Billing code 67922: Entropion repairMedicare rate & RVUs in Illinois
Reports thermocautery treatment of entropion, an inward-turning eyelid that can cause lashes to rub against the eye and irritate its surface.
Medicare pays $291.00–$319.62 for 67922 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. Which amount applies depends on the service address.
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 67922 covers
Entropion turns the eyelid margin inward, bringing the lashes into contact with the ocular surface. For this procedure, an ophthalmologist or oculoplastic surgeon uses controlled heat to create tissue contraction that helps evert the lid. It is a technique-specific option for correcting eyelid malposition; it is distinct from suture repair, tarsal wedge excision, or more extensive reconstruction. The record should identify the affected lid, the entropion and its clinical effect, and the thermocautery technique performed.
Report this code when the documented repair uses thermocautery, not simply because the patient has entropion. The 90-day global period includes the day-before preoperative visit and related postoperative care during that period. For bilateral treatment, modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. CMS lists a statutory restriction on assistant-at-surgery payment and does not permit co-surgeons or team surgery for this code.
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 67922 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.
4 payment localities
$291.00 to $319.62
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $317.19 | $187.96 |
| East St. Louis | $295.07 | $176.77 |
| Rest Of Illinois | $291.00 | $173.60 |
| Suburban Chicago | $319.62 | $187.55 |
How the 67922 rate is calculated
Each of 67922’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 · 67922
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.98Practice expense 7.10Malpractice 0.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67922
67922 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67922
Entropion 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 · 67922
Entropion 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
67922 without 50 · national office
$308.62
Entropion repair
67922-50 · Bilateral: 150%
$462.93
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).
67922 compared with similar codes
Compare codes
67922 vs 67921 vs 67923 vs 67924: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67921Entropion repair
- Choose 67922 when the repair uses thermocautery; choose 67921 when the documented method is suture repair.
- 67923Entropion repair
- 67923 describes entropion repair with tarsal wedge excision. It is not the thermocautery technique reported with 67922.
- 67924Entropion repair
- 67924 is for an extensive entropion repair. Use 67922 when the documented corrective method is thermocautery.
67922 billing questions
How does this code differ from 67921?
Both address entropion, but 67922 identifies repair using thermocautery. Code 67921 is the suture-repair approach.
When should 67923 or 67924 be considered instead?
Use 67923 when the documented repair uses tarsal wedge excision. Code 67924 describes an extensive entropion repair, rather than thermocautery.
How is bilateral treatment reported?
CMS specifies modifier 50 for bilateral reporting, with payment at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
What documentation supports 67922?
Document the affected eyelid, the entropion being treated, and that thermocautery was the repair method. The technique distinguishes this code from other entropion repair options.
Can an assistant or co-surgeon be reported?
CMS lists a statutory restriction on assistant-at-surgery payment 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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