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See a sample rate comparisonCPT 67921 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.
Rep Entropion W Suture
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 11 - Office |
| Common Modifiers | None E4 - Lower right, eyelid E2 - Lower left, eyelid |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 67921 |
| Medicaid Fee Schedule | View Medicaid rates for 67921 |
National average reimbursement for CPT 67921 by major payers:
$541.10
$571.68
$607.86
$727.55
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CPT 67921
5 of 25 sample ratesHigher to lower in this preview
Milwaukee Surgical Suites, LLC
$3,400.00Published rateDerry Surgical Center, LLC
Derry Surgical Center LLC
$2,100.00Published rateReagan Street Surgery Center, LLC
Reagan Street Surgery Center LLC
$1,072.50Published rateStone Oak Surgicenter, LLC
$591.00Published rateLive Oak Endoscopy Center, LLC
Live Oak Endoscopy Center
$440.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 67921 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67921 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 67921 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 |
|---|---|---|
| 67921-CPT | Moderate | Rep Entropion W Suture |
| 67922-CPT | Moderate | Repair Entropion;Thermocauterizat'n |
| 67923-CPT | Moderate | Rep Entropion W Blepharoplasty |
| 67924-CPT | Moderate | Rpair Of Entropion; Pextensiv (Eg Tarsal Strip Or Capsulopalpbra, Repair Of Entropion; Extensive (Eg Tarsal Strip Or Capsulopalpebral F |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67921. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67921 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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