CPT code 67975: Eyelid reconstruction, second-stage flap division2026 Medicare rate & RVUs

Medicare pays $578.50 for 67975 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 67975 covers

This staged operation divides a tarsoconjunctival flap previously transferred from the opposing eyelid to rebuild a full-thickness eyelid defect. The surgeon separates the reconstructed lid from the donor lid and shapes the new lid margin. It is commonly performed by an oculoplastic ophthalmologist after the transferred tissue has healed; a typical setting is an operating room. The procedure follows the initial flap-transfer operation rather than creating the reconstruction from a new defect at this visit.

Report 67975 for the flap-division stage, not for the initial transfer. The operative note should identify the previously reconstructed eyelid, the donor lid, and the division and shaping performed. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, payment is 150%. Medicare 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.

Where 67975 pays more and less

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

109 of 109 payment localities

67975 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 67975 rate is calculated

Each of 67975’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.

Payment rules and modifiers for 67975

67975 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

67975 compared with similar codes

How to choose

67971Eyelid reconstructionUp to two-thirds, flap stage

67971 reports an initial-stage eyelid reconstruction with a transferred flap. Use 67975 for the later operation that divides the flap.

67973Eyelid reconstructionOpposing-lid flap, over two-thirds

67973 is an initial-stage reconstruction code; 67975 describes the subsequent flap-division stage.

67974Eyelid reconstructionSecond stage, lower eyelid

67974 belongs to the initial reconstruction stage. 67975 is selected when the previously transferred flap is divided.

Codes related to 67975

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

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

Open CMS sourceHow we calculate rates