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See a sample rate comparisonCPT 67909 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Reduce Ptosis Overcorrection
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None E1 - Upper left, eyelid E3 - Upper right, eyelid |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 67909 |
| Medicaid Fee Schedule | View Medicaid rates for 67909 |
National average reimbursement for CPT 67909 by major payers:
$651.50
$700.53
$752.75
$870.46
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CPT 67909
5 of 25 sample ratesHigher to lower in this preview
Advanced Ambulatory Surgical Care, Lp, Advanced Surgical Care
Advanced Ambulatory Surgical Care Lp
$2,827.00Published rateSurgery Center Of Georgetown, LLC, Georgetown Surgery Center
Surgery Center Of Georgetown LLC
$2,164.00Published rateFirst Street Surgery Center Inc.
First Street Surgery Center Inc
$1,400.00Published rateMarin Ophthalmic Surgery Center
$1,072.50Published rateAmbulatory Surgery Center Of Wny
$783.71Published rate
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See a sample payer proposalCPT 67909 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67909 code is part of the Surgery services used for Surgical Procedures on the Eye and Ocular Adnexa. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 67909 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 67908-CPT | Moderate | Rpair Of Blepharoptosis; Conjunctivo-Tarso-Mullers Muscl-Levator, Repair Of Blepharoptosis; Conjunctivo-Tarso-Mullers Muscle-Levator Re |
| 67909-CPT | Moderate | Reduce Ptosis Overcorrection |
| 67911-CPT | Moderate | Correction Of Lid Retraction |
| 67912-CPT | High | Implant Weight In Eyelid, Surgery To Implant A Weight In The Eyelid. The Procedure Corrects Lagophthalmos A Condition That Keeps The Eyelid From Completely Covering The Eye. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67909. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67909 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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