$570.09
This code uses posterior conjunctiva and Müller muscle resection, with or without tarsus. Code 67903 represents a different levator resection or advancement technique.
On this page
CMS RVU26D · Effective 2026-10-01
67908 Ptosis repair Medicare reimbursement rates in Indiana
Reports surgical elevation of a drooping upper eyelid by resecting conjunctiva and Müller muscle, sometimes with tarsus, using a posterior approach. Compare 67908 office and facility rates across CMS payment localities in Indiana.
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 67908 in Indiana?
Indiana 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
$512.97
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
$354.13
1 of 1 localities have a supported rate.
Payment area: Indiana
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 67908: Posterior approach ptosis repair
Reports surgical elevation of a drooping upper eyelid by resecting conjunctiva and Müller muscle, sometimes with tarsus, using a posterior approach.
This code describes repair of upper eyelid ptosis through a posterior approach. The surgeon removes a portion of conjunctiva and Müller muscle to elevate the lid; tarsus may also be resected. Oculoplastic ophthalmologists typically perform the procedure in an operating room, often for a patient whose upper lid droops enough to obstruct vision or impair visual function. It is distinct from repairs using a frontalis sling or an external levator approach.
Select the code when the operative report supports the posterior conjunctiva-and-Müller-muscle technique, with or without tarsal resection. Document the affected lid, the ptosis and its functional impact, and the tissue and approach used. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For bilateral reporting, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 67908
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.17 · 32%
- Practice expense (office) RVU10.77 · 66%
- Malpractice RVU0.42 · 3%
10.8K
Medicare services in 2024 · #1431 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.
67908 compared with similar codes
Office rates for Indiana, from the same CMS release.
$699.84
This code is a posterior approach involving conjunctiva and Müller muscle. Code 67904 uses an external levator approach.
$744.58
This code repairs ptosis by posterior tissue resection. Code 67901 uses a frontalis muscle technique with suture or other material.
$617.03
Code 67900 treats brow ptosis, not drooping of the eyelid itself. Select based on the anatomic structure repaired.
Compare 67908 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
Indiana →
Office / nonfacility
$512.97
Facility
$354.13
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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 67908 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
7,510
- Code
- 67908
- Physician work
- 5.17
- Practice expense
- 10.77
- Malpractice
- 0.42
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.17 | × 1.000 | 5.1700 |
| Practice expense | 10.77 | × 0.927 | 9.9838 |
| Malpractice | 0.42 | × 0.486 | 0.2041 |
| Total RVUs | 15.3579 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$512.97
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.17 | 1 |
| Practice expense | 10.77 | 0.927 |
| Malpractice | 0.42 | 0.486 |
(5.17 × 1 + 10.77 × 0.927 + 0.42 × 0.486) × $33.4009 = $512.97
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.17 | 1 |
| Practice expense | 5.64 | 0.927 |
| Malpractice | 0.42 | 0.486 |
(5.17 × 1 + 5.64 × 0.927 + 0.42 × 0.486) × $33.4009 = $354.13
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.
67908 billing questions
How does this differ from 67903 or 67904?
This code is for posterior resection of conjunctiva and Müller muscle, with or without tarsus. Codes 67903 and 67904 describe different levator resection or advancement approaches; use the operative technique to distinguish them.
When is this code chosen instead of a frontalis sling code?
Use this code for the posterior conjunctiva-and-Müller-muscle resection technique. Codes 67901 and 67902 describe frontalis muscle techniques, including sling approaches.
Can modifier 50 be reported for both eyelids?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. The operative and follow-up documentation should support the ptosis repair and the technique performed.
Can an assistant surgeon or co-surgeon be paid?
CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session affected?
Under the standard multiple procedure rule, 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.
7,50767903,,Repair eyelid defect,A,,6.35,11.30,,5.38,,0.50,18.15,12.23,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,50867904,,Repair eyelid defect,A,,7.77,13.88,,6.79,,0.65,22.30,15.21,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,50967906,,Repair eyelid defect,A,,6.76,5.51,NA,5.51,,0.53,12.80,12.80,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51067908,,Repair eyelid defect,A,,5.17,10.77,,5.64,,0.42,16.36,11.23,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51167909,,Revise eyelid defect,A,,5.43,10.65,,5.43,,0.48,16.56,11.34,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51267911,,Revise eyelid defect,A,,7.31,6.38,NA,6.38,,0.60,14.29,14.29,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51367912,,Correction eyelid w/implant,A,,6.20,19.90,,5.81,,0.68,26.78,12.69,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915