Billing code 67916: Ectropion repairMedicare rate & RVUs in Iowa
Reports surgical correction of ectropion by removing a tarsal wedge to shorten and reposition an outward-turning eyelid, typically the lower lid.
Medicare pays $566.96 for 67916 in the office in Iowa (Iowa). 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 67916 covers
An ophthalmic or oculoplastic surgeon uses this procedure to correct ectropion, in which the eyelid turns outward and may expose the ocular surface. The surgeon removes a wedge of tarsal tissue to shorten the lid and improve its position against the eye. It is commonly used for lower-lid laxity, including involutional ectropion, and may be performed in an operating room or an appropriately equipped office procedure setting.
Choose this code when the operative technique includes tarsal wedge excision, rather than a suture-only or thermocautery repair or a more extensive repair. The operative note should identify the affected eyelid, the ectropion being corrected, and the wedge excision and repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery reported with modifier 50, CMS pays 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment is restricted; 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.
67916 in Iowa
| Payment locality | Office | Facility |
|---|---|---|
| Iowa | $566.96 | $347.53 |
How the 67916 rate is calculated
Each of 67916’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 · 67916
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.34Practice expense 12.52Malpractice 0.45
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67916
67916 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67916
Ectropion 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 · 67916
Ectropion 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
67916 without 50 · national office
$611.57
Ectropion repair
67916-50 · Bilateral: 150%
$917.36
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).
67916 compared with similar codes
Compare codes
67916 vs 67914 vs 67915 vs 67917 vs 67923: national Medicare rates
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How to choose
- 67914Ectropion repair
- 67914 is for ectropion repair using sutures. Use 67916 when the documented repair includes excision of a tarsal wedge.
- 67915Ectropion repair
- 67915 describes ectropion repair by thermocautery. It is distinct from the tarsal wedge excision represented by 67916.
- 67917Eyelid repair
- 67917 is for an extensive ectropion repair, such as a tarsal strip operation; 67916 is selected for repair by tarsal wedge excision.
- 67923Entropion repair
- 67923 treats entropion, where the eyelid turns inward, by tarsal wedge excision. Code 67916 is for outward-turning eyelid malposition, or ectropion.
67916 billing questions
When should 67916 be chosen over 67914 or 67915?
Use 67916 when the documented ectropion repair includes excision of a tarsal wedge. Suture-only repair and thermocautery repair are represented by 67914 and 67915, respectively.
How does 67916 differ from 67917?
67916 represents ectropion correction by tarsal wedge excision. Choose 67917 when the operative method is an extensive ectropion repair, such as a tarsal strip operation.
Can 67916 be reported for both eyelids?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%. Document the side treated and the work performed on each eyelid.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The procedure's routine closure and care are part of the repair.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others, which are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported for 67916?
CMS has 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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