CPT 67902
Global 090 ActiveRepair eyelid defect
CPT 67902 Billing & Documentation Guide
CPT code 67902 (Repair eyelid defect) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 9.57, a non-facility practice expense RVU of 8.07, and a malpractice RVU of 0.78, a total non-facility RVU of 18.42 and facility RVU of 18.42. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $629.79, though rates vary from $564.6 to $780.89 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 67902, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 67902 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 67902 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 67902
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 9.57 | 9.57 |
| Practice Expense RVU | 8.07 | 8.07 |
| Malpractice RVU | 0.78 | 0.78 |
| Total RVU | 18.42 | 18.42 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 67902
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $664.18 | $664.18 | $634.47 - $757.46 | 29 |
| Florida | $640.81 | $640.81 | $616.49 - $666.13 | 3 |
| Georgia | $608.44 | $608.44 | $591.14 - $625.75 | 2 |
| Illinois | $631 | $631 | $606.46 - $652.57 | 4 |
| Michigan | $609.42 | $609.42 | $595.15 - $623.68 | 2 |
| North Carolina | $587.78 | $587.78 | $587.78 - $587.78 | 1 |
| New York | $670.92 | $670.92 | $594.03 - $708.97 | 5 |
| Ohio | $592 | $592 | $592 - $592 | 1 |
| Pennsylvania | $614.4 | $614.4 | $591.71 - $637.08 | 2 |
| Texas | $610.97 | $610.97 | $589.14 - $628.55 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 67902
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 67902 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0565T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 67902
What does CPT code 67902 mean? +
CPT code 67902 represents: Repair eyelid defect. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 67902? +
The 2026 Medicare national average non-facility payment for CPT 67902 is $629.79. Rates range from $564.6 to $780.89 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 67902? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 67902? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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