How much does Medicare pay for CPT 67810?

Medicare allowed an average of $171.92 per service and paid $129.08 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $432.79, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67810?

Biopsy of eyelid. It was billed 6,540 times to 6,118 Medicare beneficiaries by 255 providers in 2024.

Does 67810 pay differently in an office than a hospital?

Yes. The allowed amount averaged $176.49 in an office setting and $62.42 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 67810 most?

Ophthalmology, with 3,342 services from 139 clinicians. Next are Dermatology, Physician Assistant, Plastic and Reconstructive Surgery.

CPT 67810

Biopsy of eyelid

$171.92Medicare-allowed amount per service, averaged across 6,540 services

Providers submitted

$432.79

Asking price, not received

Medicare allowed

$171.92

The fee schedule figure

Medicare paid

$129.08

Balance is patient coinsurance

Providers submitted an average of $432.79 for this code and Medicare allowed $171.92 — 2.5× 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 $129.08 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $176.49
Hospital / facility: $62.42

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. 6,278 services were billed in an office setting and 262 in a facility.

Services: 6,540
Beneficiaries: 6,118
Providers billing it: 255
Total allowed: $1,124,357

What Medicare pays for CPT 67810

Across 6,540 services billed by 255 providers to 6,118 beneficiaries, Medicare allowed an average of $171.92 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 67810

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	3,342	3,186	$167.26	139
Dermatology	2,609	2,373	$182.28	88
Physician Assistant	245	235	$147.56	8
Plastic and Reconstructive Surgery	124	114	$159.35	6
Nurse Practitioner	89	86	$143.42	6
Micrographic Dermatologic Surgery	71	68	$178.21	4
Otolaryngology	25	25	$174.80	2
General Practice	23	19	$138.66	1
Ambulatory Surgical Center	12	12	$76.17	1

67810 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
New York	1,144	$193.75	$126.20	35
Florida	1,004	$169.69	$125.02	39
California	740	$189.35	$122.87	33
Tennessee	353	$155.58	$126.93	13
Massachusetts	310	$135.99	$90.96	12
Pennsylvania	271	$166.90	$123.48	10
New Jersey	269	$197.67	$139.12	5
Mississippi	220	$143.34	$114.63	4
Texas	189	$166.78	$124.70	8
South Carolina	175	$164.38	$128.56	9
Connecticut	171	$192.38	$130.10	5
Oklahoma	138	$155.44	$122.15	5
Ohio	118	$167.01	$134.07	4
Georgia	106	$153.05	$110.19	6
Arkansas	104	$136.86	$114.32	4
North Carolina	95	$166.67	$132.19	3
Kentucky	95	$147.53	$119.25	4
Illinois	91	$178.64	$130.11	4
Virginia	87	$157.41	$117.78	5
New Mexico	83	$150.83	$120.78	2
Colorado	77	$161.06	$119.67	5
Minnesota	72	$166.26	$130.64	3
Washington	68	$174.17	$132.04	5
Arizona	63	$173.69	$131.38	4
Missouri	62	$165.95	$130.61	4
Montana	59	$178.04	$121.59	2
Oregon	56	$144.12	$101.14	4
Idaho	43	$159.69	$129.18	3
Iowa	37	$171.22	$127.43	2
Vermont	32	$175.91	$136.69	1
Kansas	32	$158.40	$118.97	2
Alabama	30	$159.87	$133.61	1
Nevada	29	$188.49	$135.44	1
Indiana	26	$167.22	$133.10	1
Michigan	23	$164.60	$134.46	2
Louisiana	17	$160.41	$124.33	1
New Hampshire	15	$62.42	$47.21	1
Maryland	13	$182.12	$134.16	1
Delaware	12	$178.91	$143.34	1
Nebraska	11	$143.06	$123.75	1

Related codes

67820Removal of eyelashes$19.86
67840Removal of growth of eyelid$253.00
67850Destruction of growth of eyelid margin$213.19
67800Removal of chronic growth of eyelid$126.17
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.