How much does Medicare pay for CPT 67800?

Medicare allowed an average of $126.17 per service and paid $92.66 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $325.56, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67800?

Removal of chronic growth of eyelid. It was billed 4,094 times to 3,847 Medicare beneficiaries by 213 providers in 2024.

Does 67800 pay differently in an office than a hospital?

Yes. The allowed amount averaged $127.30 in an office setting and $95.47 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 67800 most?

Ophthalmology, with 3,948 services from 205 clinicians. Next are Physician Assistant, Ambulatory Surgical Center, Plastic and Reconstructive Surgery.

CPT 67800

Removal of chronic growth of eyelid

$126.17Medicare-allowed amount per service, averaged across 4,094 services

Providers submitted

$325.56

Asking price, not received

Medicare allowed

$126.17

The fee schedule figure

Medicare paid

$92.66

Balance is patient coinsurance

Providers submitted an average of $325.56 for this code and Medicare allowed $126.17 — 2.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $92.66 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $127.30
Hospital / facility: $95.47

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 3,949 services were billed in an office setting and 145 in a facility.

Services: 4,094
Beneficiaries: 3,847
Providers billing it: 213
Total allowed: $516,540

What Medicare pays for CPT 67800

Across 4,094 services billed by 213 providers to 3,847 beneficiaries, Medicare allowed an average of $126.17 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 67800

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	3,948	3,715	$127.58	205
Physician Assistant	55	52	$90.52	2
Ambulatory Surgical Center	31	29	$71.00	2
Plastic and Reconstructive Surgery	24	23	$112.09	2
Dermatology	20	14	$72.15	1
Nurse Practitioner	16	14	$95.66	1

67800 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	789	$131.63	$86.13	31
New York	564	$141.42	$91.10	24
Florida	459	$119.46	$87.01	23
Pennsylvania	277	$123.66	$87.94	15
Massachusetts	249	$127.78	$86.79	12
New Jersey	158	$138.04	$94.02	9
Georgia	134	$110.97	$82.34	8
Louisiana	126	$105.78	$84.18	8
Illinois	126	$122.00	$88.44	8
Arizona	122	$120.45	$88.53	8
Texas	121	$125.51	$91.48	9
North Carolina	120	$117.43	$89.77	6
Connecticut	108	$139.34	$94.36	4
Ohio	106	$109.02	$80.00	7
Virginia	88	$126.50	$86.40	5
Tennessee	72	$115.37	$92.13	4
South Carolina	52	$119.28	$87.97	4
Montana	42	$125.00	$96.52	3
Michigan	41	$124.75	$99.14	3
Alabama	41	$110.81	$96.85	2
Arkansas	39	$110.41	$90.70	2
Maryland	39	$135.32	$93.56	3
Mississippi	37	$114.21	$90.92	3
Wisconsin	29	$109.12	$79.61	2
Minnesota	26	$121.79	$77.90	1
Colorado	21	$121.46	$88.50	1
Missouri	16	$95.66	$77.00	1
New Mexico	16	$120.26	$72.66	1
Vermont	16	$125.03	$92.26	1
Rhode Island	13	$129.53	$85.00	1
Oregon	13	$118.74	$87.06	1
Delaware	12	$133.38	$90.97	1
Nevada	11	$125.70	$80.46	1
Kentucky	11	$105.90	$74.71	1

Related codes

67820Removal of eyelashes$19.86
67840Removal of growth of eyelid$253.00
67810Biopsy of eyelid$171.92
67850Destruction of growth of eyelid margin$213.19
67875Temporary closure of eyelids by suture$128.17
67825Removal of eyelashes$118.64

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.