CPT 67115 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 67115 by major payers:
$650.74
$632.06
$681.16
$816.18
| 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 67115 | ||||||
United | 67115 | $1871.00 | 1861487324 - DOCTORS PARK SURGERY INC | 431608281 - (MO) DOCTORS PARK SURGERY, INC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $2353.00 | 1851950281 - YUMA ADVANCED SURGICAL SUITES LLC | 833076801 - (AZ) YUMA ADVANCED SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $1100.00 | 1487776365 - SEYMOUR OPERATIONS LLC, FAIR PARK SURGERY CENTER | 203173824 - (AR) SEYMOUR OPERATIONS LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $1355.00 | 1346317039 - UNIVERSITY OF MIAMI, UMIAMI MEDICINE - OPHTHALMOLOGY (PALM BEACH BASCOM PALMER - ASC) | 592579938 - UNIVERSITY OF MIAMI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $1528.00 | 1093121196 - GULF COAST OUTPATIENT SURGERY CENTER, LLC | 640935301 - (MS) GULF COAST OUTPATIENT SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $2063.00 | 1649269663 - PHYSICIANS ALLIANCE LC, PHYSICIANS ALLIANCE SURGERY CENTER | 431832038 - (MO) PHYSICIANS ALLIANCE LC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $2816.00 | 1831274208 - MT KISCO SURGERY CENTER LLC, THE AMBULATORY SURGERY CENTER OF WESTCHESTER | 134158313 - (NY) MOUNT KISCO SURGERY CENTER, L.L.C. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $1711.00 | 1528021573 - SUMMIT SURGERY CENTER LP | 621777535 - (TN) SUMMIT SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $2859.00 | 1194351833 - DELRAY BEACH ASC, LLC, DELRAY BEACH SURGERY CENTER | 843067076 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $1375.00 | 1174503080 - THE SURGICAL CENTER FOR EXCELLENCE, LLLP | 743107832 - (FL) SURGICAL CENTER FOR EXCELLENCE, LLLP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $2859.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $4495.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $835.00 | 1710985445 - HERSHEY ENDOSCOPY CENTER, LLC | 562336622 - (PA) HERSHEY ENDOSCOPY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $1387.00 | 1821167479 - EVERGREEN EYE CENTER, PLLC, EVERGREEN EYE SURGERY CENTER | 911628032 - (WA) EVERGREEN EYE CENTER, INC. P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67115 | $2353.00 | 1154323988 - CENTRAL VIRGINIA SURGI-CENTER LP, SURGI-CENTER OF CENTRAL VIRGINIA | 752967162 - (VA) CENTRAL VIRGINIA SURGICENTER LP | VA | 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 67115 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67115 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 67115 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 |
|---|---|---|
| 67115-CPT | Moderate | Release Encircling Mat Post Segment |
| 67120-CPT | Moderate | Remove Implant Material Posterior Seg;Ex |
| 67121-CPT | High | Rem Implant Post Segment Intraocul |
| 67141-CPT | Moderate | Prophylaxis Of Retinal Detachment (Eg, Retinal Break, Lattice Degeneration) Without Drainage, 1 Or More Sessions; Cryotherapy, Diathermy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67115. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67115 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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