Billing code 67971: Eyelid reconstructionMedicare rate & RVUs

Medicare pays $607.56 for 67971 nationally in a facility.

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

What 67971 covers

This procedure rebuilds a full-thickness eyelid defect by transferring a tarsoconjunctival flap from the opposing eyelid. It is commonly used for substantial lower-eyelid defects, such as after removal of an eyelid tumor, when local tissue alone cannot restore the lid. An ophthalmologist with oculoplastic expertise typically performs the surgery in an operating room. The code covers a one-stage reconstruction or the first stage of a staged repair; the flap is generally taken from the upper eyelid to reconstruct the lower lid.

Select this code when the defect involves up to two-thirds of the eyelid and the operative method uses the opposing-lid flap. Document the defect’s extent, the donor eyelid, the flap transfer, and whether this is the first or only stage. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons require 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 67971 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

67971 rates by state

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

How the 67971 rate is calculated

Each of 67971’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 67971

67971 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

67971 compared with similar codes

How to choose

67973Eyelid reconstruction

Both codes use an opposing-eyelid tarsoconjunctival flap, but 67973 is selected when the defect exceeds two-thirds of the eyelid.

67974Eyelid reconstruction

67971 describes the one-stage or first-stage flap reconstruction for a defect up to two-thirds of the eyelid; 67974 is a related later-stage code.

67966Eyelid repair

Choose 67966 for full-thickness excision and repair of a large eyelid defect when the documented repair is not the opposing-eyelid flap reconstruction reported with 67971.

67961Eyelid repair

67961 is for full-thickness excision and repair of a smaller eyelid defect; 67971 involves a larger defect and transfer of a tarsoconjunctival flap.

Codes related to 67971

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