CPT 67911
Global 090 ActiveRevise eyelid defect
CPT 67911 Billing & Documentation Guide
CPT code 67911 (Revise 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 7.31, a non-facility practice expense RVU of 6.38, and a malpractice RVU of 0.6, a total non-facility RVU of 14.29 and facility RVU of 14.29. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $488.7, though rates vary from $437.53 to $604.23 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 67911, 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 67911 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 2 units of 67911 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 67911
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 7.31 | 7.31 |
| Practice Expense RVU | 6.38 | 6.38 |
| Malpractice RVU | 0.6 | 0.6 |
| Total RVU | 14.29 | 14.29 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 67911
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 | $515.93 | $515.93 | $492.61 - $589.05 | 29 |
| Florida | $496.98 | $496.98 | $478 - $516.68 | 3 |
| Georgia | $471.8 | $471.8 | $458.13 - $485.47 | 2 |
| Illinois | $489.22 | $489.22 | $470.04 - $506.03 | 4 |
| Michigan | $472.47 | $472.47 | $461.34 - $483.59 | 2 |
| North Carolina | $455.79 | $455.79 | $455.79 - $455.79 | 1 |
| New York | $520.71 | $520.71 | $460.69 - $550.38 | 5 |
| Ohio | $458.92 | $458.92 | $458.92 - $458.92 | 1 |
| Pennsylvania | $476.51 | $476.51 | $458.72 - $494.3 | 2 |
| Texas | $473.92 | $473.92 | $456.7 - $487.86 | 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 67911
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 67911 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 |
| 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 |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 67911
What does CPT code 67911 mean? +
CPT code 67911 represents: Revise 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 67911? +
The 2026 Medicare national average non-facility payment for CPT 67911 is $488.7. Rates range from $437.53 to $604.23 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 67911? +
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 67911? +
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 2, 2026.
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