{
    "code": "67904",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/67904/2019/A",
    "release_specific_url": "https://localishealth.com/cpt/67904/2019/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 2019?",
        "text": "Medicare paid $754.66 for CPT 67904 in the office (non-facility) setting and $612.30 in a facility under the Q4 2019 Physician Fee Schedule, effective October 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2019, when it increased 0.3%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2019,
        "quarter": "D",
        "label": "Q4 2019",
        "effective": "October 1 – December 31, 2019",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 754.66,
        "facility": 612.3,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 7.97,
        "practice_expense_non_facility": 12.34,
        "practice_expense_facility": 8.39,
        "malpractice": 0.63
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0391,
    "source": {
        "label": "Physician relative value file (Q4 2019)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2019/D",
        "file": "PPRRVU19_OCT.csv",
        "row": 11643,
        "sha256": "4efa7bdbffa98a56affa6d5b05e25d7ac5c39f26c7b281d0c773e7e530767cae"
    },
    "modified_at": "2026-08-04T03:09:13+00:00"
}