CPT 67105 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 |
| Medicare Fee Schedule | View Medicare rates for 67105 |
National average reimbursement for CPT 67105 by major payers:
$504.00
$581.57
$585.50
$638.68
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 67105 | $320.00 | 1942261599 - SDOSC, LP, SAN DIEGO OUTPATIENT AMBULATORY SURGICAL CENTER | 30506487 - (CA) SDOSC, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $611.00 | 1942414750 - HAMILTON EYE INSTITUTE SURGERY CENTER, L.P. | 202873438 - (TN) HAMILTON EYE INSTITUTE SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $250.00 | 1033560420 - ABINGDON SURGICAL CENTER PC | 813054896 - (MD) ABINGDON SURGICAL CENTER PC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $416.00 | 1538336219 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $1161.00 | 1144283292 - LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP | 943419282 - (LA) LAFAYETTE SURGERY CENTER LIMITED PARTNERSHIP | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $689.00 | 1639605595 - QUEEN CREEK SURGICAL CENTER, LLC | 821292127 - (AZ) QUEEN CREEK SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $318.00 | 1962869446 - FAYETTEVILLE GASTROENTEROLOGY ENDOSCOPY CENTER, LLC | 473997859 - (NC) FAYETTEVILLE GASTROENTEROLOGY ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $893.00 | 1770929044 - SURGCENTER OF PALM BEACH GARDENS, SURGCENTER OF PALM BEACH GARDENS, LLC | 462315994 - (FL) SURGCENTER OF PALM BEACH GARDENS, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $609.00 | 1104125939 - GASTROENTEROLOGY CARE INC | 263101232 - (NY) GASTROENTEROLOGY CARE INC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $552.00 | 1740831437 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $377.00 | 1396123865 - SOUND SURGEONS PLLC, NORTHWEST WEIGHT LOSS SURGERY | 461190829 - (WA) SOUND SURGEONS, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $295.00 | 1851342430 - BEL AIR AMBULATORY SURGICAL CENTER ,L.L.C. | 522125649 - (MD) BEL AIR AMBULATORY SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $1708.00 | 1801987805 - ENDO SURGI CENTER OF OLD BRIDGE LLC | 223679920 - (NJ) ENDO-SURGI CENTER OF OLD BRIDGE, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $675.00 | 1336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER | 860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67105 | $967.00 | 1992250922 - MIAMI SURGICAL SUITES LLC | 474339341 - (FL) MIAMI SURGICAL SUITES LLC | FL | 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 67105 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67105 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 67105 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 67105. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67105 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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