Billing code 67901: Ptosis repairMedicare rate & RVUs
Corrects upper eyelid drooping by suspending the lid from the frontalis muscle with suture or other nonautologous material.
Medicare pays $793.61 for 67901 nationally in the office and $502.35 in a hospital or facility. Local office rates run $709.43–$1,043.56.
Medicare rate · 67901
Ptosis repair
Swap in your local Medicare rate.
- Work RVUs
- 7.4
- Total RVUs
- 23.76
- Global days
- 090
National rate · 2026
$793.61
Office setting, before claim adjustments.
See every locality for 67901 → · 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
What 67901 covers
This operation treats blepharoptosis, or a drooping upper eyelid, by linking the eyelid to the frontalis muscle so brow movement helps elevate it. An ophthalmologist, commonly an oculoplastic surgeon, may use a suture or another nonautologous sling material. The technique is distinct from harvesting the patient’s own fascia for the suspension and from shortening or advancing the eyelid elevator muscle.
Report the code for the frontalis suspension technique, with the operative note identifying the method and material used, the treated eyelid, and the ptosis being corrected. The code has a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. 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 67901 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
$709.43 to $1043.56
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $718.90 | $464.05 |
| Alaska* | $942.06 | $631.88 |
| Arizona | $774.33 | $492.10 |
| Arkansas | $709.43 | $459.25 |
| Atlanta | $806.92 | $511.01 |
| Austin | $822.23 | $514.08 |
| Bakersfield | $840.67 | $521.46 |
| Baltimore/Surr. Cntys | $840.85 | $528.33 |
| Beaumont | $744.82 | $479.78 |
| Brazoria | $786.30 | $497.66 |
| Chicago | $824.78 | $532.07 |
| Chico | $838.67 | $519.45 |
| Colorado | $825.68 | $515.79 |
| Connecticut | $843.38 | $529.70 |
| Dallas | $790.79 | $500.70 |
| Dc + Md/Va Suburbs | $902.87 | $559.77 |
| Delaware | $786.44 | $498.68 |
| Detroit | $789.41 | $508.35 |
| East St. Louis | $772.55 | $504.59 |
| El Centro | $838.77 | $519.56 |
| Fort Lauderdale | $817.17 | $522.13 |
| Fort Worth | $785.80 | $498.62 |
| Fresno | $838.67 | $519.45 |
| Galveston | $788.34 | $499.12 |
| Hanford-Corcoran | $838.67 | $519.45 |
| Hawaii, Guam | $856.91 | $525.75 |
| Houston | $799.69 | $510.47 |
| Idaho | $740.63 | $472.68 |
| Indiana | $744.58 | $474.59 |
| Iowa | $736.43 | $469.93 |
| Kansas | $732.86 | $469.57 |
| Kentucky | $733.49 | $474.56 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $892.99 | $548.43 |
| Madera | $838.67 | $519.45 |
| Manhattan | $906.73 | $568.29 |
| Merced | $838.67 | $519.45 |
| Metropolitan Boston | $903.45 | $555.69 |
| Metropolitan Kansas City | $761.06 | $487.57 |
| Metropolitan Philadelphia | $823.61 | $520.41 |
| Metropolitan St. Louis | $768.41 | $491.14 |
| Miami | $846.82 | $543.63 |
| Minnesota | $794.27 | $494.57 |
| Mississippi | $715.12 | $464.35 |
| Modesto | $838.67 | $519.45 |
| Montana** | $793.56 | $502.31 |
| Napa | $966.17 | $582.30 |
| Nebraska | $740.24 | $471.41 |
| Nevada** | $790.67 | $499.13 |
| New Hampshire | $812.57 | $509.37 |
| New Mexico | $754.13 | $487.05 |
| New Orleans | $765.40 | $491.33 |
| North Carolina | $750.91 | $479.16 |
| North Dakota** | $781.30 | $490.05 |
| Northern Nj | $894.70 | $556.85 |
| Nyc Suburbs/Long Island | $926.53 | $580.23 |
| Ohio | $748.03 | $482.12 |
| Oklahoma | $732.73 | $472.64 |
| Oxnard-Thousand Oaks-Ventura | $888.40 | $544.14 |
| Portland | $850.61 | $527.03 |
| Poughkpsie/N Nyc Suburbs | $859.02 | $540.10 |
| Puerto Rico | $799.08 | $504.62 |
| Queens | $914.26 | $570.00 |
| Redding | $838.67 | $519.45 |
| Rest Of California | $838.67 | $519.45 |
| Rest Of Florida | $780.89 | $502.45 |
| Rest Of Georgia | $740.80 | $481.00 |
| Rest Of Illinois | $759.53 | $493.61 |
| Rest Of Louisiana | $732.28 | $474.52 |
| Rest Of Maine | $743.72 | $475.76 |
| Rest Of Maryland | $800.69 | $505.94 |
| Rest Of Massachusetts | $821.22 | $514.53 |
| Rest Of Michigan | $750.54 | $484.62 |
| Rest Of Missouri | $720.52 | $469.45 |
| Rest Of New Jersey | $853.87 | $535.82 |
| Rest Of New York | $761.17 | $484.48 |
| Rest Of Oregon | $785.35 | $495.26 |
| Rest Of Pennsylvania | $749.36 | $481.98 |
| Rest Of Texas | $764.78 | $488.38 |
| Rest Of Washington | $819.73 | $513.04 |
| Rhode Island | $813.41 | $512.55 |
| Riverside-San Bernardino-Ontario | $845.48 | $526.26 |
| Sacramento-Roseville-Folsom | $878.59 | $539.86 |
| Salinas | $875.25 | $537.68 |
| San Diego-Chula Vista-Carlsbad | $894.58 | $546.24 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $1,021.43 | $610.76 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $1,020.73 | $610.06 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,043.56 | $623.57 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,040.68 | $620.69 |
| San Luis Obispo-Paso Robles | $861.27 | $529.53 |
| Santa Cruz-Watsonville | $902.22 | $548.34 |
| Santa Maria-Santa Barbara | $878.19 | $538.58 |
| Santa Rosa-Petaluma | $911.28 | $553.62 |
| Seattle (King Cnty) | $921.51 | $564.14 |
| South Carolina | $750.54 | $481.42 |
| South Dakota** | $779.85 | $488.60 |
| Southern Maine | $781.23 | $492.60 |
| Stockton | $838.67 | $519.45 |
| Suburban Chicago | $825.52 | $526.40 |
| Tennessee | $736.18 | $471.42 |
| Utah | $759.95 | $486.17 |
| Vallejo | $965.16 | $581.28 |
| Vermont | $778.12 | $489.77 |
| Virgin Islands | $799.08 | $504.62 |
| Virginia | $778.58 | $492.28 |
| Visalia | $838.67 | $519.45 |
| West Virginia | $733.66 | $480.56 |
| Wisconsin | $757.19 | $478.17 |
| Wyoming** | $788.22 | $496.97 |
| Yuba City | $838.67 | $519.45 |
67901 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.
$709.43
$942.06
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $942.06 | 1 |
| AL | $718.90 | 1 |
| AR | $709.43 | 1 |
| AZ | $774.33 | 1 |
| CA | $838.67–$1,043.56 | 29 |
| CO | $825.68 | 1 |
| CT | $843.38 | 1 |
| DC | $902.87 | 1 |
| DE | $786.44 | 1 |
| FL | $780.89–$846.82 | 3 |
| GA | $740.80–$806.92 | 2 |
| GU | $856.91 | 1 |
| HI | $856.91 | 1 |
| IA | $736.43 | 1 |
| ID | $740.63 | 1 |
| IL | $759.53–$825.52 | 4 |
| IN | $744.58 | 1 |
| KS | $732.86 | 1 |
| KY | $733.49 | 1 |
| LA | $732.28–$765.40 | 2 |
| MA | $821.22–$903.45 | 2 |
| MD | $800.69–$902.87 | 3 |
| ME | $743.72–$781.23 | 2 |
| MI | $750.54–$789.41 | 2 |
| MN | $794.27 | 1 |
| MO | $720.52–$768.41 | 3 |
| MS | $715.12 | 1 |
| MT | $793.56 | 1 |
| NC | $750.91 | 1 |
| ND | $781.30 | 1 |
| NE | $740.24 | 1 |
| NH | $812.57 | 1 |
| NJ | $853.87–$894.70 | 2 |
| NM | $754.13 | 1 |
| NV | $790.67 | 1 |
| NY | $761.17–$926.53 | 5 |
| OH | $748.03 | 1 |
| OK | $732.73 | 1 |
| OR | $785.35–$850.61 | 2 |
| PA | $749.36–$823.61 | 2 |
| PR | $799.08 | 1 |
| RI | $813.41 | 1 |
| SC | $750.54 | 1 |
| SD | $779.85 | 1 |
| TN | $736.18 | 1 |
| TX | $744.82–$822.23 | 8 |
| UT | $759.95 | 1 |
| VA | $778.58–$902.87 | 2 |
| VI | $799.08 | 1 |
| VT | $778.12 | 1 |
| WA | $819.73–$921.51 | 2 |
| WI | $757.19 | 1 |
| WV | $733.66 | 1 |
| WY | $788.22 | 1 |
How the 67901 rate is calculated
Each of 67901’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 · 67901
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.40Practice expense 15.74Malpractice 0.62
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67901
67901 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67901
Ptosis repair
| 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) | 0 | Not permitted. |
| 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 · 67901
Ptosis repair
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
67901 without 50 · national office
$793.61
Ptosis repair
67901-50 · Bilateral: 150%
$1,190.42
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).
67901 compared with similar codes
Compare codes
67901 vs 67902 vs 67903 vs 67904 vs 67900: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67902Ptosis repair
- Both use a frontalis suspension approach, but 67902 is for a sling made from the patient’s own fascia; 67901 uses suture or other nonautologous material.
- 67903Ptosis repair
- 67903 repairs ptosis by external levator resection or advancement. Choose 67901 when the operative technique suspends the eyelid from the frontalis muscle.
- 67904Ptosis repair
- 67904 is an internal levator resection or advancement, rather than a frontalis suspension.
- 67900Brow repair
- 67900 addresses a brow defect. Code 67901 corrects upper eyelid ptosis with a frontalis suspension.
67901 billing questions
When is 67901 selected instead of 67902?
Use 67901 for a frontalis suspension using suture or other nonautologous material. Code 67902 describes the frontalis technique using the patient’s own fascia.
How does this differ from levator repair?
This code represents a sling connecting the eyelid to the frontalis muscle. Codes 67903 and 67904 describe levator resection or advancement by external and internal approaches, respectively.
What should the operative note identify?
Document the ptosis treated, eyelid laterality, frontalis suspension technique, and material used. The note should make clear that the repair is not an autologous fascia sling or a levator procedure.
How is bilateral surgery reported?
Report bilateral surgery with modifier 50; CMS pays the procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. Services unrelated to the operation should be distinguished from care related to the repair.
Can an assistant or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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 67901 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →