CPT code 67903: Ptosis repair2026 Medicare rate & RVUs in Rhode Island
Corrects upper eyelid ptosis through an internal approach by adjusting the levator mechanism when that technique is performed.
Medicare pays $620.91 for 67903 in the office in Rhode Island (Rhode Island). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 67903 covers
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.
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 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | $620.91 | $416.65 |
How the 67903 rate is calculated
Each of 67903’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 67903
RVUs × geographic indexes × conversion factor
Work6.35
6.35 RVUs× 1.000 GPCI
Practice expense11.30
11.30 RVUs× 1.000 GPCI
Malpractice0.50
0.50 RVUs× 1.000 GPCI
Adjusted RVUs
18.1500
Conversion factor
$33.4009
Medicare rate
$606.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 67903
67903 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67903
Ptosis repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 67903
Ptosis repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
67903 without 50 · national office
$606.23
Ptosis repair
67903-50 · Bilateral: 150%
$909.35
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
67903 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 67904Ptosis repair
- Both address upper eyelid ptosis through the levator mechanism. Choose 67903 for the internal approach and 67904 for the external approach.
- 67901Ptosis repair
- 67901 uses a frontalis muscle technique with suture or other material. 67903 adjusts the levator mechanism through an internal approach.
- 67906Ptosis repair
- 67906 describes a conjunctival and muscle resection technique, such as the Fasanella-Servat approach. 67903 is selected for internal levator adjustment.
- 67900Brow repair
- 67900 repairs brow ptosis, while 67903 corrects upper eyelid ptosis through an internal levator approach.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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