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CMS RVU26D · Effective 2026-10-01

67904 in Nevada**

Office / nonfacility

$741.68

Base rate per service

Facility setting

$504.63

Base rate per service

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.

Oculoplastic surgery

About 67904: External levator advancement for ptosis

Reports surgical correction of upper-eyelid ptosis through an external approach that resects or advances the levator mechanism to improve eyelid position.

This operation corrects upper-eyelid ptosis by reaching the levator mechanism through an external incision, typically in the eyelid crease, then shortening or advancing it to raise the lid. Ophthalmologists, including oculoplastic surgeons, perform it when the levator mechanism can be repaired and the eyelid droop warrants surgical correction. The surgeon assesses lid position and function and adjusts the repair to achieve appropriate eyelid height.

Report 67904 for the external levator approach, not a frontalis sling or an internal approach. The record should support the ptosis diagnosis, affected side, clinical findings and functional impact, and the operative method. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is not permitted.

CMS billing rules for 67904

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 paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU7.77 · 35%
  • Practice expense (office) RVU13.88 · 62%
  • Malpractice RVU0.65 · 3%

56.2K

Medicare services in 2024 · #740 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.

67904 compared with similar codes

Office rates for Nevada**, from the same CMS release.

67901

Ptosis repair

Frontalis sling, nonautologous material

$790.67

67901 describes frontalis suspension using suture or other material. Choose 67904 when the operative method is external levator resection or advancement.

67902

Ptosis repair

Frontalis sling with fascia

No office rate

67902 uses an autologous fascial sling with a frontalis technique. 67904 repairs ptosis through the levator mechanism using an external approach.

67903

Ptosis repair

Internal approach

$603.81

67903 is an internal-approach ptosis repair; 67904 is selected for an external levator approach.

67900

Brow repair

Brow ptosis

$654.73

67900 corrects a brow defect, while 67904 corrects upper-eyelid ptosis through the levator mechanism.

The same code, a different location

How does Nevada** compare?

67904 across payment areas

Same release and payment basis · bars start at $0

  1. Nevada** · This locality

    $741.68

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $833.03

    $91.35 higher than Nevada**

  3. Dc + Md/Va Suburbs

    $843.83

    $102.15 higher than Nevada**

  4. Miami

    $797.04

    $55.36 higher than Nevada**

  5. Chicago

    $777.09

    $35.41 higher than Nevada**

  6. Manhattan

    $849.28

    $107.60 higher than Nevada**

  7. Alaska*

    $894.99

    $153.31 higher than Nevada**

Other payment areas listed in Nevada appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 67904 ranges from $668.94 in Arkansas to $968.23 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 67904

    Office

    $677.47

    Facility

    $470.26

    $64.21 lower than Nevada** for the office setting.

  • Arkansas

    Arkansas · 67904

    Office

    $668.94

    Facility

    $465.52

    $72.74 lower than Nevada** for the office setting.

  • Arizona

    Arizona · 67904

    Office

    $727.34

    Facility

    $497.87

    $14.34 lower than Nevada** for the office setting.

  • Bakersfield

    California · 67904

    Office

    $785.79

    Facility

    $526.24

    $44.11 higher than Nevada** for the office setting.

  • Chico

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • El Centro

    California · 67904

    Office

    $783.79

    Facility

    $524.25

    $42.11 higher than Nevada** for the office setting.

  • Fresno

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Hanford-Corcoran

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Madera

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Merced

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Modesto

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Napa

    California · 67904

    Office

    $897.93

    Facility

    $585.82

    $156.25 higher than Nevada** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 67904

    Office

    $828.30

    Facility

    $548.39

    $86.62 higher than Nevada** for the office setting.

  • Redding

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Rest Of California

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 67904

    Office

    $790.83

    Facility

    $531.28

    $49.15 higher than Nevada** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 67904

    Office

    $819.68

    Facility

    $544.26

    $78.00 higher than Nevada** for the office setting.

  • Salinas

    California · 67904

    Office

    $816.52

    Facility

    $542.06

    $74.84 higher than Nevada** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 67904

    Office

    $833.55

    Facility

    $550.32

    $91.87 higher than Nevada** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 67904

    Office

    $947.83

    Facility

    $613.92

    $206.15 higher than Nevada** for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 67904

    Office

    $947.09

    Facility

    $613.18

    $205.41 higher than Nevada** for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 67904

    Office

    $968.23

    Facility

    $626.74

    $226.55 higher than Nevada** for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 67904

    Office

    $965.21

    Facility

    $623.73

    $223.53 higher than Nevada** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 67904

    Office

    $803.62

    Facility

    $533.89

    $61.94 higher than Nevada** for the office setting.

  • Santa Cruz-Watsonville

    California · 67904

    Office

    $839.89

    Facility

    $552.16

    $98.21 higher than Nevada** for the office setting.

  • Santa Maria-Santa Barbara

    California · 67904

    Office

    $818.99

    Facility

    $542.87

    $77.31 higher than Nevada** for the office setting.

  • Santa Rosa-Petaluma

    California · 67904

    Office

    $848.25

    Facility

    $557.45

    $106.57 higher than Nevada** for the office setting.

  • Stockton

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Vallejo

    California · 67904

    Office

    $896.87

    Facility

    $584.75

    $155.19 higher than Nevada** for the office setting.

  • Visalia

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Yuba City

    California · 67904

    Office

    $783.68

    Facility

    $524.14

    $42.00 higher than Nevada** for the office setting.

  • Colorado

    Colorado · 67904

    Office

    $772.87

    Facility

    $520.90

    $31.19 higher than Nevada** for the office setting.

  • Connecticut

    Connecticut · 67904

    Office

    $790.29

    Facility

    $535.24

    $48.61 higher than Nevada** for the office setting.

  • Delaware

    Delaware · 67904

    Office

    $738.38

    Facility

    $504.41

    $3.30 lower than Nevada** for the office setting.

  • Fort Lauderdale

    Florida · 67904

    Office

    $768.41

    Facility

    $528.52

    $26.73 higher than Nevada** for the office setting.

  • Rest Of Florida

    Florida · 67904

    Office

    $735.36

    Facility

    $508.97

    $6.32 lower than Nevada** for the office setting.

  • Atlanta

    Georgia · 67904

    Office

    $757.40

    Facility

    $516.80

    $15.72 higher than Nevada** for the office setting.

  • Rest Of Georgia

    Georgia · 67904

    Office

    $698.94

    Facility

    $487.70

    $42.74 lower than Nevada** for the office setting.

  • Hawaii, Guam

    Hawaii · 67904

    Office

    $799.21

    Facility

    $529.96

    $57.53 higher than Nevada** for the office setting.

  • Iowa

    Iowa · 67904

    Office

    $692.34

    Facility

    $475.66

    $49.34 lower than Nevada** for the office setting.

  • Idaho

    Idaho · 67904

    Office

    $696.31

    Facility

    $478.44

    $45.37 lower than Nevada** for the office setting.

  • East St. Louis

    Illinois · 67904

    Office

    $729.77

    Facility

    $511.90

    $11.91 lower than Nevada** for the office setting.

  • Rest Of Illinois

    Illinois · 67904

    Office

    $716.73

    Facility

    $500.52

    $24.95 lower than Nevada** for the office setting.

  • Suburban Chicago

    Illinois · 67904

    Office

    $775.93

    Facility

    $532.73

    $34.25 higher than Nevada** for the office setting.

  • Indiana

    Indiana · 67904

    Office

    $699.84

    Facility

    $480.31

    $41.84 lower than Nevada** for the office setting.

  • Kansas

    Kansas · 67904

    Office

    $689.57

    Facility

    $475.49

    $52.11 lower than Nevada** for the office setting.

  • Kentucky

    Kentucky · 67904

    Office

    $691.53

    Facility

    $481.01

    $50.15 lower than Nevada** for the office setting.

  • New Orleans

    Louisiana · 67904

    Office

    $720.44

    Facility

    $497.60

    $21.24 lower than Nevada** for the office setting.

  • Rest Of Louisiana

    Louisiana · 67904

    Office

    $690.61

    Facility

    $481.03

    $51.07 lower than Nevada** for the office setting.

  • Metropolitan Boston

    Massachusetts · 67904

    Office

    $843.03

    Facility

    $560.28

    $101.35 higher than Nevada** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 67904

    Office

    $769.16

    Facility

    $519.79

    $27.48 higher than Nevada** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 67904

    Office

    $787.98

    Facility

    $533.88

    $46.30 higher than Nevada** for the office setting.

  • Rest Of Maryland

    Maryland · 67904

    Office

    $751.22

    Facility

    $511.56

    $9.54 higher than Nevada** for the office setting.

  • Rest Of Maine

    Maine · 67904

    Office

    $699.55

    Facility

    $481.68

    $42.13 lower than Nevada** for the office setting.

  • Southern Maine

    Maine · 67904

    Office

    $732.66

    Facility

    $497.98

    $9.02 lower than Nevada** for the office setting.

  • Detroit

    Michigan · 67904

    Office

    $743.51

    Facility

    $514.98

    $1.83 higher than Nevada** for the office setting.

  • Rest Of Michigan

    Michigan · 67904

    Office

    $707.31

    Facility

    $491.10

    $34.37 lower than Nevada** for the office setting.

  • Minnesota

    Minnesota · 67904

    Office

    $743.00

    Facility

    $499.32

    $1.32 higher than Nevada** for the office setting.

  • Metropolitan Kansas City

    Missouri · 67904

    Office

    $716.06

    Facility

    $493.69

    $25.62 lower than Nevada** for the office setting.

  • Metropolitan St. Louis

    Missouri · 67904

    Office

    $722.63

    Facility

    $497.19

    $19.05 lower than Nevada** for the office setting.

  • Rest Of Missouri

    Missouri · 67904

    Office

    $680.30

    Facility

    $476.17

    $61.38 lower than Nevada** for the office setting.

  • Mississippi

    Mississippi · 67904

    Office

    $674.73

    Facility

    $470.84

    $66.95 lower than Nevada** for the office setting.

  • Montana**

    Montana · 67904

    Office

    $744.80

    Facility

    $507.98

    $3.12 higher than Nevada** for the office setting.

  • North Carolina

    North Carolina · 67904

    Office

    $705.94

    Facility

    $485.00

    $35.74 lower than Nevada** for the office setting.

  • North Dakota**

    North Dakota · 67904

    Office

    $731.94

    Facility

    $495.13

    $9.74 lower than Nevada** for the office setting.

  • Nebraska

    Nebraska · 67904

    Office

    $695.64

    Facility

    $477.06

    $46.04 lower than Nevada** for the office setting.

  • New Hampshire

    New Hampshire · 67904

    Office

    $761.13

    Facility

    $514.61

    $19.45 higher than Nevada** for the office setting.

  • Northern Nj

    New Jersey · 67904

    Office

    $836.84

    Facility

    $562.14

    $95.16 higher than Nevada** for the office setting.

  • Rest Of New Jersey

    New Jersey · 67904

    Office

    $799.98

    Facility

    $541.38

    $58.30 higher than Nevada** for the office setting.

  • New Mexico

    New Mexico · 67904

    Office

    $710.72

    Facility

    $493.57

    $30.96 lower than Nevada** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 67904

    Office

    $867.68

    Facility

    $586.11

    $126.00 higher than Nevada** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 67904

    Office

    $805.12

    Facility

    $545.81

    $63.44 higher than Nevada** for the office setting.

  • Queens

    New York · 67904

    Office

    $855.42

    Facility

    $575.51

    $113.74 higher than Nevada** for the office setting.

  • Rest Of New York

    New York · 67904

    Office

    $715.21

    Facility

    $490.24

    $26.47 lower than Nevada** for the office setting.

  • Ohio

    Ohio · 67904

    Office

    $704.68

    Facility

    $488.47

    $37.00 lower than Nevada** for the office setting.

  • Oklahoma

    Oklahoma · 67904

    Office

    $690.39

    Facility

    $478.92

    $51.29 lower than Nevada** for the office setting.

  • Portland

    Oregon · 67904

    Office

    $794.89

    Facility

    $531.80

    $53.21 higher than Nevada** for the office setting.

  • Rest Of Oregon

    Oregon · 67904

    Office

    $736.54

    Facility

    $500.67

    $5.14 lower than Nevada** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 67904

    Office

    $772.71

    Facility

    $526.19

    $31.03 higher than Nevada** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 67904

    Office

    $705.63

    Facility

    $488.24

    $36.05 lower than Nevada** for the office setting.

  • Puerto Rico

    Puerto Rico · 67904

    Office

    $749.61

    Facility

    $510.20

    $7.93 higher than Nevada** for the office setting.

  • Rhode Island

    Rhode Island · 67904

    Office

    $762.73

    Facility

    $518.10

    $21.05 higher than Nevada** for the office setting.

  • South Carolina

    South Carolina · 67904

    Office

    $706.35

    Facility

    $487.53

    $35.33 lower than Nevada** for the office setting.

  • South Dakota**

    South Dakota · 67904

    Office

    $730.42

    Facility

    $493.61

    $11.26 lower than Nevada** for the office setting.

  • Tennessee

    Tennessee · 67904

    Office

    $692.60

    Facility

    $477.34

    $49.08 lower than Nevada** for the office setting.

  • Austin

    Texas · 67904

    Office

    $769.77

    Facility

    $519.23

    $28.09 higher than Nevada** for the office setting.

  • Beaumont

    Texas · 67904

    Office

    $701.57

    Facility

    $486.07

    $40.11 lower than Nevada** for the office setting.

  • Brazoria

    Texas · 67904

    Office

    $737.97

    Facility

    $503.29

    $3.71 lower than Nevada** for the office setting.

  • Dallas

    Texas · 67904

    Office

    $742.24

    Facility

    $506.37

    $0.56 higher than Nevada** for the office setting.

  • Fort Worth

    Texas · 67904

    Office

    $737.88

    Facility

    $504.39

    $3.80 lower than Nevada** for the office setting.

  • Galveston

    Texas · 67904

    Office

    $739.94

    Facility

    $504.78

    $1.74 lower than Nevada** for the office setting.

  • Houston

    Texas · 67904

    Office

    $751.83

    Facility

    $516.68

    $10.15 higher than Nevada** for the office setting.

  • Rest Of Texas

    Texas · 67904

    Office

    $719.09

    Facility

    $494.36

    $22.59 lower than Nevada** for the office setting.

  • Utah

    Utah · 67904

    Office

    $714.81

    Facility

    $492.21

    $26.87 lower than Nevada** for the office setting.

  • Virginia

    Virginia · 67904

    Office

    $730.58

    Facility

    $497.79

    $11.10 lower than Nevada** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 67904

    Office

    $749.61

    Facility

    $510.20

    $7.93 higher than Nevada** for the office setting.

  • Vermont

    Vermont · 67904

    Office

    $729.48

    Facility

    $495.03

    $12.20 lower than Nevada** for the office setting.

  • Rest Of Washington

    Washington · 67904

    Office

    $767.60

    Facility

    $518.23

    $25.92 higher than Nevada** for the office setting.

  • Seattle (King Cnty)

    Washington · 67904

    Office

    $859.08

    Facility

    $568.51

    $117.40 higher than Nevada** for the office setting.

  • Wisconsin

    Wisconsin · 67904

    Office

    $710.34

    Facility

    $483.48

    $31.34 lower than Nevada** for the office setting.

  • West Virginia

    West Virginia · 67904

    Office

    $693.47

    Facility

    $487.68

    $48.21 lower than Nevada** for the office setting.

  • Wyoming**

    Wyoming · 67904

    Office

    $739.20

    Facility

    $502.38

    $2.48 lower than Nevada** for the office setting.

See how rates vary across the country

67904 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$668.94

$894.99

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$894.991
AL$677.471
AR$668.941
AZ$727.341
CA$783.68–$968.2329
CO$772.871
CT$790.291
DC$843.831
DE$738.381
FL$735.36–$797.043
GA$698.94–$757.402
GU$799.211
HI$799.211
IA$692.341
ID$696.311
IL$716.73–$777.094
IN$699.841
KS$689.571
KY$691.531
LA$690.61–$720.442
MA$769.16–$843.032
MD$751.22–$843.833
ME$699.55–$732.662
MI$707.31–$743.512
MN$743.001
MO$680.30–$722.633
MS$674.731
MT$744.801
NC$705.941
ND$731.941
NE$695.641
NH$761.131
NJ$799.98–$836.842
NM$710.721
NV$741.681
NY$715.21–$867.685
OH$704.681
OK$690.391
OR$736.54–$794.892
PA$705.63–$772.712
PR$749.611
RI$762.731
SC$706.351
SD$730.421
TN$692.601
TX$701.57–$769.778
UT$714.811
VA$730.58–$843.832
VI$749.611
VT$729.481
WA$767.60–$859.082
WI$710.341
WV$693.471
WY$739.201

Explore 67904 on the national rate map →

Where does this rate apply?

Nevada** is a Medicare payment area. Our Census mapping connects it to 138 cities and communities in Nevada, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Nevada →

Why are the office and facility amounts different?

For 67904 in Nevada**, the physician’s office rate is $741.68 and the facility-setting rate is $504.63: a difference of $237.05.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 67904 in Nevada**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$815.85

$741.68 × 110% = $815.85

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 67904 in Nevada**.

PPRRVU2026_Oct_nonQPP.csv

7,508

Code
67904
Physician work
7.77
Practice expense
13.88
Malpractice
0.65

GPCI2026.csv

73

Locality
Nevada**
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office / nonfacility calculation for 67904 in Nevada**
ComponentRVULocality factorAdjusted
Physician work7.77× 1.0007.7700
Practice expense13.88× 1.00113.8939
Malpractice0.65× 0.8330.5414
Total RVUs22.2053
Conversion factor× 33.4009

Office / nonfacility rate, Nevada**$741.68

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 67904 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work7.771
Practice expense13.881.001
Malpractice0.650.833

(7.77 × 1 + 13.88 × 1.001 + 0.65 × 0.833) × $33.4009 = $741.68

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work7.771
Practice expense6.791.001
Malpractice0.650.833

(7.77 × 1 + 6.79 × 1.001 + 0.65 × 0.833) × $33.4009 = $504.63

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

67904 · Office / nonfacility

$741.68

Effective 2026-10-01

The base rate is $35.65 higher than on 2025-10-01, moving from $706.03 to $741.68 (5.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $706.03changed to$741.68

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.97 changed to 7.77
    • Practice expense RVU 13.30 changed to 13.88
    • Malpractice RVU 0.66 changed to 0.65
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $706.03

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$741.68$504.63RVU26D
2026-07-01$741.68$504.63RVU26C
2026-04-01$741.68$504.63RVU26B
2026-01-01$741.68$504.63RVU26A
2025-10-01$706.03$569.20RVU25D
2025-07-01$706.03$569.20RVU25C
2025-04-01$706.03$569.20RVU25B
2025-01-01$706.03$569.20RVU25A

67904 billing questions

When should 67904 be selected instead of a frontalis sling code?

Use 67904 when the surgeon corrects ptosis by externally resecting or advancing the levator mechanism. Frontalis suspension codes describe a different operative technique.

How does 67904 differ from an internal ptosis repair?

67904 uses an external approach to the levator mechanism. Select an internal-approach code when the operative report documents correction through the inside of the eyelid.

Does the 90-day global period include routine postoperative visits?

Yes. Related postoperative care for 90 days and the preoperative visit on the day before surgery are included in the global period.

How is bilateral 67904 paid?

CMS pays bilateral surgery reported with modifier 50 at 150%.

Can an assistant or co-surgeon be reported for 67904?

Assistant-at-surgery payment is restricted. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

What happens when 67904 is performed with another procedure in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

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.

RVUs for 67904PPRRVU2026_Oct_nonQPP.csv, line 7,508 (RVU26D)
Geographic factors for Nevada**GPCI2026.csv, line 73 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet