CPT 66174 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 66174 by major payers:
$1,009.56
$1,273.70
$1,138.16
$1,332.86
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 66174 | ||||||
United | 66174 | $2781.00 | 1922160357 - ARAPAHOE ENDOSCOPY CENTER PARTNERSHIP PLLP | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $1538.00 | 1154538544 - COLLIER ENDOSCOPY & SURGERY CENTER | 651093702 - (FL) COLLIER ENDOSCOPY SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $2174.00 | 1558538231 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $3708.00 | 1033177373 - SURGICARE OF LA VETA LTD, LAVETA SURGERY CENTER | 752507129 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $3600.00 | 1639149255 - COLD SPRINGS MEDICAL SURGICAL GROUP LLC, DE LA VINA SURGICENTER | 770521530 - (CA) COLD SPRINGS MEDICAL SURGICAL GROUP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $3000.00 | 1407202484 - SPORTSORTHO SURGERY CENTER LLC | 811465819 - (TX) SPORTSORTHO SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $3000.00 | 1841325214 - AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERY | 208422547 - (MD) AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERY | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $894.00 | 1437237393 - LAUREL AMBULATORY SURGICAL CENTER | 263869837 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $3365.00 | 1851029060 - COLORADO SPRINGS SURGICENTER, LLC | 862813124 - COLORADO SPRINGS SURGICENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $2994.00 | 1205871050 - KLAMATH SURGERY CENTER LLC, KLAMATH SURGEONS LLC | 911836091 - (OR) KLAMATH SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $4488.00 | 1225531544 - ANNE ARUNDEL-SCA SURGICENTER, LLC | 824763728 - (MD) ANNE ARUNDELSCA SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $10714.00 | 1538245717 - LUBBOCK COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER | 751301362 - LUBBOCK COUNTY HOSPITAL DISTRICT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $3000.00 | 1619071214 - RADS OF AMERICA, LLC, PREMIER RADIOLOGY PAIN MANAGEMENT CENTER | 200597581 - (TN) RADS OF AMERICA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $1544.00 | 1710904701 - ENDOSCOPIC DIAGNOSTIC & TREATMENT CENTER LLC | 770611981 - (NY) ENDOSCOPIC DIAGNOSTIC TREATMENT CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66174 | $860.00 | 1407131949 - LEE SURGERY CENTER LLC | 453606333 - (OH) LEE SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 66174 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 66174 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 66174 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 |
|---|---|---|
| 66172-CPT | High | Fistulization Of Sclera For Glaucoma; Trabeculectomy Ab Externo With Scarring From Previous Ocular Surgery Or Trauma (Includes Injection Of Antifibrotic Agents) |
| 66174-CPT | High | Transluminal Dilation Of Aqueous Outflow Canal (Eg Canaloplasty); Without Retention Of Device Or Stent (Desc Rvsd 1/1/23) |
| 66175-CPT | High | Transluminal Dilation Of Aqueous Outflow Canal (Eg Canaloplasty); With Retention Of Device Or Stent (Desc Rvsd 1/1/23) |
| 66179-CPT | High | Once Per Dos Aqueous Shunt To Extraocular Equatorial Plate Reservoir, External Approach Without Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 66174. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 66174 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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