No office rate
67343 addresses release of extensive scar tissue without muscle detachment. 67340 describes exploration or repair of restrictive myopathy without detaching an extraocular muscle.
On this page
CMS RVU26D · Effective 2026-10-01
67343 Scar tissue release Medicare reimbursement rates in Rhode Island
Reports release of extensive scar tissue around the eye without detaching an extraocular muscle, such as during surgery for restrictive scarring. Compare 67343 office and facility rates across CMS payment localities in Rhode Island.
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 67343 in Rhode Island?
Rhode Island 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
$595.06
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 67343: Extensive periocular scar tissue release
Reports release of extensive scar tissue around the eye without detaching an extraocular muscle, such as during surgery for restrictive scarring.
An ophthalmic surgeon uses this service to free extensive scar tissue that restricts eye movement, while leaving the extraocular muscle attached. It may be performed when prior surgery, trauma, or another process has created adhesions around the eye muscles. The operative report should identify the scar tissue released and explain its effect on movement or the surgical repair. This service is distinct from repositioning an extraocular muscle by recession or resection.
CMS classifies the procedure as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Because this is a separate procedure, document the distinct scar release rather than routine dissection integral to another operation.
CMS billing rules for 67343
- 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 RVU8.26 · 47%
- Practice expense (office) RVU8.52 · 49%
- Malpractice RVU0.67 · 4%
220
Medicare services in 2024 · #4240 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.
67343 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
67311 is for recession or resection of one horizontal muscle. Choose 67343 when the service is extensive scar release without detaching the muscle.
No office rate
67314 is for recession or resection of one vertical muscle. It does not describe a scar-release service with the muscle left attached.
Compare 67343 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$595.06
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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 67343 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,464
- Code
- 67343
- Physician work
- 8.26
- Practice expense
- 8.52
- Malpractice
- 0.67
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.26 | × 1.019 | 8.4169 |
| Practice expense | 8.52 | × 1.033 | 8.8012 |
| Malpractice | 0.67 | × 0.892 | 0.5976 |
| Total RVUs | 17.8157 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$595.06
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.26 | 1.019 |
| Practice expense | 8.52 | 1.033 |
| Malpractice | 0.67 | 0.892 |
(8.26 × 1.019 + 8.52 × 1.033 + 0.67 × 0.892) × $33.4009 = $595.06
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.
67343 billing questions
When should this be chosen instead of an eye-muscle recession or resection code?
Use this code for release of extensive scar tissue without detaching an extraocular muscle. Recession or resection codes describe changing an eye muscle's position or length.
Can routine scar dissection during another eye operation be reported separately?
This is designated as a separate procedure. The record should support a distinct, extensive scar-release service, not ordinary exposure or dissection integral to another operation.
What documentation supports reporting this service?
Document the location and extent of the scar tissue, how it restricted movement or impeded the repair, and the release performed without detaching the extraocular muscle.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are bilateral cases and additional procedures handled?
CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted. Co-surgeons are paid only with supporting documentation, and 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.
7,46167334,,Revise eye muscle w/suture,A,,2.01,0.81,NA,0.81,,0.16,2.98,2.98,0,ZZZ,0.00,0.00,0.00,0,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46267335,,Eye suture during surgery,A,,3.15,1.09,NA,1.09,,0.24,4.48,4.48,0,ZZZ,0.00,0.00,0.00,0,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46367340,,Revise eye muscle add-on,A,,4.88,1.72,NA,1.72,,0.39,6.99,6.99,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46467343,,Release eye tissue,A,,8.26,8.52,NA,8.52,,0.67,17.45,17.45,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46567345,,Destroy nerve of eye muscle,A,,2.93,4.06,,2.25,,0.53,7.52,5.71,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46667346,,Biopsy eye muscle,A,,2.80,1.81,NA,1.81,,0.21,4.82,4.82,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,46767399,,Unlisted px extraocular musc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537