No office rate
67911 addresses eyelid retraction. Use 67912 when the surgeon implants an upper eyelid load to improve closure in lagophthalmos.
On this page
CMS RVU26D · Effective 2026-10-01
67912 Eyelid weight Medicare reimbursement rates in Kentucky
Reports upper eyelid weight implantation to improve closure in lagophthalmos, commonly when facial nerve weakness leaves the cornea exposed. Compare 67912 office and facility rates across CMS payment localities in Kentucky.
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 67912 in Kentucky?
Kentucky 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
$818.77
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$400.39
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Ophthalmic surgery
About 67912: Upper eyelid weight implantation for lagophthalmos
Reports upper eyelid weight implantation to improve closure in lagophthalmos, commonly when facial nerve weakness leaves the cornea exposed.
67912 covers operative placement of a weight in the upper eyelid to help the lid close when spontaneous closure is incomplete. Oculoplastic ophthalmologists commonly use a gold or platinum load for lagophthalmos related to facial nerve weakness or paralysis, which can leave the cornea exposed. The added weight helps the upper lid descend; this is different from surgery to lift a drooping eyelid. The procedure is performed in a surgical setting.
Choose this code when the operative service includes upper eyelid load implantation to address lagophthalmos. The record should support the incomplete closure, its clinical cause or consequences, the treated side, and the implant procedure. This major surgery has 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 procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 67912
- 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 RVU6.20 · 23%
- Practice expense (office) RVU19.90 · 74%
- Malpractice RVU0.68 · 3%
1.2K
Medicare services in 2024 · #2830 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.
67912 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$733.49
67901 repairs blepharoptosis using a frontalis muscle technique. It elevates a drooping lid rather than adding weight to improve closure.
$691.53
67904 repairs blepharoptosis through an external approach. It is for lid elevation, not upper eyelid loading for lagophthalmos.
Compare 67912 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
Kentucky →
Office / nonfacility
$818.77
Facility
$400.39
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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 67912 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,513
- Code
- 67912
- Physician work
- 6.20
- Practice expense
- 19.90
- Malpractice
- 0.68
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.20 | × 1.000 | 6.2000 |
| Practice expense | 19.90 | × 0.889 | 17.6911 |
| Malpractice | 0.68 | × 0.915 | 0.6222 |
| Total RVUs | 24.5133 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$818.77
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.2 | 1 |
| Practice expense | 19.9 | 0.889 |
| Malpractice | 0.68 | 0.915 |
(6.2 × 1 + 19.9 × 0.889 + 0.68 × 0.915) × $33.4009 = $818.77
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.2 | 1 |
| Practice expense | 5.81 | 0.889 |
| Malpractice | 0.68 | 0.915 |
(6.2 × 1 + 5.81 × 0.889 + 0.68 × 0.915) × $33.4009 = $400.39
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.
67912 billing questions
When should 67912 be chosen over a ptosis repair code?
Choose 67912 when an upper eyelid weight is implanted to improve closure in lagophthalmos. Ptosis repair codes address a drooping lid that needs elevation.
Does 67912 include the eyelid weight placement?
Yes. The service represented is correction of lagophthalmos by implanting an upper eyelid load; document the implantation in the operative report.
What documentation supports 67912?
Document incomplete eyelid closure, the clinical reason for treatment, the side treated, and the operative placement of the upper eyelid load.
How is bilateral 67912 reported under the CMS facts?
Use modifier 50 for a bilateral procedure. CMS pays bilateral reporting at 150%.
What global period and multiple-procedure rules apply?
The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. In the same session, the highest-valued procedure is paid in full and other procedures at 50%.
Can an assistant surgeon or co-surgeon be reported?
CMS restricts 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 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.
7,51067908,,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
7,51467914,,Repair eyelid defect,A,,3.66,10.67,,4.73,,0.34,14.67,8.73,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51567915,,Repair eyelid defect,A,,1.98,7.31,,3.25,,0.16,9.45,5.39,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51667916,,Repair eyelid defect,A,,5.34,12.52,,5.34,,0.45,18.31,11.13,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631