{
    "code": "67904",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/67904/2015/D",
    "release_specific_url": "https://localishealth.com/cpt/67904/2015/D",
    "description": "Surgery to raise a sagging upper eyelid by tightening the muscle that lifts it. Through an incision hidden in the eyelid crease on the outside of the lid, the surgeon exposes the levator muscle and its tendon, shortens or advances it, and reattaches it so the lid rests higher and opens fully. The external route is what marks this out from the related code that reaches the same muscle from underneath, through the inner lining of the lid.",
    "answer": {
        "question": "How much did Medicare pay for CPT 67904 in Q4 2015?",
        "text": "Medicare paid $742.75 for CPT 67904 in the office (non-facility) setting and $607.64 in a facility under the Q4 2015 Physician Fee Schedule, effective October 2015. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.5% increase from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2015,
        "quarter": "D",
        "label": "Q4 2015",
        "effective": "October 1 – December 31, 2015",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 742.75,
        "facility": 607.64,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 7.97,
        "practice_expense_non_facility": 12.07,
        "practice_expense_facility": 8.31,
        "malpractice": 0.63
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.9335,
    "source": {
        "label": "Physician relative value file (Q4 2015)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu15d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2015/D",
        "file": "PPRRVU15_OCT05_V1001.csv",
        "row": 10781,
        "sha256": "302a55af716b26df5b42e80da7b2bd7cf5268007658df88133553f5e4e75523f"
    },
    "modified_at": "2026-08-04T03:06:14+00:00"
}