CPT 67101 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 | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 67101 by major payers:
$537.23
$640.74
$624.13
$726.98
| 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 67101 | ||||||
United | 67101 | $2713.00 | 1275886319 - SURGERY CENTER OF BAY AREA HOUSTON, LLC | 320383244 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $3500.00 | 1043708019 - OAK POINT SURGICAL SUITES LLC | 823437812 - (TX) OAK POINT SURGICAL SUITES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $774.00 | 1407247208 - COLONOSCOPY AND ENDOSCOPY CENTER LLC | 471628673 - (OH) COLONOSCOPY AND ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $715.00 | 1558372029 - HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | 593591411 - (FL) HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $1045.00 | 1003875873 - WILDCREEK SURGERY CENTER | 880377689 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $2388.00 | 1831489335 - HAGERSTOWN SURGERY CENTER,LLC | 274935096 - (MD) HAGERSTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $1129.00 | 1396203238 - SUN CITY CENTER AMBULATORY SURGERY CENTER, LLC, SUN CITY ASC | 832043435 - (FL) SUN CITY CENTER AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $1624.00 | 1033181862 - EL PASO ASC LP, ENDOSCOPY CENTER OF EL PASO | 621731682 - (TX) EL PASO ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $2865.72 | 1205030731 - PIERCE STREET SAME DAY SURGERY, LC, PIERCE STREET SAME DAY SURGERY, LC | 205895205 - (IA) PIERCE STREET SAME DAY SURGERY | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $1144.00 | 1073588646 - ESCONDIDO CA ENDOSCOPY ASC LP, PARKWAY ENDOSCOPY CENTER | 201627039 - (CA) ESCONDIDO CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $936.00 | 1821074485 - SURGERY CENTER OF FARMINGTON, L.L.C. | 431811835 - (MO) SURGERY CENTER OF FARMINGTON | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $3906.00 | 1457960536 - LAKE GEORGE SURGERY CENTER, LLC | 844411548 - (IN) LAKE GEORGE SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $900.00 | 1669181822 - ALLIANCE SURGERY CENTER AT CUMMING | 881953675 - (GA) ALLIANCE SURGERY CENTER AT CUMMING | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $2198.00 | 1750491205 - ENT SURGERY CENTER OF ATLANTA,LLC | 200075229 - (GA) ENT SURGERY CENTER OF ATLANTALLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67101 | $1543.00 | 1447613344 - PREMIER SURGICAL CENTER LLC | 811222482 - (MO) PREMIER SURGICAL CENTER LLC | MO | 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 67101 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67101 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 67101 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 |
|---|---|---|
| 67101-CPT | Moderate | Repair Of Retinal Detachment Including Drainage Of Subretinal Fluid When Performed; Cryotherapy (Desc Revised 1/1/2017) |
| 67105-CPT | Moderate | Repair Of Retinal Detachment Including Drainage Of Subretinal Fluid When Performed. (Desc Revised 1/1/2017) |
| 67107-CPT | High | Repair Of Retinal Detachment; Scleral Buckling (Such As Lamellar Scleral Dissection Imbrication Or Encircling Procedure) Including When Performed Implant Cryotherapy Photocoagulation And Drainage Of Subretinal Fluid Revised 01/01/2016 |
| 67108-CPT | High | Repair Of Retinal Detachment; With Vitrectomy Any Method Including When Performed Air Or Gas Tamponade Focal Endolaser Photocoagulaton Cryotherapy Drainage Of Subretinal Fluid Scleralbuckling And/Or Removal Of Lens By Same Techniquerevised 01/01/2016 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67101 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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