CPT code 67921: Entropion repair, suture technique2026 Medicare rate & RVUs in Maine
Reports suture-based correction of an inward-turned eyelid margin, commonly performed by an ophthalmologist to relieve irritation and protect the ocular surface.
Medicare pays $445.56–$470.89 for 67921 in the office in Maine, from Rest of Maine to Southern Maine, ME. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 67921 covers
This procedure corrects entropion, in which the eyelid margin turns inward and lashes or skin may rub against the eye. The surgeon uses sutures to rotate the lid margin outward. It is commonly performed by an ophthalmologist or oculoplastic surgeon in an office procedure room or operating facility, often for involutional lower-lid entropion.
Select this code when the documented repair uses sutures, rather than thermal treatment, tarsal wedge excision, or a more extensive repair. The operative note should identify the affected eyelid, the entropion being corrected, and the suture-based technique. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral repair, modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures at 50%. CMS does not pay an assistant at surgery, and 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 67921 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | $445.56 | $260.88 |
| Southern Maine, ME | $470.89 | $271.96 |
How the 67921 rate is calculated
Each of 67921’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 · 67921
RVUs × geographic indexes × conversion factor
Work3.38
3.38 RVUs× 1.000 GPCI
Practice expense10.65
10.65 RVUs× 1.000 GPCI
Malpractice0.26
0.26 RVUs× 1.000 GPCI
Adjusted RVUs
14.2900
Conversion factor
$33.4009
Medicare rate
$477.30
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67921
67921 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67921
Entropion repair, suture technique
| 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) | 0 | Not permitted. |
| 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 · 67921
Entropion repair, suture technique
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
67921 without 50 · national office
$477.30
Entropion repair, suture technique
67921-50 · Bilateral: 150%
$715.95
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).
67921 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 67922Entropion repairThermocautery technique
- Both correct entropion, but 67922 uses thermocauterization; 67921 is for a suture-based repair.
- 67923Entropion repairTarsal wedge excision
- 67923 involves tarsal wedge excision. Choose 67921 when the documented correction is performed with sutures instead.
- 67924Entropion repairExtensive repair
- 67924 describes an extensive entropion repair. Use 67921 for the suture-based approach when the documented operation does not support the extensive repair code.
- 67914Ectropion repairSuture technique
- 67914 is a suture repair for ectropion, where the lid turns outward. This code is for entropion, where the lid turns inward.
67921 billing questions
How does this differ from 67922?
Use 67921 for suture-based correction of entropion. Code 67922 describes correction using thermocauterization.
When would 67923 or 67924 be selected instead?
Those codes represent different operative approaches: tarsal wedge excision for 67923 and an extensive repair for 67924. The operative note should support the technique and extent reported.
Can this be reported for both eyelids?
Yes. CMS identifies the procedure as bilateral, with modifier 50 paid at 150%.
Are related postoperative visits separately reported?
The 90-day global period includes related postoperative care, as well as the preoperative visit on the day before surgery.
Can an assistant or co-surgeon be billed for this repair?
CMS does not pay an assistant at surgery 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
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