CPT 67145 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 67145 by major payers:
$412.39
$644.52
$554.41
$599.61
| 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 67145 | ||||||
United | 67145 | $595.00 | 1518995513 - AFFILIATED ENDOSCOPY CENTERS, LLC | 411923237 - (MN) AFFILIATED ENDOSCOPY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $320.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $390.00 | 1881728590 - SYSTEM OPTICS LLC | 341572960 - (OH) SYSTEM OPTICS, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $410.00 | 1295015212 - MOSC, LLC | 452913174 - (AZ) MOSC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $258.00 | 1316976137 - CENTRAL MARYLAND ENDOSCOPY LLC | 201580201 - (MD) CENTRAL MARYLAND ENDOSCOPY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $1656.00 | 1407992241 - LAKESIDE ENDOSCOPY CENTER LLC | 205544496 - (NE) LAKESIDE ENDOSCOPY CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $934.00 | 1114926714 - ENDOSCOPY CENTER OF DAYTON LTD | 311460799 - (OH) ENDOSCOPY CENTER OF DAYTON LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $550.00 | 1407327356 - ADVANCED SURGICAL CENTER OF BEVERLY HILLS LLC, SURGERY CENTER OF BEVERLY HILLS LLC | 832822673 - (CA) ADVANCED SURGICAL CENTER OF BEVERLY HILLS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $953.00 | 1861071250 - ADVENTHEALTH SURGERY CENTER MILLS PARK LLC, ADVENTHEALTH SURGERY CENTER MILLS PARK | 832780608 - (FL) ADVENTHEALTH SURGERY CENTER MILLS PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $550.00 | 1497105803 - GEORGIA INTERVENTIONAL PAIN | 812947115 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $967.00 | 1598083594 - MID-STATE ENDOSCOPY CENTER LLC | 270673692 - (TN) MIDSTATE ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $330.00 | 1295817435 - WILLS SURGERY CENTER OF CHERRY HILL, SURGERY CENTER OF CHERY HILL | 223335953 - (NJ) WILLS SURGERY CENTER OF CHERRY HILL | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $532.00 | 1699748855 - MIDDLETOWN ENDOSCOPY ASC LLC, THE GI ENDOSCOPY CENTER | 621835826 - (OH) MIDDLETOWN ENDOSCOPY ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $389.00 | 1770911463 - SALUBRIOUS ASC, LLC | 463866454 - (GA) SALUBRIOUS ASC LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67145 | $1167.00 | 1720407273 - BRONX SC LLC, EMPIRE STATE AMBULATORY SURGERY CENTER | 273045919 - (NY) BRONX SC LLC DBA EMPIRE STATE AMBULATORY SURGERY CENTER | NY | 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 67145 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67145 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 67145 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 |
|---|---|---|
| 67141-CPT | Moderate | Prophylaxis Of Retinal Detachment (Eg, Retinal Break, Lattice Degeneration) Without Drainage, 1 Or More Sessions; Cryotherapy, Diathermy |
| 67145-CPT | Moderate | Prophylaxis Of Retinal Detachment (Eg, Retinal Break, Lattice Degeneration) Without Drainage, 1 Or More Sessions; Photocoagulation (Laser Or Xenon Arc) |
| 67220-CPT | Moderate | Destruction Of Localized Lesion Of Choroid (Eg, Choroidal Neovascularization); Photocoagulation (Eg, Laser), 1 Or More Sessions |
| 67221-CPT | Moderate | Destruction Of Localized Lesion Of Choroid (Eg, Choroidal Neovascularization); Photodynamic Therapy (Includes Intravenous Infusion) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67145. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67145 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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