Billing code 67975: Eyelid reconstructionMedicare rate & RVUs in Utah
Reports the second-stage division of a transferred eyelid flap after full-thickness eyelid reconstruction, restoring separation between the reconstructed lid and donor lid.
CMS doesn’t publish an office rate for 67975 in Utah.
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 67975 covers
This staged operation divides a tarsoconjunctival flap previously transferred from the opposing eyelid to rebuild a full-thickness eyelid defect. The surgeon separates the reconstructed lid from the donor lid and shapes the new lid margin. It is commonly performed by an oculoplastic ophthalmologist after the transferred tissue has healed; a typical setting is an operating room. The procedure follows the initial flap-transfer operation rather than creating the reconstruction from a new defect at this visit.
Report 67975 for the flap-division stage, not for the initial transfer. The operative note should identify the previously reconstructed eyelid, the donor lid, and the division and shaping performed. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are 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.
67975 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $560.96 |
How the 67975 rate is calculated
Each of 67975’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 · 67975
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.12Practice expense 7.41Malpractice 0.79
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67975
67975 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67975
Eyelid reconstruction
| 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) | 0 | Not permitted. |
| 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 · 67975
Eyelid reconstruction
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
67975 without 50 · national facility
$578.50
Eyelid reconstruction
67975-50 · Bilateral: 150%
$867.75
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).
67975 compared with similar codes
Compare codes
67975 vs 67971 vs 67973 vs 67974: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67971Eyelid reconstruction
- 67971 reports an initial-stage eyelid reconstruction with a transferred flap. Use 67975 for the later operation that divides the flap.
- 67973Eyelid reconstruction
- 67973 is an initial-stage reconstruction code; 67975 describes the subsequent flap-division stage.
- 67974Eyelid reconstruction
- 67974 belongs to the initial reconstruction stage. 67975 is selected when the previously transferred flap is divided.
67975 billing questions
How is 67975 different from the initial eyelid reconstruction codes?
67975 is for the later operation that divides a previously transferred flap. Codes 67971, 67973, and 67974 describe initial-stage eyelid reconstruction.
What documentation supports reporting 67975?
Document the prior flap reconstruction, the eyelid and donor site involved, and the division and shaping performed at this stage.
Is 67975 an add-on code?
No. It reports the second-stage flap division as a procedure; it is not an add-on to the initial transfer code.
Can an assistant surgeon be reported?
Medicare does not pay an assistant at surgery for 67975. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 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 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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