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CPT code 67916: Ectropion repair, tarsal wedge excision2026 Medicare rate & RVUs in New Mexico

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 New Mexico, Medicare pays $579.88 for 67916 in the office and $359.97 when it’s performed in a hospital or facility.

$579.88Office (non-facility)
$359.97Hospital or facility
−5.2%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 New Mexico
  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 New Mexico 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. New Mexico pays $579.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

67916 in New Mexico vs other payment areas
  1. New Mexico · this page$579.88
  2. Los Angeles, CA · California$690.36+$110.48
  3. Washington, DC area · District of Columbia$697.34+$117.46
  4. Miami, FL · Florida$651.70+$71.82
  5. Chicago, IL · Illinois$634.37+$54.49
  6. Manhattan, NY · New York$699.54+$119.66
  7. Alaska · Alaska$721.18+$141.30

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

Every other payment area

67916 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$552.77$342.93
ArkansasArkansas$545.32$339.31
ArizonaArizona$596.44$364.06
Bakersfield, CACalifornia$649.23$386.39
Chico, CACalifornia$647.77$384.93
El Centro, CACalifornia$647.85$385.01
Fresno, CACalifornia$647.77$384.93
Hanford, CACalifornia$647.77$384.93

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 New Mexico 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

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 67916 in New Mexico
ComponentRVULocality factorAdjusted
Physician work5.34× 1.0005.3400
Practice expense12.52× 0.91711.4808
Malpractice0.45× 1.2010.5405
Total RVUs17.3613
Conversion factor× 33.4009

Office rate, New Mexico$579.88

Office: (5.34 × 1 + 12.52 × 0.917 + 0.45 × 1.201) × $33.4009 = $579.88

Facility: (5.34 × 1 + 5.34 × 0.917 + 0.45 × 1.201) × $33.4009 = $359.97

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, New Mexico
Same family
67914Ectropion repair, suture techniqueEctropion repair by suture technique rather than tarsal wedge excision.$462.69
67915Ectropion repair, thermocautery techniqueEctropion repair by thermocautery rather than tarsal wedge excision.$296.45
67917Eyelid repair, extensive entropion correctionExtensive ectropion repair, including methods such as a tarsal strip operation.$594.25

How 67916 has changed in New Mexico

67916 · Office / nonfacility

$579.88

Effective 2026-10-01

The base rate is $31.10 higher than on 2025-10-01, moving from $548.78 to $579.88 (5.7%).

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

    $548.78changed to$579.88

    • 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
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $571.44changed to$548.78

    • 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

    $562.11changed to$571.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $578.18changed to$562.11

    • 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
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172

  5. January 1, 2023

    RVU23A

    $585.06changed to$578.18

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 12.18 changed to 12.27
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $592.20changed to$585.06

    • 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

    $585.27changed to$592.20

    • 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
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $586.58changed to$585.27

    • 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
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $580.42changed to$586.58

    • 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

    $572.60changed to$580.42

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.81 changed to 10.96
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $569.53changed to$572.60

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.79 changed to 10.81
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $571.26changed to$569.53

    • 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

    $568.42changed to$571.26

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $584.67changed to$568.42

    • 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
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $535.62changed to$584.67

    • 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
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $535.62

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$579.88$359.97RVU26D
2026-07-01$579.88$359.97RVU26C
2026-04-01$579.88$359.97RVU26B
2026-01-01$579.88$359.97RVU26A
2025-10-01$548.78$397.53RVU25D
2025-07-01$548.78$397.53RVU25C
2025-04-01$548.78$397.53RVU25B
2025-01-01$548.78$397.53RVU25A
2024-10-01$571.44$407.01RVU24D
2024-07-01$571.44$407.01RVU24C
2024-04-01$571.44$407.01RVU24B
2024-03-09$571.44$407.01RVU24AR
2024-01-01$562.11$400.37RVU24A
2023-10-01$578.18$408.23RVU23D
2023-07-01$578.18$408.23RVU23C
2023-04-01$578.18$408.23RVU23B
2023-01-01$578.18$408.23RVU23A
2022-10-01$585.06$408.94RVU22D
2022-07-01$585.06$408.94RVU22C
2022-04-01$585.06$408.94RVU22B
2022-01-01$585.06$408.94RVU22A
2021-10-01$592.20$411.49RVU21D
2021-07-01$592.20$411.49RVU21C
2021-04-01$592.20$411.49RVU21B
2021-01-01$592.20$411.49RVU21A
2020-10-01$585.27$421.09RVU20D
2020-07-01$585.27$421.09RVU20C
2020-04-01$585.27$421.09RVU20B
2020-01-01$585.27$421.09RVU20A
2019-10-01$586.58$426.92RVU19D
2019-07-01$586.58$426.92RVU19C
2019-04-01$586.58$426.92RVU19B
2019-01-01$586.58$426.92RVU19A
2018-10-01$580.42$428.56RVU18D
2018-07-01$580.42$428.56RVU18C
2018-04-01$580.42$428.56RVU18B
2018-01-01$580.42$428.56RVU18AR1
2017-10-01$572.60$424.35RVU17D
2017-07-01$572.60$424.35RVU17C
2017-04-01$572.60$424.35RVU17B
2017-01-01$572.60$424.35RVU17A
2016-10-01$569.53$421.79RVU16D
2016-07-01$569.53$421.79RVU16C
2016-04-01$569.53$421.79RVU16B
2016-01-01$569.53$421.79RVU16A
2015-10-01$571.26$422.66RVU15D
2015-07-01$571.26$422.66RVU15C
2015-04-01$568.42$420.55RVU15B
2015-01-01$568.42$420.55RVU15A
2014-10-01$584.67$438.66RVU14D
2014-07-01$584.67$438.66RVU14C
2014-04-01$584.67$438.66RVU14B
2014-01-01$584.67$438.66RVU14A
2013-10-01$535.62$433.71RVU13D
2013-07-01$535.62$433.71RVU13C
2013-04-01$535.62$433.71RVU13B
2013-01-01$535.62$433.71RVU13AR

Price 67916 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

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 New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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