CPT code 67971: Eyelid reconstruction, up to two-thirds, flap stage2026 Medicare rate & RVUs in Florida

Reports full-thickness eyelid reconstruction using tissue transferred from the opposing eyelid for a defect involving up to two-thirds of the lid.

CMS RVU26DEffective Oct 1, 20263 payment localities1.5K Medicare services in 2024

CMS doesn’t publish an office rate for 67971 in Florida.

—Office (non-facility)
$609.97–$659.36Hospital or facility

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 9 sections
  1. Rate in Florida
  2. What 67971 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 67971 covers

This procedure rebuilds a full-thickness eyelid defect by transferring a tarsoconjunctival flap from the opposing eyelid. It is commonly used for substantial lower-eyelid defects, such as after removal of an eyelid tumor, when local tissue alone cannot restore the lid. An ophthalmologist with oculoplastic expertise typically performs the surgery in an operating room. The code covers a one-stage reconstruction or the first stage of a staged repair; the flap is generally taken from the upper eyelid to reconstruct the lower lid.

Select this code when the defect involves up to two-thirds of the eyelid and the operative method uses the opposing-lid flap. Document the defect’s extent, the donor eyelid, the flap transfer, and whether this is the first or only stage. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons require supporting documentation, and team surgery is 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 67971 pays more and less in Florida

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

67971 office and facility rates by payment locality
Payment localityOfficeFacility
Fort Lauderdale, FLUnavailable$632.73
Miami, FLUnavailable$659.36
Rest of FloridaUnavailable$609.97

How the 67971 rate is calculated

Each of 67971’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 · 67971

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.76

9.76 RVUs× 1.000 GPCI

Practice expense7.62

7.62 RVUs× 1.000 GPCI

Malpractice0.81

0.81 RVUs× 1.000 GPCI

Adjusted RVUs

18.1900

Conversion factor

$33.4009

Medicare rate

$607.56

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

Payment rules and modifiers for 67971

67971 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67971

Eyelid reconstruction, up to two-thirds, flap stage

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)1Permitted with supporting documentation.
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 · 67971

Eyelid reconstruction, up to two-thirds, flap stage

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

67971 without 50 · national facility

$607.56

Eyelid reconstruction, up to two-thirds, flap stage

67971-50 · Bilateral: 150%

$911.34

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

67971 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 67971

    Eyelid reconstruction, up to two-thirds, flap stage9.76 wRVU

    Not priced

  • 67973

    Eyelid reconstruction, opposing-lid flap, over two-thirds12.8 wRVU

    Not priced

  • 67974

    Eyelid reconstruction, second stage, lower eyelid12.77 wRVU

    Not priced

  • 67966

    Eyelid repair, over one-fourth lid margin8.75 wRVU

    $782.58

  • 67961

    Eyelid repair, up to one-fourth of lid margin5.71 wRVU

    $592.20

How to choose

67973Eyelid reconstructionOpposing-lid flap, over two-thirds
Both codes use an opposing-eyelid tarsoconjunctival flap, but 67973 is selected when the defect exceeds two-thirds of the eyelid.
67974Eyelid reconstructionSecond stage, lower eyelid
67971 describes the one-stage or first-stage flap reconstruction for a defect up to two-thirds of the eyelid; 67974 is a related later-stage code.
67966Eyelid repairOver one-fourth lid margin
Choose 67966 for full-thickness excision and repair of a large eyelid defect when the documented repair is not the opposing-eyelid flap reconstruction reported with 67971.
67961Eyelid repairUp to one-fourth of lid margin
67961 is for full-thickness excision and repair of a smaller eyelid defect; 67971 involves a larger defect and transfer of a tarsoconjunctival flap.

67971 billing questions

How do I choose this code instead of 67973?

Use 67971 for an eyelid defect involving up to two-thirds of the lid. Code 67973 is the sibling for a defect involving more than two-thirds.

Can this code represent the first stage of a staged repair?

Yes. It represents either a one-stage reconstruction or the first stage using a tarsoconjunctival flap from the opposing eyelid.

What documentation supports the code?

Record the full-thickness defect, its extent, the source and transfer of the tarsoconjunctival flap, and whether the procedure is the first or only stage.

How does the 90-day global period affect postoperative visits?

The day-before preoperative visit and related postoperative care through 90 days are included in the global period.

How is bilateral reporting handled?

When the procedure is performed bilaterally and reported with modifier 50, Medicare pays at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services are not paid. Co-surgeons are paid only with supporting documentation.

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 67971PPRRVU2026_Oct_nonQPP.csv, line 7,528 (RVU26D)

Open CMS sourceHow we calculate rates

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