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See a sample rate comparisonCPT 67101 Fee Schedule
Last Verified: October 2026
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.
Surgery For Retina Detachment, Surgery To Repair A Detached Retina Along With Any Other Damaged Portions Of The Eye. The Procedure Typically Includes An Implant To Help Regulate Internal Eye Pressure Or Drains Excess Eye Fluid.
| 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 |
| Medicare Fee Schedule | View Medicare rates for 67101 |
| Medicaid Fee Schedule | View Medicaid rates for 67101 |
National average reimbursement for CPT 67101 by major payers:
$537.23
$640.74
$624.13
$711.39
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CPT 67101
5 of 25 sample ratesHigher to lower in this preview
Lake George Surgery Center, LLC
$3,906.00Published ratePoint Of Rocks Surgery Center, LLC
$2,353.00Published ratePremier Surgical Center LLC
$1,543.00Published rateWildcreek Surgery Center
$1,045.00Published rateMidsouth Interventional Pain Institute, LLC, Midsouth Pain Treatment Center, LLC
Midsouth Interventional Pain Institute LLC
$700.00Published rate
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See a sample payer proposalCPT 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 | Surgery For Retina Detachment, Surgery To Repair A Detached Retina Along With Any Other Damaged Portions Of The Eye. The Procedure Typically Includes An Implant To Help Regulate Internal Eye Pressure Or Drains Excess Eye Fluid. |
| 67105-CPT | Moderate | Surgery For Retina Detachment, Surgery To Repair A Detached Retina Along With Any Other Damaged Portions Of The Eye. The Procedure Typically Includes An Implant To Help Regulate Internal Eye Pressure Or Drains Excess Eye Fluid. |
| 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 Detached Retina, Repair Of Retinal Detachment With Vitrectomy Any Method Including When Performed Air Or Gas Tamponade Focal Endolaser Photocoagulation Cryotherapy Drainage Of Subretinal Fluid Scleral Buckling And Or Removal Of Lens By Same Technique |
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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