No office rate
67971 reports an initial-stage eyelid reconstruction with a transferred flap. Use 67975 for the later operation that divides the flap.
On this page
CMS RVU26D · Effective 2026-10-01
67975 Eyelid reconstruction Medicare reimbursement rates in New Mexico
Reports the second-stage division of a transferred eyelid flap after full-thickness eyelid reconstruction, restoring separation between the reconstructed lid and donor lid. Compare 67975 office and facility rates across CMS payment localities in New Mexico.
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 67975 in New Mexico?
New Mexico 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
No supported rate
Facility setting
$563.26
1 of 1 localities have a supported rate.
Payment area: New Mexico
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 67975: Second-stage eyelid flap reconstruction
Reports the second-stage division of a transferred eyelid flap after full-thickness eyelid reconstruction, restoring separation between the reconstructed lid and donor lid.
This staged operation divides a tarsoconjunctival flap previously transferred from the opposing eyelid to rebuild a full-thickness eyelid defect. The surgeon separates the reconstructed lid from the donor lid and shapes the new lid margin. It is commonly performed by an oculoplastic ophthalmologist after the transferred tissue has healed; a typical setting is an operating room. The procedure follows the initial flap-transfer operation rather than creating the reconstruction from a new defect at this visit.
Report 67975 for the flap-division stage, not for the initial transfer. The operative note should identify the previously reconstructed eyelid, the donor lid, and the division and shaping performed. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 67975
- 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 RVU9.12 · 53%
- Practice expense (office) RVU7.41 · 43%
- Malpractice RVU0.79 · 5%
1.6K
Medicare services in 2024 · #2633 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.
67975 compared with similar codes
Office rates for New Mexico, from the same CMS release.
No office rate
67973 is an initial-stage reconstruction code; 67975 describes the subsequent flap-division stage.
No office rate
67974 belongs to the initial reconstruction stage. 67975 is selected when the previously transferred flap is divided.
Compare 67975 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
New Mexico →
Office / nonfacility
Unavailable
Facility
$563.26
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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 67975 in New Mexico.
PPRRVU2026_Oct_nonQPP.csv
7,531
- Code
- 67975
- Physician work
- 9.12
- Practice expense
- 7.41
- Malpractice
- 0.79
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.12 | × 1.000 | 9.1200 |
| Practice expense | 7.41 | × 0.917 | 6.7950 |
| Malpractice | 0.79 | × 1.201 | 0.9488 |
| Total RVUs | 16.8638 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$563.26
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.12 | 1 |
| Practice expense | 7.41 | 0.917 |
| Malpractice | 0.79 | 1.201 |
(9.12 × 1 + 7.41 × 0.917 + 0.79 × 1.201) × $33.4009 = $563.26
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.
67975 billing questions
How is 67975 different from the initial eyelid reconstruction codes?
67975 is for the later operation that divides a previously transferred flap. Codes 67971, 67973, and 67974 describe initial-stage eyelid reconstruction.
What documentation supports reporting 67975?
Document the prior flap reconstruction, the eyelid and donor site involved, and the division and shaping performed at this stage.
Is 67975 an add-on code?
No. It reports the second-stage flap division as a procedure; it is not an add-on to the initial transfer code.
Can an assistant surgeon be reported?
Medicare does not pay an assistant at surgery for 67975. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What happens if another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and 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.
7,52867971,,Reconstruction of eyelid,A,,9.76,7.62,NA,7.62,,0.81,18.19,18.19,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52967973,,Reconstruction of eyelid,A,,12.80,9.39,NA,9.39,,1.07,23.26,23.26,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53067974,,Reconstruction of eyelid,A,,12.77,9.38,NA,9.38,,1.06,23.21,23.21,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53167975,,Reconstruction of eyelid,A,,9.12,7.41,NA,7.41,,0.79,17.32,17.32,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53267999,,Unlisted procedure eyelids,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53368020,,Incise/drain eyelid lining,A,,1.38,2.16,,1.37,,0.09,3.63,2.84,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53468040,,Treatment of eyelid lesions,A,,0.83,0.98,,0.32,,0.04,1.85,1.19,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097
7704212,NM,05,NEW MEXICO,1.000,0.917,1.201
7813202,NY,01,MANHATTAN,1.064,1.162,1.586
7913202,NY,02,NYC SUBURBS/LONG ISLAND,1.064,1.189,1.857
8013202,NY,03,POUGHKPSIE/N NYC SUBURBS,1.045,1.095,1.210