Billing code 67800: Chalazion removalMedicare rate & RVUs

Removal of one chalazion from an eyelid, typically by an ophthalmologist when conservative treatment has not resolved the localized lump.

CMS RVU26DEffective Oct 1, 2026109 payment localities15.4K Medicare services in 2024

Medicare pays $130.60 for 67800 nationally in the office and $86.84 in a hospital or facility. Local office rates run $117.37–$169.80.

Medicare rate · 67800

Chalazion removal

Swap in your local Medicare rate.

Work RVUs
1.37
Total RVUs
3.91
Global days
010

National rate · 2026

$130.60

Office setting, before claim adjustments.

See every locality for 67800 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 67800 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 67800 covers

67800 represents surgical removal of one chalazion, a localized inflammatory lump associated with an obstructed eyelid oil gland. An ophthalmologist commonly performs the procedure in an office procedure room under local anesthesia, opening and curetting the lesion from the inner eyelid. Persistent or symptomatic chalazia are typical reasons for removal; this code is not for excising any type of eyelid growth.

Report this code for one chalazion. For multiple chalazia, select the applicable sibling code based on the number and lid distribution, or the anesthesia circumstances. Document the diagnosis, lesion count and location, anesthesia, and work performed. Related postoperative visits during the 10-day global period are included. When other 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. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 67800 pays more and less

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

109 payment localities

$117.37 to $169.80

$117.37$143.59$169.80
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

67800 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$118.86$80.57
Alaska*$157.10$110.50
Arizona$127.55$85.15
Arkansas$117.37$79.79
Atlanta$132.77$88.32
Austin$134.98$88.68
Bakersfield$137.82$89.87
Baltimore/Surr. Cntys$138.13$91.18
Beaumont$123.03$83.21
Brazoria$129.42$86.06

67800 rates by state

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

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.

$117.37

$157.10

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

View every state and territory as a table
67800 office rate range by state
State / territoryOffice rate rangeLocalities
AK$157.101
AL$118.861
AR$117.371
AZ$127.551
CA$137.46–$169.8029
CO$135.541
CT$138.531
DC$147.931
DE$129.481
FL$128.87–$139.543
GA$122.54–$132.772
GU$140.171
HI$140.171
IA$121.481
ID$122.171
IL$125.60–$136.084
IN$122.781
KS$120.981
KY$121.281
LA$121.11–$126.312
MA$134.89–$147.822
MD$131.73–$147.933
ME$122.72–$128.512
MI$124.01–$130.282
MN$130.361
MO$119.30–$126.713
MS$118.361
MT$130.591
NC$123.831
ND$128.421
NE$122.061
NH$133.471
NJ$140.25–$146.722
NM$124.601
NV$130.071
NY$125.45–$152.015
OH$123.571
OK$121.091
OR$129.18–$139.402
PA$123.74–$135.462
PR$131.441
RI$133.751
SC$123.881
SD$128.161
TN$121.511
TX$123.03–$134.988
UT$125.351
VA$128.14–$147.932
VI$131.441
VT$127.971
WA$134.62–$150.642
WI$124.651
WV$121.551
WY$129.641

How the 67800 rate is calculated

Each of 67800’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 · 67800

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.37Practice expense 2.43Malpractice 0.11

3.9100 adjusted RVUs×$33.4009 conversion factor=$130.60

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 67800

67800 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67800

Chalazion removal

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 67800

Chalazion removal

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

67800 without 51 · national office

$130.60

Chalazion removal

67800-51 · Second procedure: 50%

$65.30

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

67800 compared with similar codes

Compare codes

67800 vs 67801 vs 67805 vs 67840 vs 67810: national Medicare rates

Swap in your local Medicare rate.

  • 67800
    Chalazion removal · 1.37 wRVU
    $130.60
  • 67801
    Chalazion excision · 1.86 wRVU
    $165.00+$34.40
  • 67805
    Chalazion excision · 2.21 wRVU
    $206.42+$75.82
  • 67840
    Eyelid lesion excision · 2.04 wRVU
    $277.90+$147.30
  • 67810
    Eyelid biopsy · 1.15 wRVU
    $181.03+$50.43

How to choose

67801Chalazion excision
67800 is for one chalazion. Choose 67801 when multiple chalazia are removed from the same eyelid.
67805Chalazion excision
67805 is the multiple-chalazion code for lesions involving different eyelids; 67800 is for one chalazion.
67840Eyelid lesion excision
67800 is specific to a chalazion. 67840 is for excision of a different type of eyelid lesion.
67810Eyelid biopsy
67810 describes an eyelid lesion biopsy. Use 67800 when the procedure removes a diagnosed chalazion.

67800 billing questions

When should 67800 be chosen over a multiple-chalazion code?

Use 67800 for removal of one chalazion. For more than one, choose the applicable sibling code based on lesion count, lid distribution, and anesthesia circumstances.

Is 67800 appropriate for a non-chalazion eyelid growth?

No. It is for a chalazion; a different code may apply to excision or biopsy of another eyelid lesion, depending on the service performed.

Can modifier 50 be appended for chalazia on both eyelids?

No. CMS identifies bilateral adjustment as inappropriate for 67800.

What documentation supports reporting 67800?

Record the chalazion diagnosis, the number and eyelid location of lesions, anesthesia, and the removal technique. The record should support that one chalazion was treated.

How are other procedures performed in the same session paid?

The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction. The 10-day global period includes related postoperative visits.

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 67800PPRRVU2026_Oct_nonQPP.csv, line 7,490 (RVU26D)

Open CMS sourceHow we calculate rates

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