How can I find the cost of a specific medical procedure?

To find the cost of a specific medical procedure, especially one defined by a CPT code, it's best to use a tool that provides localized fee schedules. We recommend using Payerprice's fee schedule lookup tool. It allows you to search using a CPT code and your specific location to get detailed pricing information relevant to your situation.

What is a CPT code and why is it important for understanding medical costs?

CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services to health insurance companies. They are crucial for understanding medical costs because insurers use these codes to determine reimbursement, and you can use them to research the typical costs of procedures in your area using tools like Payerprice.

What is CMS and how does it relate to healthcare pricing?

CMS stands for the Centers for Medicare & Medicaid Services. It's a federal agency that administers the Medicare program and works with states to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance marketplaces. While CMS sets reimbursement rates for Medicare and Medicaid, which can influence commercial payer rates, for specific out-of-pocket costs and commercial fee schedules tailored to your individual situation, a tool like Payerprice would be more directly helpful than trying to navigate general CMS data.

Where can I find fee schedules for medical services?

Fee schedules for medical services can be found through various sources. For comprehensive and specific information based on CPT codes and your location, we recommend using Payerprice's fee schedule lookup tool. This tool is designed to help users find relevant pricing data for their specific healthcare needs.

Why do medical costs vary by location?

Medical costs vary by location due to several factors, including local market competition, differing overhead costs for healthcare facilities, varying labor costs for medical professionals, state and local regulations, and the negotiation power of local insurance providers. Tools like Payerprice account for these geographical variations by allowing you to search for costs based on your specific location.

CPT 67145 Fee Schedule

Q: What factors 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.).

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.

Prophylaxis Of Retinal Detachm, Prophylaxis Of Retinal Detachment (Eg Retinal Breaklattice Degeneration) Without Drainage One Or More Sessions Photocoagulation (Laser Or Xenon Arc)

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
Medicare Fee Schedule	View Medicare rates for 67145
Medicaid Fee Schedule	View Medicaid rates for 67145

National average reimbursement for CPT 67145 by major payers:

$412.39

$644.52

$554.41

$592.25

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 67145.

CPT 67145

5 of 25 sample ratesHigher to lower in this preview

Lakeside Endoscopy Center LLC
Lakeside Endoscopy Center, LLC
NEAmbulatory Surgical Clinic/CenterNPI 1407992241Tax ID 20-5544496
$1,656.00Published rate
Advanced Surgical Center Of Beverly Hills LLC, Surgery Center Of Beverly Hills LLC
Advanced Surgical Center Of Beverly Hills LLC
CAAmbulatory Surgical Clinic/CenterNPI 1407327356Tax ID 83-2822673
$550.00Published rate
Mosc, LLC
Mosc LLC
AZAmbulatory Surgical Clinic/CenterNPI 1295015212Tax ID 45-2913174
$410.00Published rate
Wills Surgery Center Of Cherry Hill, Surgery Center Of Chery Hill
Wills Surgery Center Of Cherry Hill
NJAmbulatory Surgical Clinic/CenterNPI 1295817435Tax ID 22-3335953
$330.00Published rate
Childrens Surgery Center, LLC
PAAmbulatory Surgical Clinic/CenterNPI 1619284536Tax ID 27-3074039
$170.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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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 Detachm, Prophylaxis Of Retinal Detachment (Eg Retinal Breaklattice Degeneration) Without Drainage One Or More Sessions Cryotherapy Diathermy
67145-CPT	Moderate	Prophylaxis Of Retinal Detachm, Prophylaxis Of Retinal Detachment (Eg Retinal Breaklattice Degeneration) Without Drainage One Or More Sessions Photocoagulation (Laser Or Xenon Arc)
67220-CPT	Moderate	Treat Abnormal Eye Tissue, Treatment In One Or More Sessions In One Or Both Eyes Of Abnormal Tissue Beneath The Retina. The Procedure May Include Stopping Or Stabilizing Leaking Fluid.
67221-CPT	Moderate	Treat Abnormal Eye Tissue, Treatment In One Or More Sessions In One Or Both Eyes Of Abnormal Tissue Beneath The Retina. The Procedure May Include Stopping Or Stabilizing Leaking Fluid.

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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CPT 67145 Fee Schedule

Lakeside Endoscopy Center LLC

Advanced Surgical Center Of Beverly Hills LLC, Surgery Center Of Beverly Hills LLC

Mosc, LLC

Wills Surgery Center Of Cherry Hill, Surgery Center Of Chery Hill

Childrens Surgery Center, LLC