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CPT code 67966: Eyelid repair, over one-fourth lid margin2026 Medicare rate & RVUs in Washington, DC area

Report 67966 when excision and repair involve a full-thickness eyelid segment extending over one-fourth of the lid margin.

CMS RVU26DEffective Oct 1, 2026One payment locality7.7K Medicare services in 2024

In Washington, DC area, Medicare pays $884.06 for 67966 in the office and $615.72 when it’s performed in a hospital or facility.

$884.06Office (non-facility)
$615.72Hospital or facility
+13.0%vs the national office rate ($782.58)

Check a contract rate as a % of Medicare · 67966 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 67966 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 67966 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 67966 covers

An ophthalmic or oculoplastic surgeon uses this service to remove and repair a substantial eyelid segment involving the lid margin and deeper structures, such as the tarsus and conjunctiva. A typical setting is an operating room or ambulatory surgery center, including treatment of a lesion or tumor that leaves a large full-thickness defect. The defining extent is more than one-fourth of the horizontal lid margin; this is not a code for a skin-only removal or a small defect.

The operative report should identify the affected eyelid, structures involved, amount of lid margin excised, and how the resulting defect was repaired. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays at 150%. CMS does not pay an assistant at surgery for this code; 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 Washington, DC area compares for 67966

Across 109 of 109 payment localities, the office rate for 67966 runs from $705.06 in Arkansas to $1,009.36 in San Benito County, CA. Washington, DC area pays $884.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

67966 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$884.06
  2. Los Angeles, CA · California$871.64−$12.42
  3. Miami, FL · Florida$838.97−$45.09
  4. Chicago, IL · Illinois$818.53−$65.53
  5. Manhattan, NY · New York$891.06+$7.00
  6. Alaska · Alaska$948.05+$63.99
  7. Alabama · Alabama$713.76−$170.30

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

67966 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$705.06$509.38
ArizonaArizona$764.63$543.90
Bakersfield, CACalifornia$823.33$573.67
Chico, CACalifornia$820.97$571.31
El Centro, CACalifornia$821.09$571.43
Fresno, CACalifornia$820.97$571.31
Hanford, CACalifornia$820.97$571.31
Madera, CACalifornia$820.97$571.31

67966 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.

$705.06

$948.05

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

View every state and territory as a table
67966 office rate range by state
State / territoryOffice rate rangeLocalities
AK$948.051
AL$713.761
AR$705.061
AZ$764.631
CA$820.97–$1,009.3629
CO$810.571
CT$829.431
DC$884.061
DE$775.991
FL$774.35–$838.973
GA$736.94–$795.822
GU$836.151
HI$836.151
IA$728.281
ID$732.461
IL$755.77–$818.534
IN$736.041
KS$725.761
KY$728.791
LA$727.98–$758.412
MA$807.00–$882.282
MD$789.10–$884.063
ME$736.09–$769.392
MI$745.19–$783.002
MN$778.931
MO$717.65–$760.273
MS$711.451
MT$782.531
NC$742.561
ND$768.101
NE$731.541
NH$798.641
NJ$839.51–$877.202
NM$748.811
NV$778.981
NY$752.04–$910.255
OH$742.241
OK$727.291
OR$773.48–$832.742
PA$743.03–$811.652
PR$787.341
RI$800.881
SC$743.511
SD$766.391
TN$728.891
TX$738.92–$807.418
UT$752.141
VA$767.49–$884.062
VI$787.341
VT$765.881
WA$805.25–$898.502
WI$746.141
WV$732.051
WY$776.241

See 67966 in every payment locality

How the 67966 rate is calculated

Each of 67966’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 · 67966

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.75

8.75 RVUs× 1.000 GPCI

Practice expense13.95

13.95 RVUs× 1.000 GPCI

Malpractice0.73

0.73 RVUs× 1.000 GPCI

Adjusted RVUs

23.4300

Conversion factor

$33.4009

Medicare rate

$782.58

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,527

Code
67966
Physician work
8.75
Practice expense
13.95
Malpractice
0.73

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 67966 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work8.75× 1.0549.2225
Practice expense13.95× 1.17816.4331
Malpractice0.73× 1.1130.8125
Total RVUs26.4681
Conversion factor× 33.4009

Office rate, Washington, DC area$884.06

Office: (8.75 × 1.054 + 13.95 × 1.178 + 0.73 × 1.113) × $33.4009 = $884.06

Facility: (8.75 × 1.054 + 7.13 × 1.178 + 0.73 × 1.113) × $33.4009 = $615.72

Open 67966 in the RVU calculator

Payment rules and modifiers for 67966

67966 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67966

Eyelid repair, over one-fourth lid margin

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 · 67966

Eyelid repair, over one-fourth lid margin

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

67966 without 50 · national office

$782.58

Eyelid repair, over one-fourth lid margin

67966-50 · Bilateral: 150%

$1,173.87

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 67966

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

Codes related to 67966
CodeHow it relatesOffice range, Washington, DC area
Same family
67961Eyelid repair, up to one-fourth of lid marginSame type of eyelid excision and repair for a segment up to one-fourth of the lid margin.$672.94
Used instead
67971Eyelid reconstruction, up to two-thirds, flap stageA full-thickness eyelid reconstruction code to consider when its reconstructive service, rather than 67966, fits the procedure.No office rate
67973Eyelid reconstruction, opposing-lid flap, over two-thirdsAn eyelid reconstruction option for a different defect and reconstructive circumstance.No office rate
67974Eyelid reconstruction, second stage, lower eyelidAn eyelid reconstruction option for a different defect and reconstructive circumstance.No office rate

How 67966 has changed in Washington, DC area

67966 · Office / nonfacility

$884.06

Effective 2026-10-01

The base rate is $34.67 higher than on 2025-10-01, moving from $849.39 to $884.06 (4.1%).

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

    $849.39changed to$884.06

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 8.97 changed to 8.75
    • Practice expense RVU 13.36 changed to 13.95
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $880.03changed to$849.39

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 13.49 changed to 13.36
    • Malpractice RVU 0.75 changed to 0.73

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $865.67changed to$880.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $901.47changed to$865.67

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 13.37 changed to 13.49
    • Malpractice RVU 0.73 changed to 0.75
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $921.06changed to$901.47

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 13.12 changed to 13.37
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $928.65changed to$921.06

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 13.14 changed to 13.12
    • Malpractice RVU 0.71 changed to 0.73

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $913.45changed to$928.65

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.27 changed to 13.14
    • Malpractice RVU 0.72 changed to 0.71
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $903.37changed to$913.45

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 12.28 changed to 12.27
    • Malpractice RVU 0.71 changed to 0.72
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $899.76changed to$903.37

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.23 changed to 12.28
    • Malpractice RVU 0.70 changed to 0.71

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $890.85changed to$899.76

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 12.06 changed to 12.23
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $889.54changed to$890.85

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.04 changed to 12.06
    • Malpractice RVU 0.71 changed to 0.70
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $891.88changed to$889.54

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.02 changed to 12.04

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $887.44changed to$891.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $925.33changed to$887.44

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 1.63 changed to 0.71
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $920.67changed to$925.33

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.13 changed to 12.02
    • Malpractice RVU 1.70 changed to 1.63
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $920.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$884.06$615.72RVU26D
2026-07-01$884.06$615.72RVU26C
2026-04-01$884.06$615.72RVU26B
2026-01-01$884.06$615.72RVU26A
2025-10-01$849.39$709.04RVU25D
2025-07-01$849.39$709.04RVU25C
2025-04-01$849.39$709.04RVU25B
2025-01-01$849.39$709.04RVU25A
2024-10-01$880.03$728.86RVU24D
2024-07-01$880.03$728.86RVU24C
2024-04-01$880.03$728.86RVU24B
2024-03-09$880.03$728.86RVU24AR
2024-01-01$865.67$716.96RVU24A
2023-10-01$901.47$742.67RVU23D
2023-07-01$901.47$742.67RVU23C
2023-04-01$901.47$742.67RVU23B
2023-01-01$901.47$742.67RVU23A
2022-10-01$921.06$753.81RVU22D
2022-07-01$921.06$753.81RVU22C
2022-04-01$921.06$753.81RVU22B
2022-01-01$921.06$753.81RVU22A
2021-10-01$928.65$758.30RVU21D
2021-07-01$928.65$758.30RVU21C
2021-04-01$928.65$758.30RVU21B
2021-01-01$928.65$758.30RVU21A
2020-10-01$913.45$764.07RVU20D
2020-07-01$913.45$764.07RVU20C
2020-04-01$913.45$764.07RVU20B
2020-01-01$913.45$764.07RVU20A
2019-10-01$903.37$761.80RVU19D
2019-07-01$903.37$761.80RVU19C
2019-04-01$903.37$761.80RVU19B
2019-01-01$903.37$761.80RVU19A
2018-10-01$899.76$763.11RVU18D
2018-07-01$899.76$763.11RVU18C
2018-04-01$899.76$763.11RVU18B
2018-01-01$899.76$763.11RVU18AR1
2017-10-01$890.85$758.08RVU17D
2017-07-01$890.85$758.08RVU17C
2017-04-01$890.85$758.08RVU17B
2017-01-01$890.85$758.08RVU17A
2016-10-01$889.54$756.65RVU16D
2016-07-01$889.54$756.65RVU16C
2016-04-01$889.54$756.65RVU16B
2016-01-01$889.54$756.65RVU16A
2015-10-01$891.88$758.95RVU15D
2015-07-01$891.88$758.95RVU15C
2015-04-01$887.44$755.18RVU15B
2015-01-01$887.44$755.18RVU15A
2014-10-01$925.33$794.43RVU14D
2014-07-01$925.33$794.43RVU14C
2014-04-01$925.33$794.43RVU14B
2014-01-01$925.33$794.43RVU14A
2013-10-01$920.67$782.09RVU13D
2013-07-01$920.67$782.09RVU13C
2013-04-01$920.67$782.09RVU13B
2013-01-01$920.67$782.09RVU13AR

Price 67966 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

67966 billing questions

How is 67966 distinguished from 67961?

Both describe eyelid excision and repair involving deeper structures. Use 67966 when the excised lid-margin segment is over one-fourth of the horizontal length; 67961 is for up to one-fourth.

What documentation supports 67966?

Document the eyelid and structures involved, the extent of the excision in relation to the horizontal lid margin, and the repair performed. The record should support that the segment exceeded one-fourth of the margin.

Does the 90-day global period include postoperative visits?

Related postoperative care during the 90-day period is included, as is the day-before preoperative visit.

How does Medicare handle bilateral reporting?

For bilateral procedures reported with modifier 50, CMS pays at 150%.

Can an assistant or co-surgeon be reported?

CMS does not pay an assistant at surgery for 67966. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 67966PPRRVU2026_Oct_nonQPP.csv, line 7,527 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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