CPT 67025 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 • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 67025 |
National average reimbursement for CPT 67025 by major payers:
$1,010.06
$940.87
$989.33
$1,208.72
| 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 67025 | ||||||
United | 67025 | $1339.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $1002.00 | 1225070527 - LIBERTY CATARACT CENTER LLC | 743099283 - (MO) LIBERTY CATARACT CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $861.00 | 1336112200 - MERCER COUNTY SURGERY CENTER LLC, MERCER COUNTY SURGERY CENTER | 223774069 - (NJ) MERCER COUNTY SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $2307.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $1283.00 | 1588962831 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $900.00 | 1942548870 - ISPM ASC AT CAMP CREEK LLC, ALLIANCE SURGERY CENTER AT CAMP CREEK | 461000991 - (GA) ISPM ASC AT CAMP CREEK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $1713.00 | 1326555491 - GI NORTH ENDOSCOPY.LLC | 822774947 - (GA) GI NORTH ENDOSCOPYLLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $715.00 | 1598848632 - SAN MATEO SURGERY CENTER | 510655329 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $2353.00 | 1891257473 - WESTGATE SURGERY CENTER, LLC, WESTGATE SURGERY CENTER | 352651945 - (AZ) WESTGATE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $2408.00 | 1194727883 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE PUGET SOUND SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $2859.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $1302.00 | 1073570552 - PHYSICIANS SURGICAL CENTER LLC, PHYSICIANS SURGICAL CENTER, AN AFFILIATE OF HEALTHSOUTH | 731452371 - (OK) PHYSICIANS SURGICAL CENETER, L.L.C. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $554.00 | 1285736207 - PODIATRY GROUP OF ANNAPOLIS AMBULATORY SURGICAL CENTER, PODIATRY GROUP OF ANNAPOLIS AMBULATORY SURGICAL CENTER LLC | 522197193 - (MD) PODIATRY GROUP OF ANNAPOLIS AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $1906.00 | 1588711162 - SEATTLE HAND SURGERY GROUP PC, SEATTLE HAND SURGERY UNIT, INC | 911652268 - (WA) SEATTLE HAND SURGERY GROUP, P.C. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67025 | $2178.00 | 1053362343 - SODERSTROM DERMATOLOGY CENTER S C, PEORIA AMBULATORY SURGERY CENTER | 371001642 - (IL) SODERSTROM DERMATOLOGY CENTER, S.C. | IL | 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 67025 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67025 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 67025 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 |
|---|---|---|
| 67005-CPT | Moderate | Rem Vitreous Partial |
| 67010-CPT | Moderate | Removal Of Vitreous, Anterior Approach (Open Sky Technique Or Limbal Incision); Subtotal Removal With Mechanical Vitrectomy |
| 67015-CPT | Moderate | Aspirate/Release Vitreous Fluid |
| 67025-CPT | High | Injection Of Vitreous Substitute, Pars Plana Or Limbal Approach (Fluid-Gas Exchange), With Or Without Aspiration (Separate Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67025. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67025 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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