CPT code 67974: Eyelid reconstruction, second stage, lower eyelid2026 Medicare rate & RVUs in Guam
Reports the second-stage operation completing a full-thickness lower eyelid reconstruction, typically by dividing a previously placed flap after the initial repair has healed.
CMS doesn’t publish an office rate for 67974 in Guam.
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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What 67974 covers
This code covers the second operation in a staged, full-thickness lower eyelid reconstruction. A typical example is division of the upper-eyelid tissue bridge used to rebuild the lower lid after a large defect, such as one left by tumor removal. An ophthalmologist or oculoplastic surgeon performs the procedure after the initial reconstruction has healed sufficiently for the transferred tissue to be separated and the eyelids to function independently. The operative report should identify the prior reconstruction and describe the second-stage work and the affected side.
Report this code for the completing operation, not the initial reconstruction or a direct repair of a smaller defect. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires 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.
67974 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $803.25 |
How the 67974 rate is calculated
Each of 67974’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 · 67974
RVUs × geographic indexes × conversion factor
Work12.77
12.77 RVUs× 1.000 GPCI
Practice expense9.38
9.38 RVUs× 1.000 GPCI
Malpractice1.06
1.06 RVUs× 1.000 GPCI
Adjusted RVUs
23.2100
Conversion factor
$33.4009
Medicare rate
$775.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67974
67974 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67974
Eyelid reconstruction, second stage, lower eyelid
| 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) | 2 | Paid. |
| 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 · 67974
Eyelid reconstruction, second stage, lower eyelid
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
67974 without 50 · national facility
$775.23
Eyelid reconstruction, second stage, lower eyelid
67974-50 · Bilateral: 150%
$1,162.85
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).
67974 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 67973Eyelid reconstructionOpposing-lid flap, over two-thirds
- 67973 is the initial stage of full-thickness lower eyelid reconstruction; 67974 is the later operation that completes the staged repair.
- 67971Eyelid reconstructionUp to two-thirds, flap stage
- 67971 describes lower eyelid full-thickness reconstruction for a smaller lid-margin extent, not the second stage of a staged reconstruction.
- 67975Eyelid reconstructionSecond-stage flap division
- 67975 applies to full-thickness upper eyelid reconstruction. 67974 is for the second stage of lower eyelid reconstruction.
- 67966Eyelid repairOver one-fourth lid margin
- 67966 is used for eyelid defect excision and repair; 67974 represents the completing operation in a staged lower eyelid reconstruction.
67974 billing questions
How does 67974 differ from 67973?
67973 reports the initial stage of a full-thickness lower eyelid reconstruction. Use 67974 for the subsequent stage that completes the reconstruction, such as dividing the tissue bridge.
Can 67974 be reported for the initial repair?
No. This code describes the second-stage operation. The operative documentation should support that the patient previously underwent the initial staged reconstruction.
Are routine postoperative visits separately reported?
The 90-day global period includes related postoperative care. The day-before preoperative visit is also included.
How is a bilateral procedure paid?
CMS pays a bilateral procedure reported with modifier 50 at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports 67974?
Document the prior staged lower eyelid reconstruction, the side treated, and the second-stage procedure performed to complete it.
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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