Billing code 67903: Ptosis repairMedicare rate & RVUs

Medicare pays $606.23 for 67903 nationally in the office and $408.49 in a hospital or facility. Local office rates run $544.91–$788.63.

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

What 67903 covers

This operation elevates a drooping upper eyelid by shortening or advancing the levator mechanism through an incision on the inner eyelid surface. Ophthalmologists and oculoplastic surgeons use it for upper eyelid ptosis, including cases in which the lid obstructs the patient’s superior visual field. The operative approach distinguishes this service from ptosis repairs performed through an external skin incision or by frontalis suspension.

Report 67903 when the surgeon performs the internal levator approach; the operative note should identify the approach and the tissue adjusted. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. With modifier 50, bilateral performance is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with 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 67903 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

67903 rates by state

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

How the 67903 rate is calculated

Each of 67903’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 67903

67903 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

67903 compared with similar codes

How to choose

67904Ptosis repair

Both address upper eyelid ptosis through the levator mechanism. Choose 67903 for the internal approach and 67904 for the external approach.

67901Ptosis repair

67901 uses a frontalis muscle technique with suture or other material. 67903 adjusts the levator mechanism through an internal approach.

67906Ptosis repair

67906 describes a conjunctival and muscle resection technique, such as the Fasanella-Servat approach. 67903 is selected for internal levator adjustment.

67900Brow repair

67900 repairs brow ptosis, while 67903 corrects upper eyelid ptosis through an internal levator approach.

Codes related to 67903

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