Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 67113 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.
Eye Surgery, Repair Of Complex Retinal Detachment (E.G. Proliferative Vitreoretinopathy Stage C-1 Or Greater Diabetic Traction Detachment Retinopathy Of Prematurity Retinal Tear Of Greater Than 90 Degrees) With Vitrectomy And Membrane Peeling Including When Performed Air Gas Or Silicone Oil Tamponade Cryotherapy Endolaser Photocoagulation Drainage Of Subretinal Fluid Scleral Buckling And/Or Subretinal Fluid Scleral Buckling And/Or Removal Of Lens
| 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 67113 |
| Medicaid Fee Schedule | View Medicaid rates for 67113 |
National average reimbursement for CPT 67113 by major payers:
$1,775.79
$1,875.86
$1,972.17
$2,272.89
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 67113.
CPT 67113
5 of 25 sample ratesHigher to lower in this preview
Calloway Creek Surgery Center Lp
$6,685.00Published rateOlive Ambulatory Surgery Center, LLC, North Campus Surgery Center
Olive Ambulatory Surgery Center LLC
$5,354.00Published rateLa Peer Surgery Center, LLC, La Peer Health Systems
Lapeer Surgery Center, LLC
$3,300.00Published rateThe Waldorf Endoscopy Asc, LLC, Waldorf Endoscopy Center
The Waldorf Endoscopy Asc LLC
$2,297.00Published rateGpddc, LLC
$1,020.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 67113 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67113 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 67113 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 |
| 67113-CPT | High | Eye Surgery, Repair Of Complex Retinal Detachment (E.G. Proliferative Vitreoretinopathy Stage C-1 Or Greater Diabetic Traction Detachment Retinopathy Of Prematurity Retinal Tear Of Greater Than 90 Degrees) With Vitrectomy And Membrane Peeling Including When Performed Air Gas Or Silicone Oil Tamponade Cryotherapy Endolaser Photocoagulation Drainage Of Subretinal Fluid Scleral Buckling And/Or Subretinal Fluid Scleral Buckling And/Or Removal Of Lens |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67113. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67113 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 67113) and we'll show you how you compare in 15 minutes or less.