How much does Medicare pay for CPT 67850?

Medicare allowed an average of $213.19 per service and paid $165.87 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $752.73, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67850?

Destruction of growth of eyelid margin, 1.0 cm or less. It was billed 6,491 times to 2,340 Medicare beneficiaries by 69 providers in 2024.

Does 67850 pay differently in an office than a hospital?

Yes. The allowed amount averaged $219.47 in an office setting and $76.32 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 67850 most?

Dermatology, with 4,980 services from 29 clinicians. Next are Ophthalmology, Optometry, Family Practice.

CPT 67850

Destruction of growth of eyelid margin, 1.0 cm or less

$213.19Medicare-allowed amount per service, averaged across 6,491 services

Providers submitted

$752.73

Asking price, not received

Medicare allowed

$213.19

The fee schedule figure

Medicare paid

$165.87

Balance is patient coinsurance

Providers submitted an average of $752.73 for this code and Medicare allowed $213.19 — 3.5× 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 $165.87 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $219.47
Hospital / facility: $76.32

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. 6,206 services were billed in an office setting and 285 in a facility.

Services: 6,491
Beneficiaries: 2,340
Providers billing it: 69
Total allowed: $1,383,816

What Medicare pays for CPT 67850

Across 6,491 services billed by 69 providers to 2,340 beneficiaries, Medicare allowed an average of $213.19 per service. That is 2.8 services per beneficiary, so this is a code patients typically receive more than once. 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 67850

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	4,980	1,245	$216.16	29
Ophthalmology	470	435	$189.13	21
Optometry	391	214	$208.08	9
Family Practice	265	156	$220.19	1
Internal Medicine	197	141	$235.40	1
Physician Assistant	114	84	$188.33	5
Micrographic Dermatologic Surgery	44	42	$199.90	2
Ambulatory Surgical Center	30	23	$69.55	1

67850 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
Maryland	3,410	$217.91	$124.62	2
New York	832	$230.83	$152.11	16
California	775	$237.78	$161.27	15
Florida	433	$206.55	$156.25	8
Texas	388	$187.88	$138.17	9
South Dakota	197	$91.34	$67.55	2
Pennsylvania	95	$127.90	$95.44	3
Massachusetts	76	$220.54	$132.75	1
North Carolina	65	$85.41	$71.53	2
Virginia	52	$220.98	$150.54	2
Michigan	47	$284.02	$218.31	2
Utah	34	$178.97	$141.54	1
Indiana	32	$216.01	$173.90	2
New Jersey	16	$223.03	$167.99	1
Illinois	15	$229.08	$180.11	1
Nebraska	13	$196.51	$156.13	1
Iowa	11	$200.54	$162.53	1

Related codes

67820Removal of eyelashes$19.86
67840Removal of growth of eyelid$253.00
67810Biopsy of eyelid$171.92
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.