge excision.$361.24
67917Eyelid repair, extensive entropion correctionExtensive ectropion repair, including methods such as a tarsal strip operation.$704.35

How 67916 has changed in Los Angeles, CA

67916 · Office / nonfacility

$690.36

Effective 2026-10-01

The base rate is $30.32 higher than on 2025-10-01, moving from $660.04 to $690.36 (4.6%).

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

    $660.04changed to$690.36

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.48 changed to 5.34
    • Practice expense RVU 12.03 changed to 12.52
    • Malpractice RVU 0.48 changed to 0.45
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.194 changed to 1.183
    • Malpractice GPCI 0.690 changed to 0.664

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $688.88changed to$660.04

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 12.29 changed to 12.03
    • Malpractice RVU 0.45 changed to 0.48

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $677.64changed to$688.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $697.57changed to$677.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 12.27 changed to 12.29
    • Malpractice RVU 0.44 changed to 0.45
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.185 changed to 1.194
    • Malpractice GPCI 0.724 changed to 0.690

  5. January 1, 2023

    RVU23A

    $705.54changed to$697.57

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 12.18 changed to 12.27
    • Work GPCI 1.048 changed to 1.045
    • Practice expense GPCI 1.175 changed to 1.185
    • Malpractice GPCI 0.757 changed to 0.724

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $714.11changed to$705.54

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 12.24 changed to 12.18
    • Malpractice RVU 0.45 changed to 0.44

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $695.62changed to$714.11

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 11.24 changed to 12.24
    • Malpractice RVU 0.44 changed to 0.45
    • Work GPCI 1.047 changed to 1.048
    • Practice expense GPCI 1.176 changed to 1.175
    • Malpractice GPCI 0.725 changed to 0.757

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $689.87changed to$695.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.14 changed to 11.24
    • Malpractice RVU 0.43 changed to 0.44
    • Work GPCI 1.046 changed to 1.047
    • Practice expense GPCI 1.177 changed to 1.176
    • Malpractice GPCI 0.694 changed to 0.725

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $681.74changed to$689.87

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.96 changed to 11.14
    • Malpractice RVU 0.44 changed to 0.43

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $672.08changed to$681.74

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.81 changed to 10.96
    • Work GPCI 1.047 changed to 1.046
    • Practice expense GPCI 1.169 changed to 1.177
    • Malpractice GPCI 0.801 changed to 0.694

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $668.26changed to$672.08

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.79 changed to 10.81
    • Practice expense GPCI 1.161 changed to 1.169
    • Malpractice GPCI 0.908 changed to 0.801

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $670.26changed to$668.26

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 10.78 changed to 10.79

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $666.92changed to$670.26

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $675.34changed to$666.92

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.74 changed to 10.78
    • Malpractice RVU 0.91 changed to 0.44
    • Work GPCI 1.042 changed to 1.047
    • Practice expense GPCI 1.158 changed to 1.161
    • Malpractice GPCI 0.775 changed to 0.908

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $613.21changed to$675.34

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.17 changed to 10.74
    • Malpractice RVU 0.95 changed to 0.91
    • Work GPCI 1.036 changed to 1.042
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.642 changed to 0.775

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$613.21

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$690.36$406.65RVU26D
2026-07-01$690.36$406.65RVU26C
2026-04-01$690.36$406.65RVU26B
2026-01-01$690.36$406.65RVU26A
2025-10-01$660.04$461.13RVU25D
2025-07-01$660.04$461.13RVU25C
2025-04-01$660.04$461.13RVU25B
2025-01-01$660.04$461.13RVU25A
2024-10-01$688.88$472.67RVU24D
2024-07-01$688.88$472.67RVU24C
2024-04-01$688.88$472.67RVU24B
2024-03-09$688.88$472.67RVU24AR
2024-01-01$677.64$464.95RVU24A
2023-10-01$697.57$474.30RVU23D
2023-07-01$697.57$474.30RVU23C
2023-04-01$697.57$474.30RVU23B
2023-01-01$697.57$474.30RVU23A
2022-10-01$705.54$474.58RVU22D
2022-07-01$705.54$474.58RVU22C
2022-04-01$705.54$474.58RVU22B
2022-01-01$705.54$474.58RVU22A
2021-10-01$714.11$477.13RVU21D
2021-07-01$714.11$477.13RVU21C
2021-04-01$714.11$477.13RVU21B
2021-01-01$714.11$477.13RVU21A
2020-10-01$695.62$482.99RVU20D
2020-07-01$695.62$482.99RVU20C
2020-04-01$695.62$482.99RVU20B
2020-01-01$695.62$482.99RVU20A
2019-10-01$689.87$485.84RVU19D
2019-07-01$689.87$485.84RVU19C
2019-04-01$689.87$485.84RVU19B
2019-01-01$689.87$485.84RVU19A
2018-10-01$681.74$487.68RVU18D
2018-07-01$681.74$487.68RVU18C
2018-04-01$681.74$487.68RVU18B
2018-01-01$681.74$487.68RVU18AR1
2017-10-01$672.08$483.71RVU17D
2017-07-01$672.08$483.71RVU17C
2017-04-01$672.08$483.71RVU17B
2017-01-01$672.08$483.71RVU17A
2016-10-01$668.26$481.62RVU16D
2016-07-01$668.26$481.62RVU16C
2016-04-01$668.26$481.62RVU16B
2016-01-01$668.26$481.62RVU16A
2015-10-01$670.26$482.52RVU15D
2015-07-01$670.26$482.52RVU15C
2015-04-01$666.92$480.12RVU15B
2015-01-01$666.92$480.12RVU15A
2014-10-01$675.34$491.16RVU14D
2014-07-01$675.34$491.16RVU14C
2014-04-01$675.34$491.16RVU14B
2014-01-01$675.34$491.16RVU14A
2013-10-01$613.21$484.82RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 67916 for an earlier date of service

Where the Los Angeles, CA rate applies

Los Angeles, CA is a Medicare payment area, not a city. Our Census mapping connects it to 189 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Anaheim
  • Long Beach
  • Los Angeles
  • Orange
  • Acton
  • Agoura Hills
  • Agua Dulce
  • Alhambra

Browse all communities in California

67916 billing questions

When should 67916 be chosen over 67914 or 67915?

Use 67916 when the documented ectropion repair includes excision of a tarsal wedge. Suture-only repair and thermocautery repair are represented by 67914 and 67915, respectively.

How does 67916 differ from 67917?

67916 represents ectropion correction by tarsal wedge excision. Choose 67917 when the operative method is an extensive ectropion repair, such as a tarsal strip operation.

Can 67916 be reported for both eyelids?

For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%. Document the side treated and the work performed on each eyelid.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The procedure's routine closure and care are part of the repair.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others, which are paid at 50% when performed in the same session.

Can an assistant or co-surgeon be reported for 67916?

CMS has a statutory restriction on assistant-at-surgery payment 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 67916PPRRVU2026_Oct_nonQPP.csv, line 7,516 (RVU26D)
Geographic factors for Los Angeles, CAGPCI2026.csv, line 13 (RVU26D)

Open CMS sourceHow we calculate rates

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