No office rate
67909 addresses a defect revision limited to skin. 67911 is for correction of eyelid retraction.
On this page
CMS RVU26D · Effective 2026-10-01
67909 Eyelid revision Medicare reimbursement rates in Pennsylvania
Revision of an eyelid defect limited to skin, such as scar-related deformity after prior surgery or injury, without full-thickness reconstruction. Compare 67909 office and facility rates across CMS payment localities in Pennsylvania.
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 67909 in Pennsylvania?
Pennsylvania 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
$523.07–$574.06
2 of 2 localities have a supported rate.
Facility setting
$363.01–$392.56
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.
Ophthalmic surgery
About 67909: Skin-only eyelid defect revision
Revision of an eyelid defect limited to skin, such as scar-related deformity after prior surgery or injury, without full-thickness reconstruction.
Code 67909 represents revision of an eyelid defect limited to skin. An oculoplastic or plastic surgeon may excise or rearrange scarred or redundant eyelid skin to address a deformity after prior surgery or injury. The procedure is performed in an operative setting, with the approach guided by the location and extent of the skin defect; it is not the code for a defect requiring full-thickness eyelid reconstruction.
Choose this code when the operative report supports skin-only revision, and document the affected eyelid, the defect or deformity, and the tissues treated. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is used for bilateral reporting and pays at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 67909
- 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 RVU5.43 · 33%
- Practice expense (office) RVU10.65 · 64%
- Malpractice RVU0.48 · 3%
136
Medicare services in 2024 · #4634 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.
67909 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$559.70–$614.48
67961 describes excision and repair of an eyelid defect. Use 67909 when the service is a skin-only revision rather than that excision-and-repair procedure.
No office rate
67971 is a full-thickness reconstruction using tissue from the opposing eyelid. 67909 is limited to skin revision.
Compare 67909 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
Metropolitan Philadelphia →
Office / nonfacility
$574.06
Facility
$392.56
Rest Of Pennsylvania →
Office / nonfacility
$523.07
Facility
$363.01
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67909 billing questions
When is 67909 appropriate instead of an eyelid reconstruction code?
Use 67909 when the revision is limited to eyelid skin. A defect that requires full-thickness reconstruction calls for a reconstruction code selected for the procedure performed.
How is 67909 distinguished from 67911?
67909 is for revision involving skin only. Use 67911 when the service is correction of eyelid retraction rather than a skin-only defect revision.
What documentation supports 67909?
Document the eyelid and side, the skin defect or deformity, its relationship to prior surgery or injury when relevant, and the tissues revised.
Can 67909 be reported for both eyelids?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
How does the 90-day global period affect follow-up visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery services are not paid 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.
7,50867904,,Repair eyelid defect,A,,7.77,13.88,,6.79,,0.65,22.30,15.21,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,50967906,,Repair eyelid defect,A,,6.76,5.51,NA,5.51,,0.53,12.80,12.80,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51067908,,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