$627.14
Both address entropion, but 67916 is for a suture repair. Report 67917 when the operative correction is extensive.
On this page
CMS RVU26D · Effective 2026-10-01
67917 Eyelid repair Medicare reimbursement rates in Rhode Island
Reports extensive surgical correction of an eyelid turned inward, typically when the repair requires more than a simple suture technique. Compare 67917 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 67917 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
$641.28
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$400.10
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 67917: Extensive entropion repair
Reports extensive surgical correction of an eyelid turned inward, typically when the repair requires more than a simple suture technique.
Entropion turns the eyelid margin inward, allowing lashes to rub the ocular surface and cause irritation, tearing, or corneal injury. This code describes an extensive surgical correction, such as a repair involving substantial lid repositioning or tissue work, rather than a simple suture repair. Ophthalmologists and oculoplastic surgeons commonly perform the procedure, often for involutional lower-lid entropion, in an operating room or an appropriately equipped outpatient surgical setting.
Select the code based on the operative technique and extent documented, not symptoms alone; the note should identify the affected eyelid, the entropion, and the corrective work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral surgery, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 67917
- 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 RVU5.78 · 31%
- Practice expense (office) RVU12.47 · 67%
- Malpractice RVU0.48 · 3%
27K
Medicare services in 2024 · #1014 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.
67917 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$317.13
67922 identifies entropion correction by tarsal wedge excision. Choose according to the specific procedure documented rather than treating the codes as interchangeable.
$324.38
67915 treats ectropion, in which the eyelid turns outward; 67917 treats entropion, in which it turns inward.
Compare 67917 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
$641.28
Facility
$400.10
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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 67917 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,517
- Code
- 67917
- Physician work
- 5.78
- Practice expense
- 12.47
- Malpractice
- 0.48
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.78 | × 1.019 | 5.8898 |
| Practice expense | 12.47 | × 1.033 | 12.8815 |
| Malpractice | 0.48 | × 0.892 | 0.4282 |
| Total RVUs | 19.1995 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$641.28
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.78 | 1.019 |
| Practice expense | 12.47 | 1.033 |
| Malpractice | 0.48 | 0.892 |
(5.78 × 1.019 + 12.47 × 1.033 + 0.48 × 0.892) × $33.4009 = $641.28
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.78 | 1.019 |
| Practice expense | 5.48 | 1.033 |
| Malpractice | 0.48 | 0.892 |
(5.78 × 1.019 + 5.48 × 1.033 + 0.48 × 0.892) × $33.4009 = $400.10
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.
67917 billing questions
How is this distinguished from 67916?
67917 is for extensive entropion correction. Use 67916 when the documented repair is a suture technique rather than an extensive repair.
What documentation supports reporting 67917?
Document the affected eyelid, the inward turning, and the operative technique and extent of correction. The record should support an extensive repair rather than a simple suture correction.
Can modifier 50 be used when both eyelids are treated?
Yes. CMS lists this as a bilateral procedure; bilateral reporting with modifier 50 is paid at 150%.
Does the code include routine postoperative visits?
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 reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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 the 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.
7,51467914,,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
7,51567915,,Repair eyelid defect,A,,1.98,7.31,,3.25,,0.16,9.45,5.39,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51667916,,Repair eyelid defect,A,,5.34,12.52,,5.34,,0.45,18.31,11.13,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51767917,,Repair eyelid defect,A,,5.78,12.47,,5.48,,0.48,18.73,11.74,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51867921,,Repair eyelid defect,A,,3.38,10.65,,4.64,,0.26,14.29,8.28,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51967922,,Repair eyelid defect,A,,1.98,7.10,,3.25,,0.16,9.24,5.39,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52067923,,Repair eyelid defect,A,,5.34,12.51,,5.34,,0.43,18.28,11.11,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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