$161.55
Both codes describe multiple chalazia, but 67801 is for lesions on the same eyelid; 67805 is for lesions on different eyelids.
On this page
CMS RVU26D · Effective 2026-10-01
67805 Chalazion excision Medicare reimbursement rates in Vermont
Reports excision of multiple chalazia located on different eyelids, typically by an ophthalmologist treating obstructed meibomian glands. Compare 67805 office and facility rates across CMS payment localities in Vermont.
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 67805 in Vermont?
Vermont 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
$202.18
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$135.06
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Ophthalmology procedure
About 67805: Multiple chalazia on different eyelids
Reports excision of multiple chalazia located on different eyelids, typically by an ophthalmologist treating obstructed meibomian glands.
An ophthalmologist typically reports this procedure when treating multiple chalazia on different eyelids. A chalazion is a localized lump caused by blockage and inflammation of an eyelid’s meibomian gland. Treatment generally involves opening the affected area and curetting the obstructed material, often in an office setting. This code distinguishes lesions on different eyelids from multiple chalazia confined to one eyelid.
Document the chalazia treated and identify the different eyelids involved; the number and location of lesions support selection of this code over a single-lesion or same-eyelid code. CMS assigns a 10-day global period, so related postoperative visits during that period are included. 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 multiple procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 67805
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU2.21 · 36%
- Practice expense (office) RVU3.79 · 61%
- Malpractice RVU0.18 · 3%
842
Medicare services in 2024 · #3101 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.
67805 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
This is the related chalazion-excision code for the specified general-anesthesia circumstance. Choose based on the anesthesia circumstance in the applicable descriptor, not simply the number of eyelids involved.
$273.05
Use 67805 for multiple chalazia on different eyelids. Code 67840 is for excision of other eyelid lesions, rather than chalazia.
$177.83
Code 67810 represents biopsy of an eyelid lesion for diagnostic tissue sampling; 67805 represents treatment by excision of multiple chalazia on different eyelids.
Compare 67805 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
Vermont →
Office / nonfacility
$202.18
Facility
$135.06
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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 67805 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
7,492
- Code
- 67805
- Physician work
- 2.21
- Practice expense
- 3.79
- Malpractice
- 0.18
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.21 | × 1.000 | 2.2100 |
| Practice expense | 3.79 | × 0.990 | 3.7521 |
| Malpractice | 0.18 | × 0.506 | 0.0911 |
| Total RVUs | 6.0532 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$202.18
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.21 | 1 |
| Practice expense | 3.79 | 0.99 |
| Malpractice | 0.18 | 0.506 |
(2.21 × 1 + 3.79 × 0.99 + 0.18 × 0.506) × $33.4009 = $202.18
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.21 | 1 |
| Practice expense | 1.76 | 0.99 |
| Malpractice | 0.18 | 0.506 |
(2.21 × 1 + 1.76 × 0.99 + 0.18 × 0.506) × $33.4009 = $135.06
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.
67805 billing questions
When should 67805 be selected instead of 67801?
Use 67805 for multiple chalazia on different eyelids. Use 67801 when multiple chalazia are treated on the same eyelid.
Can modifier 50 be added when both eyes are treated?
No. The code describes treatment of multiple chalazia on different eyelids, and CMS identifies modifier 50 as inappropriate.
Are related postoperative visits separately reported during the global period?
Related postoperative visits for 10 days are included in the procedure’s global period.
How should the record support reporting 67805?
Document the chalazia treated and the different eyelids on which they were located. This distinguishes the service from treatment of multiple lesions on one eyelid.
Can an assistant or co-surgeon be reported for this procedure?
Medicare does not pay an assistant at surgery 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.
7,48967715,,Canthotomy,A,,1.24,6.80,,1.64,,0.18,8.22,3.06,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,49067800,,Remove eyelid lesion,A,,1.37,2.43,,1.12,,0.11,3.91,2.60,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,49167801,,Remove eyelid lesions,A,,1.86,2.93,,1.29,,0.15,4.94,3.30,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,49267805,,Remove eyelid lesions,A,,2.21,3.79,,1.76,,0.18,6.18,4.15,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,49367808,,Remove eyelid lesion(s),A,,4.49,4.70,NA,4.70,,0.37,9.56,9.56,0,090,0.10,0.70,0.20,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,49467810,,Incal bx eyelid skn lid mrgn,A,,1.15,4.16,,0.39,,0.11,5.42,1.65,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,49567820,,Revise eyelashes,A,,0.31,0.23,,0.24,,0.02,0.56,0.57,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817