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See a sample rate comparisonCPT 67036 Fee Schedule
Last Verified: October 2026
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.
Remove Fluid From The Eye, Surgery To Remove Some Or All Of The Vitreous Humor The Gelatinous Clear Fluid Between The Pupil And The Back Of The Eye. The Procedure May Include Replacing The Fluid With A Synthetic Vitreous.
| 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 |
| Medicare Fee Schedule | View Medicare rates for 67036 |
| Medicaid Fee Schedule | View Medicaid rates for 67036 |
National average reimbursement for CPT 67036 by major payers:
$1,214.30
$1,176.05
$1,260.79
$1,460.03
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CPT 67036
5 of 25 sample ratesHigher to lower in this preview
Leonardtown Surgery Center LLC
Leonardtown Surgery Center, LLC
$5,433.00Published rateShawnee Mission Prairie Star Surgery Center LLC, Adventhealth Surgery Center Lenexa
Shawnee Mission Prairie Star Surgery Center LLC
$3,864.00Published rateAsc Development Company, LLC
Asc Development Company LLC
$2,693.00Published rateEvergreen Eye Center, PLLC, Eye Associates Northwest Surgery Center
Eye Associates Northwest, PLLC
$2,090.00Published rateGut Endo, LLC, Center For Digestive Health
Gut Endo, LLC
$1,300.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 67030-CPT | Moderate | Surgery To Clear Eye Fluid, Surgery To Clear Strands In The Vitreous Humor (Gelatinous Clear Fluid Between The Pupil And The Back Of The Eye). |
| 67031-CPT | Moderate | Surgery To Clear Eye Fluid, Surgery To Clear Scar Tissue Or Strands From The Gelatinous Clear Fluid Between The Pupil And The Back Of The Eye (Vitreous Humor). |
| 67036-CPT | High | Remove Fluid From The Eye, Surgery To Remove Some Or All Of The Vitreous Humor The Gelatinous Clear Fluid Between The Pupil And The Back Of The Eye. The Procedure May Include Replacing The Fluid With A Synthetic Vitreous. |
| 67039-CPT | High | Remove Fluid From The Eye, Surgery To Remove Some Or All Of The Vitreous Humor The Gelatinous Clear Fluid Between The Pupil And The Back Of The Eye. The Procedure May Include Replacing The Fluid With A Synthetic Vitreous. |
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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