How much does Medicare pay for CPT 67924?

Medicare allowed an average of $625.44 per service and paid $494.00 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2414.67, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67924?

Extensive repair of turning-inward eyelid defect. It was billed 5,491 times to 4,681 Medicare beneficiaries by 255 providers in 2024.

Does 67924 pay differently in an office than a hospital?

Yes. The allowed amount averaged $637.46 in an office setting and $624.59 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 67924 most?

Ophthalmology, with 2,799 services from 151 clinicians. Next are Ambulatory Surgical Center, Plastic and Reconstructive Surgery.

CPT 67924

Extensive repair of turning-inward eyelid defect

$625.44Medicare-allowed amount per service, averaged across 5,491 services

Providers submitted

$2414.67

Asking price, not received

Medicare allowed

$625.44

The fee schedule figure

Medicare paid

$494.00

Balance is patient coinsurance

Providers submitted an average of $2414.67 for this code and Medicare allowed $625.44 — 3.9× 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 $494.00 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $637.46
Hospital / facility: $624.59

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. 362 services were billed in an office setting and 5,129 in a facility.

Services: 5,491
Beneficiaries: 4,681
Providers billing it: 255
Total allowed: $3,434,291

What Medicare pays for CPT 67924

Across 5,491 services billed by 255 providers to 4,681 beneficiaries, Medicare allowed an average of $625.44 per service. That is 1.2 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 67924

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	2,799	2,677	$485.72	151
Ambulatory Surgical Center	2,624	1,938	$779.90	101
Plastic and Reconstructive Surgery	68	66	$416.15	3

67924 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
California	1,054	$667.01	$455.41	18
Florida	359	$682.29	$560.57	16
Texas	296	$664.46	$530.81	15
New York	268	$644.34	$470.06	13
Illinois	232	$614.58	$483.05	12
Washington	198	$596.46	$454.12	8
Indiana	194	$628.21	$514.78	8
Massachusetts	174	$703.36	$524.98	7
Virginia	173	$584.18	$473.64	10
Ohio	167	$544.20	$458.84	11
Maryland	155	$657.89	$503.97	8
Arizona	154	$660.90	$528.62	10
North Carolina	151	$585.94	$502.11	7
Arkansas	145	$587.02	$510.50	9
Pennsylvania	142	$633.22	$512.68	9
Georgia	130	$556.21	$454.21	9
Michigan	127	$610.95	$510.71	7
Oklahoma	113	$624.37	$530.30	5
South Carolina	92	$651.06	$545.22	5
Colorado	89	$666.46	$538.05	5
Wisconsin	88	$498.53	$406.51	4
Tennessee	77	$624.97	$573.03	4
New Jersey	77	$867.95	$619.14	5
Nevada	75	$672.52	$509.77	3
Missouri	74	$480.41	$417.38	4
Mississippi	71	$528.43	$463.77	5
Kentucky	67	$559.50	$471.35	3
Alabama	66	$324.53	$304.69	4
Iowa	65	$567.57	$521.47	5
Louisiana	65	$566.62	$503.51	4
South Dakota	56	$516.08	$441.72	3
Oregon	45	$654.96	$488.84	3
Vermont	45	$616.45	$486.54	3
Delaware	44	$630.90	$484.64	2
Kansas	32	$633.57	$566.76	2
Montana	29	$651.36	$532.26	2
Minnesota	24	$691.09	$545.74	2
New Mexico	19	$491.53	$407.48	1
Utah	18	$240.53	$187.37	1
Nebraska	15	$369.09	$322.37	1
Rhode Island	14	$285.22	$248.23	1
New Hampshire	12	$448.06	$351.96	1

Related codes

67904Repair of tendon of upper eyelid$756.97
67917Extensive repair of turning-outward eyelid defect$572.32
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
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.