$434.23–$655.69
67914 is for ectropion repair using sutures. Use 67916 when the documented repair includes excision of a tarsal wedge.
On this page
CMS RVU26D · Effective 2026-10-01
67916 Ectropion repair Medicare reimbursement rates
Reports surgical correction of ectropion by removing a tarsal wedge to shorten and reposition an outward-turning eyelid, typically the lower lid. Compare 67916 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 67916?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$545.32–$809.05
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $263.73 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 67916 pays more and less
109 payment localities
$545.32 to $809.05
Ophthalmic surgery
About 67916: Ectropion repair with tarsal wedge
Reports surgical correction of ectropion by removing a tarsal wedge to shorten and reposition an outward-turning eyelid, typically the lower lid.
An ophthalmic or oculoplastic surgeon uses this procedure to correct ectropion, in which the eyelid turns outward and may expose the ocular surface. The surgeon removes a wedge of tarsal tissue to shorten the lid and improve its position against the eye. It is commonly used for lower-lid laxity, including involutional ectropion, and may be performed in an operating room or an appropriately equipped office procedure setting.
Choose this code when the operative technique includes tarsal wedge excision, rather than a suture-only or thermocautery repair or a more extensive repair. The operative note should identify the affected eyelid, the ectropion being corrected, and the wedge excision and repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery reported with modifier 50, CMS pays 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 67916
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.34 · 29%
- Practice expense (office) RVU12.52 · 68%
- Malpractice RVU0.45 · 2%
1.4K
Medicare services in 2024 · #2711 by national volume
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.
67916 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$278.62–$428.35
67915 describes ectropion repair by thermocautery. It is distinct from the tarsal wedge excision represented by 67916.
$559.10–$823.49
67917 is for an extensive ectropion repair, such as a tarsal strip operation; 67916 is selected for repair by tarsal wedge excision.
$544.69–$808.21
67923 treats entropion, where the eyelid turns inward, by tarsal wedge excision. Code 67916 is for outward-turning eyelid malposition, or ectropion.
See how rates vary across the country
67916 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$545.32
$728.41
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $721.18 | 1 |
| AL | $552.77 | 1 |
| AR | $545.32 | 1 |
| AZ | $596.44 | 1 |
| CA | $647.77–$809.05 | 29 |
| CO | $637.18 | 1 |
| CT | $650.49 | 1 |
| DC | $697.34 | 1 |
| DE | $605.93 | 1 |
| FL | $600.73–$651.70 | 3 |
| GA | $569.29–$621.82 | 2 |
| GU | $662.53 | 1 |
| HI | $662.53 | 1 |
| IA | $566.96 | 1 |
| ID | $570.20 | 1 |
| IL | $583.65–$635.71 | 4 |
| IN | $573.32 | 1 |
| KS | $563.97 | 1 |
| KY | $563.87 | 1 |
| LA | $562.85–$588.94 | 2 |
| MA | $633.54–$698.36 | 2 |
| MD | $617.14–$697.34 | 3 |
| ME | $572.43–$602.26 | 2 |
| MI | $577.13–$607.25 | 2 |
| MN | $613.12 | 1 |
| MO | $553.47–$591.53 | 3 |
| MS | $549.52 | 1 |
| MT | $611.54 | 1 |
| NC | $578.13 | 1 |
| ND | $602.64 | 1 |
| NE | $570.02 | 1 |
| NH | $626.84 | 1 |
| NJ | $658.64–$690.74 | 2 |
| NM | $579.88 | 1 |
| NV | $609.48 | 1 |
| NY | $586.20–$714.90 | 5 |
| OH | $575.31 | 1 |
| OK | $563.47 | 1 |
| OR | $605.43–$656.99 | 2 |
| PA | $576.45–$634.83 | 2 |
| PR | $615.94 | 1 |
| RI | $627.14 | 1 |
| SC | $577.53 | 1 |
| SD | $601.59 | 1 |
| TN | $566.56 | 1 |
| TX | $572.87–$634.47 | 8 |
| UT | $584.95 | 1 |
| VA | $600.04–$697.34 | 2 |
| VI | $615.94 | 1 |
| VT | $599.96 | 1 |
| WA | $632.46–$712.66 | 2 |
| WI | $583.61 | 1 |
| WV | $563.27 | 1 |
| WY | $607.66 | 1 |
Compare 67916 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $552.77 | Facility $342.93 |
| Alaska* | Office $721.18 | Facility $465.78 |
| Arizona | Office $596.44 | Facility $364.06 |
| Arkansas | Office $545.32 | Facility $339.31 |
| Atlanta | Office $621.82 | Facility $378.16 |
| Austin | Office $634.47 | Facility $380.74 |
| Bakersfield | Office $649.23 | Facility $386.39 |
| Baltimore/Surr. Cntys | Office $648.51 | Facility $391.19 |
| Beaumont | Office $572.87 | Facility $354.63 |
| Brazoria | Office $605.93 | Facility $368.27 |
| Chicago | Office $634.37 | Facility $393.36 |
| Chico | Office $647.77 | Facility $384.93 |
| Colorado | Office $637.18 | Facility $382.02 |
| Connecticut | Office $650.49 | Facility $392.21 |
| Dallas | Office $609.37 | Facility $370.51 |
| Dc + Md/Va Suburbs | Office $697.34 | Facility $414.83 |
| Delaware | Office $605.93 | Facility $368.99 |
| Detroit | Office $607.25 | Facility $375.82 |
| East St. Louis | Office $593.36 | Facility $372.72 |
| El Centro | Office $647.85 | Facility $385.01 |
| Fort Lauderdale | Office $629.15 | Facility $386.22 |
| Fort Worth | Office $605.38 | Facility $368.92 |
| Fresno | Office $647.77 | Facility $384.93 |
| Galveston | Office $607.48 | Facility $369.35 |
| Hanford-Corcoran | Office $647.77 | Facility $384.93 |
| Hawaii, Guam | Office $662.53 | Facility $389.86 |
| Houston | Office $615.72 | Facility $377.58 |
| Idaho | Office $570.20 | Facility $349.56 |
| Indiana | Office $573.32 | Facility $351.01 |
| Iowa | Office $566.96 | Facility $347.53 |
| Kansas | Office $563.97 | Facility $347.17 |
| Kentucky | Office $563.87 | Facility $350.68 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $690.36 | Facility $406.65 |
| Madera | Office $647.77 | Facility $384.93 |
| Manhattan | Office $699.54 | Facility $420.87 |
| Merced | Office $647.77 | Facility $384.93 |
| Metropolitan Boston | Office $698.36 | Facility $412.01 |
| Metropolitan Kansas City | Office $585.72 | Facility $360.53 |
| Metropolitan Philadelphia | Office $634.83 | Facility $385.18 |
| Metropolitan St. Louis | Office $591.53 | Facility $363.22 |
| Miami | Office $651.70 | Facility $402.05 |
| Minnesota | Office $613.12 | Facility $366.34 |
| Mississippi | Office $549.52 | Facility $343.04 |
| Modesto | Office $647.77 | Facility $384.93 |
| Montana** | Office $611.54 | Facility $371.72 |
| Napa | Office $748.39 | Facility $432.31 |
| Nebraska | Office $570.02 | Facility $348.67 |
| Nevada** | Office $609.48 | Facility $369.42 |
| New Hampshire | Office $626.84 | Facility $377.19 |
| New Mexico | Office $579.88 | Facility $359.97 |
| New Orleans | Office $588.94 | Facility $363.27 |
| North Carolina | Office $578.13 | Facility $354.38 |
| North Dakota** | Office $602.64 | Facility $362.82 |
| Northern Nj | Office $690.74 | Facility $412.55 |
| Nyc Suburbs/Long Island | Office $714.90 | Facility $429.76 |
| Ohio | Office $575.31 | Facility $356.35 |
| Oklahoma | Office $563.47 | Facility $349.32 |
| Oxnard-Thousand Oaks-Ventura | Office $687.01 | Facility $403.54 |
| Portland | Office $656.99 | Facility $390.56 |
| Poughkpsie/N Nyc Suburbs | Office $662.48 | Facility $399.88 |
| Puerto Rico | Office $615.94 | Facility $373.49 |
| Queens | Office $705.74 | Facility $422.27 |
| Redding | Office $647.77 | Facility $384.93 |
| Rest Of California | Office $647.77 | Facility $384.93 |
| Rest Of Florida | Office $600.73 | Facility $371.46 |
| Rest Of Georgia | Office $569.29 | Facility $355.37 |
| Rest Of Illinois | Office $583.65 | Facility $364.70 |
| Rest Of Louisiana | Office $562.85 | Facility $350.61 |
| Rest Of Maine | Office $572.43 | Facility $351.80 |
| Rest Of Maryland | Office $617.14 | Facility $374.44 |
| Rest Of Massachusetts | Office $633.54 | Facility $381.01 |
| Rest Of Michigan | Office $577.13 | Facility $358.17 |
| Rest Of Missouri | Office $553.47 | Facility $346.75 |
| Rest Of New Jersey | Office $658.64 | Facility $396.75 |
| Rest Of New York | Office $586.20 | Facility $358.37 |
| Rest Of Oregon | Office $605.43 | Facility $366.57 |
| Rest Of Pennsylvania | Office $576.45 | Facility $356.30 |
| Rest Of Texas | Office $588.79 | Facility $361.20 |
| Rest Of Washington | Office $632.46 | Facility $379.93 |
| Rhode Island | Office $627.14 | Facility $379.40 |
| Riverside-San Bernardino-Ontario | Office $652.72 | Facility $389.88 |
| Sacramento-Roseville-Folsom | Office $679.18 | Facility $400.27 |
| Salinas | Office $676.62 | Facility $398.67 |
| San Diego-Chula Vista-Carlsbad | Office $692.00 | Facility $405.18 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $791.84 | Facility $453.69 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $791.33 | Facility $453.18 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $809.05 | Facility $463.23 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $806.96 | Facility $461.14 |
| San Luis Obispo-Paso Robles | Office $665.76 | Facility $392.60 |
| Santa Cruz-Watsonville | Office $698.25 | Facility $406.87 |
| Santa Maria-Santa Barbara | Office $679.01 | Facility $399.38 |
| Santa Rosa-Petaluma | Office $705.29 | Facility $410.79 |
| Seattle (King Cnty) | Office $712.66 | Facility $418.41 |
| South Carolina | Office $577.53 | Facility $355.94 |
| South Dakota** | Office $601.59 | Facility $361.77 |
| Southern Maine | Office $602.26 | Facility $364.60 |
| Stockton | Office $647.77 | Facility $384.93 |
| Suburban Chicago | Office $635.71 | Facility $389.42 |
| Tennessee | Office $566.56 | Facility $348.56 |
| Utah | Office $584.95 | Facility $359.52 |
| Vallejo | Office $747.66 | Facility $431.58 |
| Vermont | Office $599.96 | Facility $362.54 |
| Virgin Islands | Office $615.94 | Facility $373.49 |
| Virginia | Office $600.04 | Facility $364.30 |
| Visalia | Office $647.77 | Facility $384.93 |
| West Virginia | Office $563.27 | Facility $354.86 |
| Wisconsin | Office $583.61 | Facility $353.86 |
| Wyoming** | Office $607.66 | Facility $367.84 |
| Yuba City | Office $647.77 | Facility $384.93 |
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67916 billing questions
When should 67916 be chosen over 67914 or 67915?
Use 67916 when the documented ectropion repair includes excision of a tarsal wedge. Suture-only repair and thermocautery repair are represented by 67914 and 67915, respectively.
How does 67916 differ from 67917?
67916 represents ectropion correction by tarsal wedge excision. Choose 67917 when the operative method is an extensive ectropion repair, such as a tarsal strip operation.
Can 67916 be reported for both eyelids?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%. Document the side treated and the work performed on each eyelid.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The procedure's routine closure and care are part of the repair.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others, which are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported for 67916?
CMS has a statutory restriction on assistant-at-surgery payment 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,51367912,,Correction eyelid w/implant,A,,6.20,19.90,,5.81,,0.68,26.78,12.69,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51467914,,Repair eyelid defect,A,,3.66,10.67,,4.73,,0.34,14.67,8.73,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51567915,,Repair eyelid defect,A,,1.98,7.31,,3.25,,0.16,9.45,5.39,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51667916,,Repair eyelid defect,A,,5.34,12.52,,5.34,,0.45,18.31,11.13,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51767917,,Repair eyelid defect,A,,5.78,12.47,,5.48,,0.48,18.73,11.74,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51867921,,Repair eyelid defect,A,,3.38,10.65,,4.64,,0.26,14.29,8.28,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51967922,,Repair eyelid defect,A,,1.98,7.10,,3.25,,0.16,9.24,5.39,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00