Choose 67961 for excision and repair of a full-thickness eyelid defect involving the canthus when the defect is up to one-fourth of the lid. Choose 67950 when the procedure is canthal reconstruction rather than defect excision and repair.
On this page
CMS RVU26D · Effective 2026-10-01
67950 Canthoplasty Medicare reimbursement rates in New Jersey
Canthoplasty reconstructs the eyelid corner to address canthal malposition or deformity when the operation centers on reshaping or restoring the canthus. Compare 67950 office and facility rates across CMS payment localities in New Jersey.
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 67950 in New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$632.97–$662.62
2 of 2 localities have a supported rate.
Facility setting
$423.98–$440.61
2 of 2 localities have a supported rate.
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 67950: Canthal reconstruction by canthoplasty
Canthoplasty reconstructs the eyelid corner to address canthal malposition or deformity when the operation centers on reshaping or restoring the canthus.
Canthoplasty surgically reshapes or reconstructs the medial or lateral canthus, the corner where the upper and lower eyelids meet. Ophthalmologists, particularly oculoplastic surgeons, may perform it to restore canthal position or support when the canthus is lax, displaced, or deformed. The operative work is directed at the canthal angle itself, rather than simply removing an eyelid lesion or repairing a larger full-thickness eyelid defect.
Report the code when the documented procedure reconstructs the canthus; the operative note should identify the site, the abnormality addressed, and the reconstruction performed. CMS assigns 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 canthoplasty reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 67950
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.84 · 33%
- Practice expense (office) RVU11.29 · 64%
- Malpractice RVU0.50 · 3%
9.1K
Medicare services in 2024 · #1526 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.
67950 compared with similar codes
Office rates for New Jersey, from the same CMS release.
67966 describes excision and repair of a full-thickness eyelid defect involving more than one-fourth of the lid. Canthoplasty focuses on reconstructing the canthal angle.
67917 is for extensive repair of ectropion, or outward turning of the eyelid. Use 67950 when the documented operation reconstructs the canthus rather than primarily correcting ectropion.
Compare 67950 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.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
$662.62
Facility
$440.61
Rest Of New Jersey →
Office / nonfacility
$632.97
Facility
$423.98
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67950 billing questions
When should I choose canthoplasty rather than an eyelid defect repair code?
Use 67950 when the operative work reconstructs the canthal angle. Codes such as 67961 or 67966 describe excision and repair of a full-thickness eyelid defect, with the applicable extent determining the code.
Does the 90-day global period include postoperative visits?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is bilateral canthoplasty reported under the CMS facts?
Report bilateral surgery with modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant-at-surgery or co-surgeon be paid?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
What happens when canthoplasty is performed with another procedure in the same session?
CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full and the others at 50%. The operative documentation should make clear what canthal reconstruction was performed.
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.
