Billing code 67911: Eyelid retraction repairMedicare rate & RVUs in Illinois
Corrects an abnormally retracted eyelid without an implant, commonly to address scleral show or protect the ocular surface.
CMS doesn’t publish an office rate for 67911 in Illinois.
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 9 sections
What 67911 covers
This procedure corrects an eyelid that sits too high or is pulled away from the eye, causing visible sclera, irritation, or exposure of the ocular surface. It is commonly performed by an ophthalmologist with oculoplastic expertise for retraction associated with thyroid eye disease, scarring, or prior eyelid surgery. The operative approach adjusts the eyelid position without insertion of an implant; a repair that includes an implant belongs to the related code 67912.
Report 67911 when the documented problem is eyelid retraction and the surgeon performs a corrective repair without an implant. The operative note should identify the affected eyelid, the retracted position and clinical effect, and the repair performed. Medicare assigns 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 the others at 50%. For bilateral reporting with modifier 50, payment is at 150%. Medicare 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 67911 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $506.03 |
| East St. Louis | Unavailable | $480.57 |
| Rest Of Illinois | Unavailable | $470.04 |
| Suburban Chicago | Unavailable | $500.23 |
How the 67911 rate is calculated
Each of 67911’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 · 67911
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.31Practice expense 6.38Malpractice 0.60
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67911
67911 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67911
Eyelid retraction 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 · 67911
Eyelid retraction 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
67911 without 50 · national facility
$477.30
Eyelid retraction repair
67911-50 · Bilateral: 150%
$715.95
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).
67911 compared with similar codes
Compare codes
67911 vs 67912 vs 67901 vs 67914: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67912Eyelid weight
- Both codes correct eyelid retraction. Choose 67911 when no implant is inserted; choose 67912 when the repair includes an implant.
- 67901Ptosis repair
- 67901 addresses a drooping eyelid, not an eyelid pulled upward or away from the eye.
- 67914Ectropion repair
- 67914 treats ectropion, in which the eyelid turns outward. 67911 is for eyelid retraction.
67911 billing questions
When should 67911 be chosen over 67912?
Use 67911 for correction of eyelid retraction without an implant. When the repair includes insertion of an implant, report 67912 instead.
How is eyelid retraction different from eyelid ptosis?
Retraction means the eyelid is abnormally elevated or pulled away from the eye. Ptosis is a drooping eyelid; codes such as 67901–67908 address ptosis repair rather than retraction correction.
What documentation supports 67911?
Document the retracted eyelid and side, the effect on appearance or ocular-surface protection, and the corrective work performed. The note should also make clear whether an implant was inserted.
Does 67911 have a global period?
Yes. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How is bilateral 67911 reported?
For bilateral procedures, report modifier 50; Medicare pays the bilateral service at 150%.
Can an assistant or co-surgeon be paid for 67911?
Medicare does not pay an assistant at surgery for this code. 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 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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