Billing code 67973: Eyelid reconstructionMedicare rate & RVUs in Virginia
Reports reconstruction of a full-thickness eyelid defect exceeding two-thirds of the lid using tissue transferred from the opposing eyelid.
CMS doesn’t publish an office rate for 67973 in Virginia.
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 67973 covers
An oculoplastic surgeon typically uses this service to rebuild a very large, full-thickness eyelid defect by transferring a tarsoconjunctival flap from the opposing eyelid. A common setting is reconstruction after removal of an eyelid tumor when the resulting defect involves more than two-thirds of the lid. The transferred tissue provides the inner-lid lining and structural support; the approach is associated with staged reconstruction.
Select this code when the defect size and flap method match, rather than choosing by the diagnosis alone. The operative report should identify the affected eyelid, the extent of full-thickness tissue loss, and the opposing-lid flap used. CMS 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 is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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.
Where 67973 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $859.86 |
| Virginia | Unavailable | $761.07 |
How the 67973 rate is calculated
Each of 67973’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 · 67973
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.80Practice expense 9.39Malpractice 1.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 67973
67973 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 67973
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) | 2 | Paid. |
| 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 · 67973
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
67973 without 50 · national facility
$776.90
Eyelid reconstruction
67973-50 · Bilateral: 150%
$1,165.35
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).
67973 compared with similar codes
Compare codes
67973 vs 67971 vs 67974 vs 67966: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 67971Eyelid reconstruction
- Both use an opposing-eyelid tarsoconjunctival flap. Choose 67973 when the full-thickness defect exceeds two-thirds of the eyelid; 67971 is for defects up to two-thirds.
- 67974Eyelid reconstruction
- 67974 describes the second-stage division of the transferred flap, whereas 67973 describes the reconstruction using the flap.
- 67966Eyelid repair
- 67966 is an eyelid excision-and-repair code. Use 67973 when the documented reconstruction uses the opposing-eyelid tarsoconjunctival flap for a defect exceeding two-thirds of the lid.
67973 billing questions
How is this code distinguished from 67971?
Both describe reconstruction using a tarsoconjunctival flap from the opposing eyelid. This code is for a defect exceeding two-thirds of the eyelid; 67971 covers defects up to two-thirds.
Does this code describe the later flap-division stage?
No. Code 67974 describes the second-stage division of the flap. This code describes the reconstruction using the transferred flap.
What documentation supports selecting this code?
Document the full-thickness defect, its extent relative to the eyelid, and the tarsoconjunctival flap transferred from the opposing eyelid.
How should bilateral reconstruction be reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
Are related postoperative visits separately included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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