CPT 67030 Fee Schedule
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.
| 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 67030 by major payers:
$710.02
$678.71
$752.16
$894.40
| 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 67030 | ||||||
United | 67030 | $5729.00 | 1558331801 - MEMORIAL HERMANN SURGERY CENTER, MEMORIAL HERMANN SURGERY CENTER, THE WOODLANDS | 201765863 - (TX) MEMORIAL HERMANN SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $3150.00 | 1043708019 - OAK POINT SURGICAL SUITES LLC | 823437812 - (TX) OAK POINT SURGICAL SUITES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $2795.00 | 1043297872 - CENTRAL JERSEY AMBULATORY SURGICAL CENTER, LLC | 223669777 - (NJ) CENTRAL JERSEY AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $1490.00 | 1467442657 - HOLY REDEEMER AMBULATORY SURGERY CENTER, LLC | 233020527 - (PA) HOLY REDEEMER AMBULATORY SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $2924.00 | 1003119470 - MOUNTAIN WEST SURGERY CENTER, LLC | 371614424 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $2196.00 | 1366536880 - SOUTHWEST WASHINGTON REGIONAL SURGERY CENTER, LLC | 911959910 - (WA) SOUTHWEST WASHINGTON REGIONAL SURGERY CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $855.00 | 1588991228 - THE EYE SURGICAL CENTER OF FORT WAYNE, LLC | 271316595 - (IN) THE EYE SURGICAL CENTER OF FORT WAYNE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $2600.00 | 1245862002 - QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC, QUINCY MEDICAL GROUP SURGERY CENTER | 371206525 - QUINCY PHYSICIANS & SURGEONS CLINIC S.C. D/B/A QUINCY MEDICAL GROUP | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $2388.00 | 1093772840 - THE SURGERY CENTER AT JENSEN BEACH, LLC | 651198731 - (FL) THE SURGERY CENTER AT JENSEN B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $2353.00 | 1760486369 - MOUNTAIN EMPIRE SURGERY CENTER LP | 621772667 - (TN) MOUNTAIN EMPIRE SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $1500.00 | 1043426950 - HOSPITAL DRIVE SURGERY CENTER, LLC | 770516196 - (CA) HOSPITAL DRIVE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $1000.00 | 1497117113 - FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER, LLC | 352551684 - (PA) FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $1350.00 | 1184689408 - EVERGREEN EYE CENTER, PLLC, EYE ASSOCIATES NORTHWEST SURGERY CENTER | 911610832 - (WA) EYE ASSOCIATES NORTHWEST, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $1220.00 | 1508209743 - CRESCENT VIEW SURGERY CENTER, LLC | 462070269 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67030 | $1850.00 | 1801277819 - HAWTHORNE SURGERY CENTER LLC | 473728139 - (GA) HAWTHORNE SURGERY CENTER LLC | GA | 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 67030 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67030 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 67030 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67030. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67030 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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