CPT 67036 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 67036 by major payers:
$1,214.30
$1,176.05
$1,260.79
$1,493.27
| 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 67036 | ||||||
United | 67036 | $3792.00 | 1548322829 - GASTROINTESTINAL MEDICAL CENTER | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $6506.00 | 1104298009 - RED CEDAR SURGERY CENTER, LLC, RED CEDAR SURGERY CENTER, PLLC | 472947364 - (MI) RED CEDAR SURGERY CENTER, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $2500.00 | 1801220983 - THE MINIMALLY INVASIVE SPINE SURGERY CENTER OF PARADISE VALLEY, LLC | 461416301 - (AZ) THE MINIMALLY INVASIVE SPINE SURGERY CENTER OF PARADISE VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $1500.00 | 1376885400 - MD ANAHEIM SURGERY CENTER INC | 462311690 - (CA) MD ANAHEIM SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $1728.00 | 1851312771 - COLUMBUS ENDOSCOPY CENTER, INC | 640926861 - (MS) COLUMBUS ENDOSCOPY CENTER INC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $3162.00 | 1508135658 - SURGERY CENTER OF ATHENS LLC | 450581955 - (GA) SURGERY CENTER OF ATHENS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $3398.00 | 1376884585 - ADVANCED UROLOGY SURGERY CENTER | 461456287 - (GA) ADVANCED UROLOGY SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $3000.00 | 1376657890 - SURGICAL SPECIALTY SUITES, INC | 61784797 - (MD) SURGICAL SPECIALTY SUITES INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $2297.00 | 1154301240 - ENDOSCOPY CENTER OF WASHINGTON DC LP, THE ENDOSCOPY CENTER OF WASHINGTON, D.C. | 621543524 - (DC) ENDOSCOPY CENTER OF WASHINGTON DC LP | DC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $1400.00 | 1346288032 - ENDOSCOPY CENTER AT RIDGE PLAZA LP, ENDOSCOPY CENTER AT MEDPOINT | 383656538 - (TX) ENDOSCOPY CENTER AT MED POINT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $4704.00 | 1295702942 - GRAPEVINE SURGICARE PARTNERS LTD, BAYLOR SCOTT & WHITE SURGICARE - SOUTHLAKE | 752854711 - (TX) GRAPEVINE SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $5433.00 | 1588854772 - ALABAMA DIGESTIVE HEALTH ENDOSCOPY CENTER, LLC | 201243484 - (AL) ALABAMA DIGESTIVE HEALTH | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $2000.00 | 1023567260 - SKI AMBULATORY SURGICAL CENTERS, LLC | 813831008 - (AZ) SKI AMBULATORY SURGICAL CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $1473.00 | 1467089599 - CONWAY AMBULATORY SURGERY CENTER, LLC | 832516939 - (AR) CONWAY AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67036 | $1747.00 | 1396983847 - EYE SURGERY CENTER LLC, THE EYE SURGERY CENTER | 263915695 | MD | 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 67036 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67036 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 67036 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 67036. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67036 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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