CPT 67220 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 67220 by major payers:
$793.65
$842.88
$844.10
$994.37
| 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 67220 | ||||||
United | 67220 | $445.00 | 1740287168 - AFFILIATED PHYSICIANS & SURGEONS, LTD | 860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $330.00 | 1629153770 - COTTMAN AMBULATORY SURGERY CENTER, WILLS SURGERY CENTER OF THE NORTHEAST | 232786584 - (PA) COTTMAN AMBULATORY SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $315.00 | 1235706888 - SOUTHERN SURGICAL CENTER, LLC | 844035828 - (LA) SOUTHERN SURGICAL CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $326.00 | 1942242441 - ADVANCED EYE SURGERY CENTER, LLC | 510567447 - (FL) ADVANCED EYE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $953.00 | 1790241073 - HSS PALM BEACH AMBULATORY SURGERY CENTER, LLC | 301015589 - (FL) HSS PALM BEACH AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $374.00 | 1093757379 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $300.00 | 1699082875 - PAIN CONSULTANTS ASC LLC | 204929098 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $750.00 | 1013341734 - CENTER FOR PAIN AND SPINE, LLC | 463285029 - (GA) CENTER FOR PAIN AND SPINE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $893.00 | 1649515354 - SURGCENTER NORTHEAST LLC | 455554995 - (FL) SURGCENTER NORTHEAST, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $1200.00 | 1598258865 - NORTHERN WESTCHESTER FACILITY PROJECT LLC, YORKTOWN CENTER FOR SPECIALTY SURGERY | 383989643 - (NY) NORTHERN WESTCHESTER FACILITY PROJECT LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $355.00 | 1063512945 - TIFTON ENDOSCOPY CENTER, INC. | 582195460 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $1955.00 | 1154844553 - LONE STAR ENDOSCOPY CENTER, LLC, LONE STAR ENDOSCOPY SOUTHLAKE | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $1420.00 | 1982871935 - NORTHERN VIRGINIA SURGERY CENTER LLC | 203502477 - (VA) NORTHERN VIRGINIA SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $1829.97 | 1124022595 - THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC, SURGERY CENTER CEDAR RAPIDS | 721550812 - (IA) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67220 | $702.00 | 1073794855 - SURGICARE OF LA VETA INC., BARRANCA SURGERY CENTER | 752507129 | CA | 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 67220 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67220 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 67220 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 | Moderate | Destruction Of Localized Lesion Of Retina (Eg, Maculopathy, Choroidopathy, Small Tumors), One Or More Sessions; Cryot |
| 67210 | Moderate | Destruction Of Localized Lesion Of Retina (Eg, Maculopathy, Choroidopathy, Small Tumors), One Or More Sessions; Photo |
| 67218 | 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 | 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 67220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67220 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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