$778.58–$902.87
Use 67901 for a frontalis muscle technique with suture or other material. Use 67906 when the operative method is a superior rectus-based fascial sling.
On this page
CMS RVU26D · Effective 2026-10-01
67906 Ptosis repair Medicare reimbursement rates in Virginia
Surgical correction of upper eyelid ptosis using a superior rectus-based fascial sling, reported when the operative technique matches this specific repair. Compare 67906 office and facility rates across CMS payment localities in Virginia.
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 67906 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$419.20–$474.48
2 of 2 localities have a supported rate.
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 67906: Blepharoptosis repair with superior rectus sling
Surgical correction of upper eyelid ptosis using a superior rectus-based fascial sling, reported when the operative technique matches this specific repair.
CPT 67906 reports surgical correction of blepharoptosis using a superior rectus-based technique with a fascial sling to elevate the upper eyelid. An ophthalmologist, commonly an oculoplastic surgeon, performs this operation when the selected repair uses this specific muscle-and-sling approach. The code is selected by the technique documented, not simply because ptosis is severe or congenital.
The operative report should identify the affected eyelid, describe the superior rectus and sling technique, and support the medical need for repair. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 67906
- 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 RVU6.76 · 53%
- Practice expense (office) RVU5.51 · 43%
- Malpractice RVU0.53 · 4%
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.
67906 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
67902 describes frontalis suspension using an autologous fascial sling; 67906 identifies the superior rectus-based sling approach.
$594.90–$686.75
67903 is an internal ptosis repair approach. 67906 is selected for the superior rectus-based fascial sling technique.
$730.58–$843.83
67904 is an external levator-based ptosis repair. 67906 applies when the surgeon uses the superior rectus and a fascial sling.
Compare 67906 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$474.48
Virginia →
Office / nonfacility
Unavailable
Facility
$419.20
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
67906 billing questions
How is 67906 distinguished from other ptosis repairs?
Choose 67906 when the operative report documents the superior rectus-based fascial sling technique. Frontalis suspension or levator-based repairs belong to different codes.
What documentation supports reporting 67906?
Document the ptosis, the eyelid treated, the medical reason for repair, and the superior rectus-and-sling technique performed.
Does the 90-day global period include postoperative visits?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included.
How is bilateral 67906 handled?
For a bilateral procedure, report modifier 50; CMS pays the procedure at 150%.
What happens when 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%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted 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.
7,50667902,,Repair eyelid defect,A,,9.57,8.07,NA,8.07,,0.78,18.42,18.42,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,50767903,,Repair eyelid defect,A,,6.35,11.30,,5.38,,0.50,18.15,12.23,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,50867904,,Repair eyelid defect,A,,7.77,13.88,,6.79,,0.65,22.30,15.21,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,50967906,,Repair eyelid defect,A,,6.76,5.51,NA,5.51,,0.53,12.80,12.80,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51067908,,Repair eyelid defect,A,,5.17,10.77,,5.64,,0.42,16.36,11.23,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51167909,,Revise eyelid defect,A,,5.43,10.65,,5.43,,0.48,16.56,11.34,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,51267911,,Revise eyelid defect,A,,7.31,6.38,NA,6.38,,0.60,14.29,14.29,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00