$456.35
67921 is suture repair of entropion; 67923 requires excision of a tarsal wedge.
On this page
CMS RVU26D · Effective 2026-10-01
67923 Entropion repair Medicare reimbursement rates in Wisconsin
Repair inward-turning eyelid tissue by excising a tarsal wedge, typically when entropion requires more than a suture-based or thermocautery correction. Compare 67923 office and facility rates across CMS payment localities in Wisconsin.
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 67923 in Wisconsin?
Wisconsin 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
$583.08
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$353.65
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 67923: Entropion repair with tarsal wedge excision
Repair inward-turning eyelid tissue by excising a tarsal wedge, typically when entropion requires more than a suture-based or thermocautery correction.
This procedure corrects entropion, in which an eyelid turns inward and may cause lashes to rub the eye. The surgeon excises a wedge of tarsal tissue and closes the resulting defect to reposition the lid. Ophthalmologists, including oculoplastic surgeons, typically perform the repair in an operating room or an appropriately equipped outpatient surgical setting. The operative report should identify the affected eyelid and document the tarsal wedge excision and repair performed.
Report this code when the documented technique is tarsal wedge excision, rather than suture repair, thermocautery, or an extensive repair using another approach. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 67923
- 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 RVU5.34 · 29%
- Practice expense (office) RVU12.51 · 68%
- Malpractice RVU0.43 · 2%
915
Medicare services in 2024 · #3034 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.
67923 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$294.97
67922 describes thermocauterization for entropion, not tarsal wedge excision.
$621.55
67924 is an extensive entropion repair using another approach, such as a tarsal strip or capsulopalpebral fascia repair.
$467.16
67914 treats ectropion with suture repair; 67923 treats the opposite lid malposition, entropion, by tarsal wedge excision.
Compare 67923 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
Wisconsin →
Office / nonfacility
$583.08
Facility
$353.65
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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 67923 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
7,520
- Code
- 67923
- Physician work
- 5.34
- Practice expense
- 12.51
- Malpractice
- 0.43
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.34 | × 1.000 | 5.3400 |
| Practice expense | 12.51 | × 0.958 | 11.9846 |
| Malpractice | 0.43 | × 0.308 | 0.1324 |
| Total RVUs | 17.4570 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$583.08
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.34 | 1 |
| Practice expense | 12.51 | 0.958 |
| Malpractice | 0.43 | 0.308 |
(5.34 × 1 + 12.51 × 0.958 + 0.43 × 0.308) × $33.4009 = $583.08
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.34 | 1 |
| Practice expense | 5.34 | 0.958 |
| Malpractice | 0.43 | 0.308 |
(5.34 × 1 + 5.34 × 0.958 + 0.43 × 0.308) × $33.4009 = $353.65
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.
67923 billing questions
When should this code be selected instead of 67921?
Use 67923 when the surgeon corrects entropion by excising a tarsal wedge. Code 67921 describes suture-based repair.
How does 67923 differ from 67922?
Both address entropion, but 67923 is for tarsal wedge excision and 67922 is for thermocauterization.
What operative documentation supports 67923?
Document the affected eyelid, the entropion being corrected, and the tarsal wedge excision and repair actually performed.
How is bilateral repair reported?
Report modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.
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 postoperative care is 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 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.
7,51767917,,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
7,52167924,,Repair eyelid defect,A,,5.78,13.24,,5.49,,0.47,19.49,11.74,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52267930,,Repair eyelid wound,A,,3.56,7.30,,2.00,,0.33,11.19,5.89,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,52367935,,Repair eyelid wound,A,,6.20,11.38,,4.26,,0.57,18.15,11.03,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,