CPT 67218 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 67218 by major payers:
$1,809.86
$1,770.21
$1,948.17
$2,256.16
| 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 67218 | ||||||
United | 67218 | $7286.00 | 1740236454 - PRINCESS ANNE AMBULATORY SURGERY MANAGEMENT LLC, PRINCESS ANNE AMBULATORY SURGERY CENTER | 204920880 - (VA) PRINCESS ANNE AMBULATORY SURGERY MANAGEMENT, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $3570.00 | 1912265653 - BRASELTON ENDOSCOPY CENTER, LLC | 453369410 - (GA) BRASELTON ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $679.00 | 1881616357 - CINCINNATI HEALTH CARE GROUP PSC | 621719097 | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $1300.00 | 1326512070 - RICHFIELD SURGERY CENTER, LLC | 825304896 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $1950.00 | 1255351714 - FASA FAMILY WELLNESS, PLLC | 472330607 - (WA) FASA FAMILY WELLNESS PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $2937.00 | 1962506618 - THE POLYCLINIC, ASC POLYCLINIC SURGERY CENTER | 910369070 - (WA) THE POLYCLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $4600.00 | 1154844553 - LONE STAR ENDOSCOPY CENTER, LLC, LONE STAR ENDOSCOPY SOUTHLAKE | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $10978.00 | 1558501916 - ST. FRANCIS MOORESVILLE SURGERY CENTER, LLC | 202256900 - (IN) ST. FRANCIS MOORESVILLE SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $2344.00 | 1295463990 - SHARPEVISION PLLC | 454849447 - (WA) SHARPEVISION, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $619.00 | 1306260815 - SURGERY CENTER OF EYE SPECIALISTS OF INDIANA, PC | 351938206 - (IN) SURGERY CENTER OF EYE SPECIALISTS OF INDIANA PC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $4774.00 | 1184195877 - ALPINE SURGICENTER, LLC | 204038061 | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $1603.00 | 1104877976 - VICTOR R. MICHALAK, DBA COSMETIC SURGERY & DERMATOLOGY OF ISSAQUAH, INC. | 911521306 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $2010.00 | 1083000715 - CLEBURNE ENDOSCOPY CENTER, LLC | 471803806 - (TX) CLEBURNE ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $2277.00 | 1295233658 - LEGENT OUTPATIENT SURGERY WESTOVER HILLS, LLC | 823717201 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67218 | $2717.00 | 1114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER | 113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLC | NJ | 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 67218 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67218 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 67218 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 |
|---|---|---|
| 67208-CPT | Moderate | Destruction Of Localized Lesion Of Retina (Eg, Maculopathy, Choroidopathy, Small Tumors), One Or More Sessions; Cryot |
| 67210-CPT | Moderate | Destruction Of Localized Lesion Of Retina (Eg, Maculopathy, Choroidopathy, Small Tumors), One Or More Sessions; Photo |
| 67218-CPT | High | Destruction Of Localized Lesion Of Retina (Eg, Macular Edema, Tumors), 1 Or More Sessions; Radiation By Implantation Of Source (Includes Removal Of Source) |
| 67220-CPT | Moderate | Destruction Of Localized Lesion Of Choroid (Eg, Choroidal Neovascularization); Photocoagulation (Eg, Laser), 1 Or More Sessions |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67218. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67218 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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