CPT code 67971: Eyelid reconstruction, up to two-thirds, flap stage2026 Medicare rate & RVUs in Texas
Reports full-thickness eyelid reconstruction using tissue transferred from the opposing eyelid for a defect involving up to two-thirds of the lid.
CMS doesn’t publish an office rate for 67971 in Texas.
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
On this page 9 sections
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 Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $619.89 |
| Beaumont, TX | Unavailable | $582.74 |
| Brazoria, TX | Unavailable | $601.93 |
| Dallas, TX | Unavailable | $605.64 |
| Fort Worth, TX | Unavailable | $603.44 |
| Galveston, TX | Unavailable | $603.74 |
| Houston, TX | Unavailable | $618.56 |
| Rest of Texas | Unavailable | $591.96 |
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
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
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 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.
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).
67971 compared with similar codes
Compare codes · National
5 codes, side by side
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
Fee sheets
Put 67971 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet