CPT code 67966: Eyelid repair2026 Medicare rate & RVUs
Report 67966 when excision and repair involve a full-thickness eyelid segment extending over one-fourth of the lid margin.
Medicare pays $782.58 for 67966 nationally in the office and $554.79 in a hospital or facility. Local office rates run $705.06–$1,009.36.
Medicare rate · 67966
Eyelid repair
- Work RVUs
- 8.75
- Total RVUs
- 23.43
- Global days
- 090
National rate · 2026
$782.58
Office setting, before claim adjustments.
See every locality for 67966 →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 67966 covers
An ophthalmic or oculoplastic surgeon uses this service to remove and repair a substantial eyelid segment involving the lid margin and deeper structures, such as the tarsus and conjunctiva. A typical setting is an operating room or ambulatory surgery center, including treatment of a lesion or tumor that leaves a large full-thickness defect. The defining extent is more than one-fourth of the horizontal lid margin; this is not a code for a skin-only removal or a small defect.
The operative report should identify the affected eyelid, structures involved, amount of lid margin excised, and how the resulting defect was repaired. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays at 150%. CMS does not pay an assistant at surgery for this code; 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 67966 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
$705.06 to $1009.36
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $713.76 | $514.44 |
| Alaska* | $948.05 | $705.45 |
| Arizona | $764.63 | $543.90 |
| Arkansas | $705.06 | $509.38 |
| Atlanta | $795.82 | $564.38 |
| Austin | $807.41 | $566.41 |
| Bakersfield | $823.33 | $573.67 |
| Baltimore/Surr. Cntys | $827.05 | $582.63 |
| Beaumont | $738.92 | $531.62 |
| Brazoria | $775.36 | $549.62 |
| Chicago | $818.53 | $589.60 |
| Chico | $820.97 | $571.31 |
| Colorado | $810.57 | $568.20 |
| Connecticut | $829.43 | $584.09 |
| Dallas | $779.89 | $553.00 |
| Dc + Md/Va Suburbs | $884.06 | $615.72 |
| Delaware | $775.99 | $550.93 |
| Detroit | $783.00 | $563.18 |
| East St. Louis | $770.03 | $560.46 |
| El Centro | $821.09 | $571.43 |
| Fort Lauderdale | $808.34 | $577.59 |
| Fort Worth | $775.54 | $550.94 |
| Fresno | $820.97 | $571.31 |
| Galveston | $777.47 | $551.27 |
| Hanford-Corcoran | $820.97 | $571.31 |
| Hawaii, Guam | $836.15 | $577.15 |
| Houston | $790.83 | $564.63 |
| Idaho | $732.46 | $522.89 |
| Indiana | $736.04 | $524.87 |
| Iowa | $728.28 | $519.84 |
| Kansas | $725.76 | $519.83 |
| Kentucky | $728.79 | $526.28 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $871.64 | $602.16 |
| Madera | $820.97 | $571.31 |
| Manhattan | $891.06 | $626.36 |
| Merced | $820.97 | $571.31 |
| Metropolitan Boston | $882.28 | $610.29 |
| Metropolitan Kansas City | $753.60 | $539.70 |
| Metropolitan Philadelphia | $811.65 | $574.52 |
| Metropolitan St. Louis | $760.27 | $543.41 |
| Miami | $838.97 | $601.83 |
| Minnesota | $778.93 | $544.53 |
| Mississippi | $711.45 | $515.32 |
| Modesto | $820.97 | $571.31 |
| Montana** | $782.53 | $554.74 |
| Napa | $937.17 | $636.94 |
| Nebraska | $731.54 | $521.29 |
| Nevada** | $778.98 | $550.96 |
| New Hampshire | $798.64 | $561.51 |
| New Mexico | $748.81 | $539.92 |
| New Orleans | $758.41 | $544.05 |
| North Carolina | $742.56 | $530.03 |
| North Dakota** | $768.10 | $540.31 |
| Northern Nj | $877.20 | $612.96 |
| Nyc Suburbs/Long Island | $910.25 | $639.40 |
| Ohio | $742.24 | $534.27 |
| Oklahoma | $727.29 | $523.87 |
| Oxnard-Thousand Oaks-Ventura | $866.38 | $597.12 |
| Portland | $832.74 | $579.66 |
| Poughkpsie/N Nyc Suburbs | $845.12 | $595.69 |
| Puerto Rico | $787.34 | $557.04 |
| Queens | $896.87 | $627.61 |
| Redding | $820.97 | $571.31 |
| Rest Of California | $820.97 | $571.31 |
| Rest Of Florida | $774.35 | $556.57 |
| Rest Of Georgia | $736.94 | $533.75 |
| Rest Of Illinois | $755.77 | $547.80 |
| Rest Of Louisiana | $727.98 | $526.38 |
| Rest Of Maine | $736.09 | $526.52 |
| Rest Of Maryland | $789.10 | $558.57 |
| Rest Of Massachusetts | $807.00 | $567.14 |
| Rest Of Michigan | $745.19 | $537.22 |
| Rest Of Missouri | $717.65 | $521.29 |
| Rest Of New Jersey | $839.51 | $590.75 |
| Rest Of New York | $752.04 | $535.64 |
| Rest Of Oregon | $773.48 | $546.59 |
| Rest Of Pennsylvania | $743.03 | $533.92 |
| Rest Of Texas | $756.45 | $540.28 |
| Rest Of Washington | $805.25 | $565.38 |
| Rhode Island | $800.88 | $565.57 |
| Riverside-San Bernardino-Ontario | $828.99 | $579.33 |
| Sacramento-Roseville-Folsom | $857.74 | $592.81 |
| Salinas | $854.41 | $590.40 |
| San Diego-Chula Vista-Carlsbad | $871.51 | $599.07 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $988.19 | $667.00 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $987.36 | $666.17 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,009.36 | $680.89 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,005.98 | $677.50 |
| San Luis Obispo-Paso Robles | $841.00 | $581.55 |
| Santa Cruz-Watsonville | $877.58 | $600.81 |
| Santa Maria-Santa Barbara | $856.80 | $591.19 |
| Santa Rosa-Petaluma | $886.27 | $606.54 |
| Seattle (King Cnty) | $898.50 | $619.00 |
| South Carolina | $743.51 | $533.03 |
| South Dakota** | $766.39 | $538.60 |
| Southern Maine | $769.39 | $543.65 |
| Stockton | $820.97 | $571.31 |
| Suburban Chicago | $816.03 | $582.09 |
| Tennessee | $728.89 | $521.83 |
| Utah | $752.14 | $538.01 |
| Vallejo | $935.97 | $635.74 |
| Vermont | $765.88 | $540.36 |
| Virgin Islands | $787.34 | $557.04 |
| Virginia | $767.49 | $543.57 |
| Visalia | $820.97 | $571.31 |
| West Virginia | $732.05 | $534.10 |
| Wisconsin | $746.14 | $527.91 |
| Wyoming** | $776.24 | $548.45 |
| Yuba City | $820.97 | $571.31 |
67966 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.
$705.06
$948.05
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 | $948.05 | 1 |
| AL | $713.76 | 1 |
| AR | $705.06 | 1 |
| AZ | $764.63 | 1 |
| CA | $820.97–$1,009.36 | 29 |
| CO | $810.57 | 1 |
| CT | $829.43 | 1 |
| DC | $884.06 | 1 |
| DE | $775.99 | 1 |
| FL | $774.35–$838.97 | 3 |
| GA | $736.94–$795.82 | 2 |
| GU | $836.15 | 1 |
| HI | $836.15 | 1 |
| IA | $728.28 | 1 |
| ID | $732.46 | 1 |
| IL | $755.77–$818.53 | 4 |
| IN | $736.04 | 1 |
| KS | $725.76 | 1 |
| KY | $728.79 | 1 |
| LA | $727.98–$758.41 | 2 |
| MA | $807.00–$882.28 | 2 |
| MD | $789.10–$884.06 | 3 |
| ME | $736.09–$769.39 | 2 |
| MI | $745.19–$783.00 | 2 |
| MN | $778.93 | 1 |
| MO | $717.65–$760.27 | 3 |
| MS | $711.45 | 1 |
| MT | $782.53 | 1 |
| NC | $742.56 | 1 |
| ND | $768.10 | 1 |
| NE | $731.54 | 1 |
| NH | $798.64 | 1 |
| NJ | $839.51–$877.20 | 2 |
| NM | $748.81 | 1 |
| NV | $778.98 | 1 |
| NY | $752.04–$910.25 | 5 |
| OH | $742.24 | 1 |
| OK | $727.29 | 1 |
| OR | $773.48–$832.74 | 2 |
| PA | $743.03–$811.65 | 2 |
| PR | $787.34 | 1 |
| RI | $800.88 | 1 |
| SC | $743.51 | 1 |
| SD | $766.39 | 1 |
| TN | $728.89 | 1 |
| TX | $738.92–$807.41 | 8 |
| UT | $752.14 | 1 |
| VA | $767.49–$884.06 | 2 |
| VI | $787.34 | 1 |
| VT | $765.88 | 1 |
| WA | $805.25–$898.50 | 2 |
| WI | $746.14 | 1 |
| WV | $732.05 | 1 |
| WY | $776.24 | 1 |
How the 67966 rate is calculated
Each of 67966’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 · 67966
RVUs × geographic indexes × conversion factor
Work8.75
8.75 RVUs× 1.000 GPCI
Practice expense13.95
13.95 RVUs× 1.000 GPCI
Malpractice0.73
0.73 RVUs× 1.000 GPCI
Adjusted RVUs
23.4300
Conversion factor
$33.4009
Medicare rate
$782.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67966
67966 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67966
Eyelid 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 · 67966
Eyelid 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
67966 without 50 · national office
$782.58
Eyelid repair
67966-50 · Bilateral: 150%
$1,173.87
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).
67966 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67961Eyelid repair
- The key distinction is the amount of lid margin excised: 67961 applies to up to one-fourth, while 67966 applies to more than one-fourth.
- 67971Eyelid reconstruction
- 67971 describes eyelid reconstruction for a full-thickness defect under its own criteria; 67966 describes excision and repair of a segment extending over one-fourth of the lid margin.
- 67950Canthoplasty
- 67950 is canthoplasty. It is not the code for excision and repair of a full-thickness eyelid segment over one-fourth of the lid margin.
67966 billing questions
How is 67966 distinguished from 67961?
Both describe eyelid excision and repair involving deeper structures. Use 67966 when the excised lid-margin segment is over one-fourth of the horizontal length; 67961 is for up to one-fourth.
What documentation supports 67966?
Document the eyelid and structures involved, the extent of the excision in relation to the horizontal lid margin, and the repair performed. The record should support that the segment exceeded one-fourth of the margin.
Does the 90-day global period include postoperative visits?
Related postoperative care during the 90-day period is included, as is the day-before preoperative visit.
How does Medicare handle bilateral reporting?
For bilateral procedures reported with modifier 50, CMS pays at 150%.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for 67966. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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
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