How much does Medicare pay for CPT 67875?

Medicare allowed an average of $128.17 per service and paid $102.10 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1261.78, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67875?

Temporary closure of eyelids by suture. It was billed 3,066 times to 2,783 Medicare beneficiaries by 116 providers in 2024.

Does 67875 pay differently in an office than a hospital?

Yes. The allowed amount averaged $70.54 in an office setting and $129.70 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 67875 most?

Ophthalmology, with 1,834 services from 73 clinicians. Next are Ambulatory Surgical Center, Plastic and Reconstructive Surgery, Otolaryngology.

CPT 67875

Temporary closure of eyelids by suture

$128.17Medicare-allowed amount per service, averaged across 3,066 services

Providers submitted

$1261.78

Asking price, not received

Medicare allowed

$128.17

The fee schedule figure

Medicare paid

$102.10

Balance is patient coinsurance

Providers submitted an average of $1261.78 for this code and Medicare allowed $128.17 — 9.8× 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 $102.10 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $70.54
Hospital / facility: $129.70

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 79 services were billed in an office setting and 2,987 in a facility.

Services: 3,066
Beneficiaries: 2,783
Providers billing it: 116
Total allowed: $392,969

What Medicare pays for CPT 67875

Across 3,066 services billed by 116 providers to 2,783 beneficiaries, Medicare allowed an average of $128.17 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 67875

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	1,834	1,715	$52.64	73
Ambulatory Surgical Center	1,155	995	$253.45	39
Plastic and Reconstructive Surgery	62	59	$48.44	3
Otolaryngology	15	14	$46.27	1

67875 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
Florida	581	$146.85	$128.52	19
Illinois	280	$120.91	$99.46	4
Texas	258	$119.47	$102.57	9
New York	199	$174.46	$118.71	4
California	174	$122.94	$90.16	11
Utah	164	$117.63	$97.53	4
Tennessee	134	$127.74	$110.18	6
Washington	123	$167.04	$130.98	6
Minnesota	123	$141.76	$110.08	5
Pennsylvania	107	$60.39	$42.58	5
Virginia	99	$56.96	$40.34	3
Nevada	72	$91.39	$73.37	3
West Virginia	71	$58.24	$50.29	2
Kentucky	70	$125.02	$105.02	4
North Carolina	70	$114.06	$96.15	4
Mississippi	69	$103.55	$90.79	3
Maryland	64	$192.13	$153.07	2
Montana	53	$157.38	$135.34	2
Indiana	46	$263.98	$214.81	1
Oklahoma	43	$109.75	$88.00	3
Kansas	42	$44.96	$36.94	1
Michigan	30	$169.70	$140.79	2
Arizona	26	$142.27	$114.94	2
Iowa	23	$140.12	$119.37	2
Alabama	23	$54.41	$45.03	1
Arkansas	23	$44.42	$37.01	2
South Carolina	20	$264.21	$206.73	1
Nebraska	17	$43.21	$36.98	1
Louisiana	17	$53.64	$36.99	1
Massachusetts	15	$252.04	$205.85	1
Georgia	15	$46.83	$36.94	1
Delaware	15	$46.27	$36.93	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
67800Removal of chronic growth of eyelid$126.17
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.