$705.06–$1,009.36
The determining distinction is the amount of lid margin excised: 67961 covers no more than one-fourth, while 67966 covers more than one-fourth.
On this page
CMS RVU26D · Effective 2026-10-01
67961 Eyelid repair Medicare reimbursement rates
Reports excision and repair of an eyelid defect involving the lid margin and deeper eyelid structures when the excision spans no more than one-fourth of the margin. Compare 67961 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 67961?
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
$530.19–$776.41
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $246.22 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 67961 pays more and less
109 payment localities
$530.19 to $776.41
Ophthalmic surgery
About 67961: Full-thickness eyelid margin excision and repair
Reports excision and repair of an eyelid defect involving the lid margin and deeper eyelid structures when the excision spans no more than one-fourth of the margin.
An ophthalmologist, often an oculoplastic surgeon, reports this service when removing eyelid tissue requires excision through the margin and repair of the resulting defect. The excision may involve the tarsus and/or palpebral conjunctiva, and the affected portion must be no more than one-fourth of the lid margin. A typical setting is an operating room or ambulatory surgery center for removal of a lesion that requires this depth of excision and reconstruction.
Select the code based on the extent of lid margin removed, not just the lesion’s surface dimensions. The operative report should identify the eyelid and side, the proportion of the margin excised, involved tissue layers, and how the defect was repaired; the repair is part of this service. A 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are paid at 50%. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 67961
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.71 · 32%
- Practice expense (office) RVU11.55 · 65%
- Malpractice RVU0.47 · 3%
5.3K
Medicare services in 2024 · #1833 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.
67961 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$246.37–$372.96
67840 is for eyelid lesion excision without the full-thickness margin excision and repair represented by 67961.
No office rate
67971 describes full-thickness reconstruction using a flap from the opposing eyelid; 67961 covers excision and repair of a limited margin defect.
See how rates vary across the country
67961 · 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.
$530.19
$705.58
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 | $705.58 | 1 |
| AL | $537.16 | 1 |
| AR | $530.19 | 1 |
| AZ | $577.98 | 1 |
| CA | $625.19–$776.41 | 29 |
| CO | $615.74 | 1 |
| CT | $629.01 | 1 |
| DC | $672.94 | 1 |
| DE | $586.94 | 1 |
| FL | $583.12–$632.02 | 3 |
| GA | $553.55–$602.10 | 2 |
| GU | $638.44 | 1 |
| HI | $638.44 | 1 |
| IA | $549.94 | 1 |
| ID | $553.06 | 1 |
| IL | $567.47–$616.07 | 4 |
| IN | $555.97 | 1 |
| KS | $547.38 | 1 |
| KY | $548.04 | 1 |
| LA | $547.17–$571.57 | 2 |
| MA | $612.51–$673.13 | 2 |
| MD | $597.45–$672.94 | 3 |
| ME | $555.40–$582.93 | 2 |
| MI | $560.66–$589.46 | 2 |
| MN | $592.33 | 1 |
| MO | $538.55–$573.71 | 3 |
| MS | $534.48 | 1 |
| MT | $592.17 | 1 |
| NC | $560.68 | 1 |
| ND | $582.87 | 1 |
| NE | $552.73 | 1 |
| NH | $606.05 | 1 |
| NJ | $636.84–$667.01 | 2 |
| NM | $563.33 | 1 |
| NV | $589.96 | 1 |
| NY | $568.25–$690.77 | 5 |
| OH | $558.76 | 1 |
| OK | $547.42 | 1 |
| OR | $585.99–$634.05 | 2 |
| PA | $559.70–$614.48 | 2 |
| PR | $596.21 | 1 |
| RI | $606.86 | 1 |
| SC | $560.52 | 1 |
| SD | $581.77 | 1 |
| TN | $549.82 | 1 |
| TX | $556.36–$613.17 | 8 |
| UT | $567.45 | 1 |
| VA | $581.02–$672.94 | 2 |
| VI | $596.21 | 1 |
| VT | $580.59 | 1 |
| WA | $611.37–$686.43 | 2 |
| WI | $565.13 | 1 |
| WV | $548.43 | 1 |
| WY | $588.12 | 1 |
Compare 67961 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 $537.16 | Facility $360.64 |
| Alaska* | Office $705.58 | Facility $490.73 |
| Arizona | Office $577.98 | Facility $382.49 |
| Arkansas | Office $530.19 | Facility $356.89 |
| Atlanta | Office $602.10 | Facility $397.13 |
| Austin | Office $613.17 | Facility $399.72 |
| Bakersfield | Office $626.72 | Facility $405.61 |
| Baltimore/Surr. Cntys | Office $627.13 | Facility $410.66 |
| Beaumont | Office $556.36 | Facility $372.78 |
| Brazoria | Office $586.80 | Facility $386.87 |
| Chicago | Office $615.79 | Facility $413.04 |
| Chico | Office $625.19 | Facility $404.08 |
| Colorado | Office $615.74 | Facility $401.09 |
| Connecticut | Office $629.01 | Facility $411.74 |
| Dallas | Office $590.14 | Facility $389.21 |
| Dc + Md/Va Suburbs | Office $672.94 | Facility $435.29 |
| Delaware | Office $586.94 | Facility $387.62 |
| Detroit | Office $589.46 | Facility $394.78 |
| East St. Louis | Office $577.25 | Facility $391.65 |
| El Centro | Office $625.27 | Facility $404.16 |
| Fort Lauderdale | Office $609.90 | Facility $405.53 |
| Fort Worth | Office $586.49 | Facility $387.57 |
| Fresno | Office $625.19 | Facility $404.08 |
| Galveston | Office $588.32 | Facility $387.99 |
| Hanford-Corcoran | Office $625.19 | Facility $404.08 |
| Hawaii, Guam | Office $638.44 | Facility $409.06 |
| Houston | Office $596.93 | Facility $396.60 |
| Idaho | Office $553.06 | Facility $367.46 |
| Indiana | Office $555.97 | Facility $368.95 |
| Iowa | Office $549.94 | Facility $365.35 |
| Kansas | Office $547.38 | Facility $365.00 |
| Kentucky | Office $548.04 | Facility $368.69 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $665.34 | Facility $426.68 |
| Madera | Office $625.19 | Facility $404.08 |
| Manhattan | Office $676.10 | Facility $441.68 |
| Merced | Office $625.19 | Facility $404.08 |
| Metropolitan Boston | Office $673.13 | Facility $432.25 |
| Metropolitan Kansas City | Office $568.30 | Facility $378.87 |
| Metropolitan Philadelphia | Office $614.48 | Facility $404.46 |
| Metropolitan St. Louis | Office $573.71 | Facility $381.65 |
| Miami | Office $632.02 | Facility $422.01 |
| Minnesota | Office $592.33 | Facility $384.74 |
| Mississippi | Office $534.48 | Facility $360.78 |
| Modesto | Office $625.19 | Facility $404.08 |
| Montana** | Office $592.17 | Facility $390.43 |
| Napa | Office $719.17 | Facility $453.27 |
| Nebraska | Office $552.73 | Facility $366.52 |
| Nevada** | Office $589.96 | Facility $388.02 |
| New Hampshire | Office $606.05 | Facility $396.04 |
| New Mexico | Office $563.33 | Facility $378.34 |
| New Orleans | Office $571.57 | Facility $381.73 |
| North Carolina | Office $560.68 | Facility $372.46 |
| North Dakota** | Office $582.87 | Facility $381.13 |
| Northern Nj | Office $667.01 | Facility $432.99 |
| Nyc Suburbs/Long Island | Office $690.77 | Facility $450.90 |
| Ohio | Office $558.76 | Facility $374.57 |
| Oklahoma | Office $547.42 | Facility $367.26 |
| Oxnard-Thousand Oaks-Ventura | Office $661.83 | Facility $423.37 |
| Portland | Office $634.05 | Facility $409.92 |
| Poughkpsie/N Nyc Suburbs | Office $640.73 | Facility $419.82 |
| Puerto Rico | Office $596.21 | Facility $392.25 |
| Queens | Office $681.55 | Facility $443.10 |
| Redding | Office $625.19 | Facility $404.08 |
| Rest Of California | Office $625.19 | Facility $404.08 |
| Rest Of Florida | Office $583.12 | Facility $390.26 |
| Rest Of Georgia | Office $553.55 | Facility $373.59 |
| Rest Of Illinois | Office $567.47 | Facility $383.28 |
| Rest Of Louisiana | Office $547.17 | Facility $368.63 |
| Rest Of Maine | Office $555.40 | Facility $369.80 |
| Rest Of Maryland | Office $597.45 | Facility $393.28 |
| Rest Of Massachusetts | Office $612.51 | Facility $400.08 |
| Rest Of Michigan | Office $560.66 | Facility $376.47 |
| Rest Of Missouri | Office $538.55 | Facility $364.65 |
| Rest Of New Jersey | Office $636.84 | Facility $416.54 |
| Rest Of New York | Office $568.25 | Facility $376.59 |
| Rest Of Oregon | Office $585.99 | Facility $385.06 |
| Rest Of Pennsylvania | Office $559.70 | Facility $374.50 |
| Rest Of Texas | Office $571.00 | Facility $379.55 |
| Rest Of Washington | Office $611.37 | Facility $398.94 |
| Rhode Island | Office $606.86 | Facility $398.46 |
| Riverside-San Bernardino-Ontario | Office $630.36 | Facility $409.25 |
| Sacramento-Roseville-Folsom | Office $654.66 | Facility $420.04 |
| Salinas | Office $652.17 | Facility $418.35 |
| San Diego-Chula Vista-Carlsbad | Office $666.34 | Facility $425.06 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $759.99 | Facility $475.54 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $759.46 | Facility $475.00 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $776.41 | Facility $485.50 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $774.23 | Facility $483.31 |
| San Luis Obispo-Paso Robles | Office $641.78 | Facility $412.00 |
| Santa Cruz-Watsonville | Office $671.86 | Facility $426.75 |
| Santa Maria-Santa Barbara | Office $654.29 | Facility $419.06 |
| Santa Rosa-Petaluma | Office $678.59 | Facility $430.85 |
| Seattle (King Cnty) | Office $686.43 | Facility $438.90 |
| South Carolina | Office $560.52 | Facility $374.11 |
| South Dakota** | Office $581.77 | Facility $380.03 |
| Southern Maine | Office $582.93 | Facility $383.01 |
| Stockton | Office $625.19 | Facility $404.08 |
| Suburban Chicago | Office $616.07 | Facility $408.88 |
| Tennessee | Office $549.82 | Facility $366.44 |
| Utah | Office $567.45 | Facility $377.81 |
| Vallejo | Office $718.40 | Facility $452.50 |
| Vermont | Office $580.59 | Facility $380.86 |
| Virgin Islands | Office $596.21 | Facility $392.25 |
| Virginia | Office $581.02 | Facility $382.71 |
| Visalia | Office $625.19 | Facility $404.08 |
| West Virginia | Office $548.43 | Facility $373.11 |
| Wisconsin | Office $565.13 | Facility $371.86 |
| Wyoming** | Office $588.12 | Facility $386.37 |
| Yuba City | Office $625.19 | Facility $404.08 |
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67961 billing questions
When should 67961 be chosen instead of 67966?
Use 67961 when the excision involves no more than one-fourth of the lid margin. Use 67966 when it involves more than one-fourth.
Can the eyelid repair be billed separately?
The repair of the defect created by the excision is included in 67961. The operative report should describe the repair performed.
What documentation supports 67961?
Document the eyelid and laterality, the proportion of lid margin removed, the involved structures, and the method used to repair the defect.
How is bilateral 67961 reported?
Report the bilateral procedure with modifier 50. CMS pays bilateral procedures with modifier 50 at 150%.
Can an assistant surgeon be paid for 67961?
Assistant-at-surgery payment is available only when medical necessity is documented. CMS does not permit co-surgeons or team surgery for this code.
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.
7,52367935,,Repair eyelid wound,A,,6.20,11.38,,4.26,,0.57,18.15,11.03,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52467938,,Remove eyelid foreign body,A,,1.35,6.14,,1.59,,0.06,7.55,3.00,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52567950,,Revision of eyelid,A,,5.84,11.29,,5.56,,0.50,17.63,11.90,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52667961,,Revision of eyelid,A,,5.71,11.55,,5.51,,0.47,17.73,11.69,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52767966,,Revision of eyelid,A,,8.75,13.95,,7.13,,0.73,23.43,16.61,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52867971,,Reconstruction of eyelid,A,,9.76,7.62,NA,7.62,,0.81,18.19,18.19,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52967973,,Reconstruction of eyelid,A,,12.80,9.39,NA,9.39,,1.07,23.26,23.26,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00