How much does Medicare pay for CPT 67900?

Medicare allowed an average of $549.88 per service and paid $435.71 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3695.87, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67900?

Repair of brow paralysis. It was billed 16,825 times to 12,235 Medicare beneficiaries by 439 providers in 2024.

Does 67900 pay differently in an office than a hospital?

Yes. The allowed amount averaged $671.37 in an office setting and $546.84 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 67900 most?

Ambulatory Surgical Center, with 9,907 services from 176 clinicians. Next are Ophthalmology, Plastic and Reconstructive Surgery, Otolaryngology.

CPT 67900

Repair of brow paralysis

$549.88Medicare-allowed amount per service, averaged across 16,825 services

Providers submitted

$3695.87

Asking price, not received

Medicare allowed

$549.88

The fee schedule figure

Medicare paid

$435.71

Balance is patient coinsurance

Providers submitted an average of $3695.87 for this code and Medicare allowed $549.88 — 6.7× 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 $435.71 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $671.37
Hospital / facility: $546.84

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. 411 services were billed in an office setting and 16,414 in a facility.

Services: 16,825
Beneficiaries: 12,235
Providers billing it: 439
Total allowed: $9,251,731

What Medicare pays for CPT 67900

Across 16,825 services billed by 439 providers to 12,235 beneficiaries, Medicare allowed an average of $549.88 per service. That is 1.4 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 67900

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	9,907	5,349	$634.84	176
Ophthalmology	6,507	6,475	$428.63	243
Plastic and Reconstructive Surgery	282	282	$393.99	14
Otolaryngology	129	129	$482.36	6

67900 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
Texas	1,388	$533.98	$441.72	35
Florida	1,359	$586.50	$481.41	42
New York	1,228	$543.80	$405.65	20
Ohio	1,219	$575.27	$488.71	24
Tennessee	851	$515.14	$456.41	22
North Carolina	692	$538.15	$453.10	15
Minnesota	653	$569.22	$451.51	17
Pennsylvania	630	$517.30	$418.25	19
Arizona	630	$530.72	$447.36	17
Georgia	605	$533.91	$456.38	12
Mississippi	584	$487.35	$430.54	10
Maryland	542	$526.02	$416.57	11
California	530	$607.20	$434.81	21
Oklahoma	486	$564.78	$482.13	11
Utah	481	$474.88	$401.23	10
Iowa	449	$550.16	$576.44	7
Wisconsin	432	$534.11	$425.62	11
Colorado	374	$571.05	$437.57	11
North Dakota	313	$541.98	$451.06	4
Nevada	293	$560.57	$435.62	5
Virginia	262	$536.86	$447.35	5
South Dakota	253	$616.77	$538.40	3
Michigan	209	$541.25	$442.97	12
Louisiana	203	$536.15	$526.22	8
Washington	198	$681.45	$505.26	9
Arkansas	176	$535.71	$465.01	5
Maine	170	$561.15	$450.64	6
Montana	162	$557.28	$467.86	5
South Carolina	149	$579.96	$480.87	6
New Jersey	145	$660.12	$491.00	3
Massachusetts	134	$638.22	$476.35	6
Kentucky	123	$491.97	$408.03	7
Idaho	106	$551.78	$470.37	6
New Hampshire	104	$544.00	$438.40	3
Alabama	97	$477.35	$442.95	3
Alaska	76	$668.88	$471.63	3
Puerto Rico	71	$417.23	$443.08	2
Oregon	65	$736.76	$556.70	3
Nebraska	61	$617.52	$506.18	2
West Virginia	61	$447.28	$372.51	4
Kansas	43	$557.34	$498.42	2
Indiana	43	$365.69	$306.21	3
Hawaii	42	$831.05	$571.35	2
Illinois	41	$413.10	$345.48	2
Delaware	35	$762.39	$591.76	1
Rhode Island	29	$411.76	$327.01	2
Missouri	15	$426.64	$322.99	1
District of Columbia	13	$476.88	$329.83	1

Related codes

67904Repair of tendon of upper eyelid$756.97
67917Extensive repair of turning-outward eyelid defect$572.32
67908Removal of tissue$669.86
67903Shortening or advancement of upper eyelid muscle to correct drooping o$672.04
67950Reconstruction of eyelid margin$489.92
67924Extensive repair of turning-inward eyelid defect$625.44
67966Removal of over 1/4 of eyelid margin and repair of eyelid$684.96
67938Removal of embedded foreign body in eyelid$316.68
67961Removal of up to 1/4 of eyelid margin and repair of eyelid$560.01
67911Correction of widely-opened upper eyelid$512.98

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.