$28.83
Choose 65205 for a superficial foreign body on the conjunctiva. Choose 67938 when material is embedded in the eyelid.
On this page
CMS RVU26D · Effective 2026-10-01
67938 Eyelid foreign body Medicare reimbursement rates in Colorado
Report removal of a foreign body embedded in an eyelid when the clinician extracts material from the lid rather than the conjunctiva or cornea. Compare 67938 office and facility rates across CMS payment localities in Colorado.
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 67938 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$265.40
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$103.70
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Ophthalmology
About 67938: Embedded eyelid foreign body removal
Report removal of a foreign body embedded in an eyelid when the clinician extracts material from the lid rather than the conjunctiva or cornea.
This service removes material lodged within an eyelid, such as a fragment embedded in the upper or lower lid after an injury. An ophthalmologist or another qualified physician may perform the procedure in an office or facility setting. The work addresses the eyelid itself; material on the conjunctiva or cornea calls for a site-specific foreign-body service instead. Removal may require exposing the embedded material before extracting it.
Select the code when the record identifies an embedded eyelid foreign body and supports its location, laterality, and removal. For bilateral treatment, CMS pays the service with modifier 50 at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. The procedure has a 10-day global period, which includes related postoperative visits during that period. CMS does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 67938
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU1.35 · 18%
- Practice expense (office) RVU6.14 · 81%
- Malpractice RVU0.06 · 1%
3.9K
Medicare services in 2024 · #2018 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.
67938 compared with similar codes
Office rates for Colorado, from the same CMS release.
$39.21
Choose 65210 for an embedded conjunctival foreign body. The location, not simply the depth of embedding, distinguishes it from 67938.
$66.18
Choose 65220 for a superficial corneal foreign body. Use 67938 when the embedded material is in the eyelid.
$69.27
65222 describes corneal foreign-body removal using a slit lamp. It is not the eyelid code; 67938 applies to an embedded eyelid foreign body.
Compare 67938 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
$265.40
Facility
$103.70
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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 67938 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
7,524
- Code
- 67938
- Physician work
- 1.35
- Practice expense
- 6.14
- Malpractice
- 0.06
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.35 | × 1.012 | 1.3662 |
| Practice expense | 6.14 | × 1.064 | 6.5330 |
| Malpractice | 0.06 | × 0.781 | 0.0469 |
| Total RVUs | 7.9460 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$265.40
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.35 | 1.012 |
| Practice expense | 6.14 | 1.064 |
| Malpractice | 0.06 | 0.781 |
(1.35 × 1.012 + 6.14 × 1.064 + 0.06 × 0.781) × $33.4009 = $265.40
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.35 | 1.012 |
| Practice expense | 1.59 | 1.064 |
| Malpractice | 0.06 | 0.781 |
(1.35 × 1.012 + 1.59 × 1.064 + 0.06 × 0.781) × $33.4009 = $103.70
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.
67938 billing questions
How is this different from removal of a conjunctival foreign body?
Use 67938 when the foreign body is embedded in the eyelid. A foreign body embedded in the conjunctiva is coded to the conjunctival foreign-body service instead.
Can I report a corneal foreign-body removal code for the same object?
No. Choose the code that matches the location of the material removed. If separate foreign bodies in different structures are treated, document each site and service distinctly.
What documentation supports 67938?
Record the eyelid involved, the embedded location and nature of the foreign body, and the removal performed. Document each side separately when both eyelids are treated.
How should bilateral removal be reported?
For removal from both sides, CMS identifies modifier 50 and pays the bilateral procedure at 150%. The record should establish treatment on each side.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant or co-surgeon be billed for this procedure?
CMS does not pay an assistant at surgery for 67938. 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.
7,52167924,,Repair eyelid defect,A,,5.78,13.24,,5.49,,0.47,19.49,11.74,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52267930,,Repair eyelid wound,A,,3.56,7.30,,2.00,,0.33,11.19,5.89,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52367935,,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
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899