How much does Medicare pay for CPT 67917?

Medicare allowed an average of $572.32 per service and paid $452.98 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3239.02, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67917?

Extensive repair of turning-outward eyelid defect. It was billed 17,319 times to 13,519 Medicare beneficiaries by 572 providers in 2024.

Does 67917 pay differently in an office than a hospital?

Yes. The allowed amount averaged $579.65 in an office setting and $571.86 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 67917 most?

Ophthalmology, with 8,703 services from 341 clinicians. Next are Ambulatory Surgical Center, Plastic and Reconstructive Surgery, Otolaryngology.

CPT 67917

Extensive repair of turning-outward eyelid defect

$572.32Medicare-allowed amount per service, averaged across 17,319 services

Providers submitted

$3239.02

Asking price, not received

Medicare allowed

$572.32

The fee schedule figure

Medicare paid

$452.98

Balance is patient coinsurance

Providers submitted an average of $3239.02 for this code and Medicare allowed $572.32 — 5.7× 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 $452.98 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $579.65
Hospital / facility: $571.86

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. 1,012 services were billed in an office setting and 16,307 in a facility.

Services: 17,319
Beneficiaries: 13,519
Providers billing it: 572
Total allowed: $9,912,010

What Medicare pays for CPT 67917

Across 17,319 services billed by 572 providers to 13,519 beneficiaries, Medicare allowed an average of $572.32 per service. That is 1.3 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 67917

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	8,703	8,011	$429.11	341
Ambulatory Surgical Center	8,403	5,329	$726.79	222
Plastic and Reconstructive Surgery	202	168	$333.38	8
Otolaryngology	11	11	$258.52	1

67917 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	2,008	$536.48	$438.79	56
Texas	1,536	$580.18	$475.29	43
California	1,153	$676.73	$452.58	48
New York	840	$558.05	$406.57	20
Washington	750	$603.32	$443.72	21
Georgia	588	$590.24	$481.76	17
South Carolina	538	$506.67	$428.65	13
Arizona	531	$599.52	$487.18	19
Ohio	508	$492.94	$406.79	17
Maryland	489	$592.29	$459.66	18
Oklahoma	482	$547.08	$461.32	15
Pennsylvania	476	$600.13	$482.66	22
North Carolina	474	$546.75	$458.96	16
Tennessee	437	$524.01	$461.39	17
Massachusetts	422	$596.34	$431.93	16
Michigan	406	$521.61	$421.16	17
Minnesota	404	$566.26	$451.26	15
Colorado	402	$600.16	$477.77	13
Indiana	384	$552.02	$455.05	13
Utah	374	$508.26	$417.43	11
Illinois	341	$599.60	$458.79	12
Oregon	341	$627.04	$467.09	12
Missouri	327	$634.16	$542.96	9
Virginia	287	$596.22	$496.05	11
Kentucky	273	$390.96	$323.37	7
Arkansas	258	$561.26	$486.63	6
Louisiana	240	$575.22	$508.67	6
New Jersey	235	$704.00	$521.40	11
Kansas	205	$599.94	$505.93	11
Nevada	176	$612.60	$473.34	4
Iowa	161	$578.64	$507.39	7
Mississippi	149	$466.65	$415.59	5
Maine	129	$666.58	$523.94	4
Alabama	124	$515.06	$467.52	4
Wisconsin	114	$445.80	$362.57	6
Vermont	105	$645.48	$518.37	3
Montana	89	$590.93	$482.00	3
West Virginia	86	$396.87	$370.91	3
South Dakota	80	$682.20	$593.00	2
North Dakota	79	$582.93	$484.59	2
Connecticut	71	$739.41	$557.61	4
Nebraska	67	$532.84	$451.56	4
Delaware	56	$608.99	$467.07	2
New Mexico	42	$623.88	$526.39	2
Idaho	33	$565.75	$486.21	2
New Hampshire	33	$439.17	$337.45	2
District of Columbia	16	$510.67	$359.40	1

Related codes

67904Repair of tendon of upper eyelid$756.97
67900Repair of brow paralysis$549.88
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.