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CMS RVU26D · Effective 2026-10-01

67903 Ptosis repair Medicare reimbursement rates in Oklahoma

Corrects upper eyelid ptosis through an internal approach by adjusting the levator mechanism when that technique is performed. Compare 67903 office and facility rates across CMS payment localities in Oklahoma.

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 67903 in Oklahoma?

Oklahoma 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

$562.12

1 of 1 localities have a supported rate.

Payment area: Oklahoma

One mapped payment locality.

Facility setting

$385.54

1 of 1 localities have a supported rate.

Payment area: Oklahoma

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.

Find 67903 in your payment locality →

Oculoplastic surgery

About 67903: Internal levator ptosis repair

Corrects upper eyelid ptosis through an internal approach by adjusting the levator mechanism when that technique is performed.

This operation elevates a drooping upper eyelid by shortening or advancing the levator mechanism through an incision on the inner eyelid surface. Ophthalmologists and oculoplastic surgeons use it for upper eyelid ptosis, including cases in which the lid obstructs the patient’s superior visual field. The operative approach distinguishes this service from ptosis repairs performed through an external skin incision or by frontalis suspension.

Report 67903 when the surgeon performs the internal levator approach; the operative note should identify the approach and the tissue adjusted. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. With modifier 50, bilateral performance is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

CMS billing rules for 67903

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 RVU6.35 · 35%
  • Practice expense (office) RVU11.30 · 62%
  • Malpractice RVU0.50 · 3%

9.7K

Medicare services in 2024 · #1485 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.

67903 compared with similar codes

Office rates for Oklahoma, from the same CMS release.

67904

Ptosis repair

External levator approach

$690.39

Both address upper eyelid ptosis through the levator mechanism. Choose 67903 for the internal approach and 67904 for the external approach.

67901

Ptosis repair

Frontalis sling, nonautologous material

$732.73

67901 uses a frontalis muscle technique with suture or other material. 67903 adjusts the levator mechanism through an internal approach.

67906

Ptosis repair

Superior rectus sling

No office rate

67906 describes a conjunctival and muscle resection technique, such as the Fasanella-Servat approach. 67903 is selected for internal levator adjustment.

67900

Brow repair

Brow ptosis

$608.74

67900 repairs brow ptosis, while 67903 corrects upper eyelid ptosis through an internal levator approach.

Compare 67903 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

Office and facility base rates · shared scale starting at $0

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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 67903 in Oklahoma.

PPRRVU2026_Oct_nonQPP.csv

7,507

Code
67903
Physician work
6.35
Practice expense
11.30
Malpractice
0.50

GPCI2026.csv

86

Locality
Oklahoma
Physician work
1.000
Practice expense
0.893
Malpractice
0.777
Office / nonfacility calculation for 67903 in Oklahoma
ComponentRVULocality factorAdjusted
Physician work6.35× 1.0006.3500
Practice expense11.30× 0.89310.0909
Malpractice0.50× 0.7770.3885
Total RVUs16.8294
Conversion factor× 33.4009

Office / nonfacility rate, Oklahoma$562.12

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work6.351
Practice expense11.30.893
Malpractice0.50.777

(6.35 × 1 + 11.3 × 0.893 + 0.5 × 0.777) × $33.4009 = $562.12

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work6.351
Practice expense5.380.893
Malpractice0.50.777

(6.35 × 1 + 5.38 × 0.893 + 0.5 × 0.777) × $33.4009 = $385.54

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.

67903 billing questions

How does 67903 differ from 67904?

67903 is for an internal approach to the levator mechanism. 67904 is used when the repair is performed through an external approach.

When is 67903 preferred over a frontalis suspension code?

Use 67903 when the surgeon adjusts the levator mechanism internally. Codes 67901 and 67902 describe frontalis muscle techniques instead.

What documentation supports reporting 67903?

The operative report should establish upper eyelid ptosis and describe the internal approach and the levator tissue adjusted. Documenting the effect of the drooping lid, such as superior visual field obstruction, supports the clinical context.

How is bilateral 67903 reported?

Report bilateral performance with modifier 50. CMS pays the bilateral procedure at 150%.

Are the preoperative visit and postoperative checks separately included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be paid for 67903?

Assistant-at-surgery payment is restricted. Co-surgeons are paid only when supporting documentation is provided; team surgery is 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.

RVUs for 67903PPRRVU2026_Oct_nonQPP.csv, line 7,507 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet