No office rate
Both use an opposing-eyelid tarsoconjunctival flap. Choose 67973 when the full-thickness defect exceeds two-thirds of the eyelid; 67971 is for defects up to two-thirds.
On this page
CMS RVU26D · Effective 2026-10-01
67973 Eyelid reconstruction Medicare reimbursement rates in Delaware
Reports reconstruction of a full-thickness eyelid defect exceeding two-thirds of the lid using tissue transferred from the opposing eyelid. Compare 67973 office and facility rates across CMS payment localities in Delaware.
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 67973 in Delaware?
Delaware 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
No supported rate
Facility setting
$771.67
1 of 1 localities have a supported rate.
Payment area: Delaware
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.
Oculoplastic surgery
About 67973: Large full-thickness eyelid flap reconstruction
Reports reconstruction of a full-thickness eyelid defect exceeding two-thirds of the lid using tissue transferred from the opposing eyelid.
An oculoplastic surgeon typically uses this service to rebuild a very large, full-thickness eyelid defect by transferring a tarsoconjunctival flap from the opposing eyelid. A common setting is reconstruction after removal of an eyelid tumor when the resulting defect involves more than two-thirds of the lid. The transferred tissue provides the inner-lid lining and structural support; the approach is associated with staged reconstruction.
Select this code when the defect size and flap method match, rather than choosing by the diagnosis alone. The operative report should identify the affected eyelid, the extent of full-thickness tissue loss, and the opposing-lid flap used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 67973
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.80 · 55%
- Practice expense (office) RVU9.39 · 40%
- Malpractice RVU1.07 · 5%
1.3K
Medicare services in 2024 · #2794 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.
67973 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
67974 describes the second-stage division of the transferred flap, whereas 67973 describes the reconstruction using the flap.
$775.99
67966 is an eyelid excision-and-repair code. Use 67973 when the documented reconstruction uses the opposing-eyelid tarsoconjunctival flap for a defect exceeding two-thirds of the lid.
Compare 67973 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
Delaware →
Office / nonfacility
Unavailable
Facility
$771.67
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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 67973 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
7,529
- Code
- 67973
- Physician work
- 12.80
- Practice expense
- 9.39
- Malpractice
- 1.07
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.80 | × 1.005 | 12.8640 |
| Practice expense | 9.39 | × 0.988 | 9.2773 |
| Malpractice | 1.07 | × 0.899 | 0.9619 |
| Total RVUs | 23.1032 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$771.67
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.8 | 1.005 |
| Practice expense | 9.39 | 0.988 |
| Malpractice | 1.07 | 0.899 |
(12.8 × 1.005 + 9.39 × 0.988 + 1.07 × 0.899) × $33.4009 = $771.67
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.
67973 billing questions
How is this code distinguished from 67971?
Both describe reconstruction using a tarsoconjunctival flap from the opposing eyelid. This code is for a defect exceeding two-thirds of the eyelid; 67971 covers defects up to two-thirds.
Does this code describe the later flap-division stage?
No. Code 67974 describes the second-stage division of the flap. This code describes the reconstruction using the transferred flap.
What documentation supports selecting this code?
Document the full-thickness defect, its extent relative to the eyelid, and the tarsoconjunctival flap transferred from the opposing eyelid.
How should bilateral reconstruction be reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
Are related postoperative visits separately included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
7,52667961,,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
7,53067974,,Reconstruction of eyelid,A,,12.77,9.38,NA,9.38,,1.06,23.21,23.21,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53167975,,Reconstruction of eyelid,A,,9.12,7.41,NA,7.41,,0.79,17.32,17.32,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53267999,,Unlisted procedure eyelids,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503