CPT 67225 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 67225 by major payers:
$38.72
$39.12
$41.02
$48.32
| 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 67225 | ||||||
United | 67225 | $120.00 | 1629181136 - JOON Y. KIM, MD, PC, CLAYTON CATARACT & LASER SURGERY CENTER | 581603174 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $260.00 | 1033220751 - ENDOSCOPY CENTER AT ST MARY | 205253494 - (PA) ENDOSCOPY CENTER AT ST MARY | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $200.00 | 1245393602 - MARYAM RAHBAR, MD, INC., PACIFIC COAST SPINE INSTITUTE AND PAIN CENTER | 205511930 - (CA) MARYAM RAHBAR MD INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $1528.00 | 1902052350 - SURGERY CENTER, LLC | 263169180 - (WI) THE SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $622.00 | 1780021188 - ENDOSCOPY CENTER OF NIAGARA, LLC | 453630889 - (NY) ENDOSCOPY CENTER OF NIAGARA LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $200.00 | 1952398141 - AUSTIN EYE CLINIC ASSOCIATION, AUSTIN EYE LASER AND SURGICENTER | 741677021 - (TX) AUSTIN EYE CLINIC ASSOCIATION | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $340.00 | 1508942996 - PHYSICIANS SURGERY SERVICES LP, ADVANCED SURGERY CENTER | 201074818 - (CA) PHYSICIAN SURGERY SERVICES L.P. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $190.00 | 1053688036 - SUNSET SURGICAL CENTRE LLC | 270224735 - (OR) SUNSET SURGICAL CENTRE LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $150.00 | 1255510525 - EYE SURGERY CENTER OF MICHIGAN LLC | 205795977 - (MI) EYE SURGERY CENTER OF MICHIGAN | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $320.00 | 1225308257 - CROWN VALLEY OUTPATIENT SURGICAL CENTER LLC, MISSION ENDOSCOPY CENTER | 454125214 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $45.00 | 1457502239 - APOLLO SURGERY CENTER LLC | 261387775 - (FL) APOLLO SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $1108.00 | 1841444593 - TEANECK SURGICAL CENTER, LLC | 10776897 - (NJ) TEANECK SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $375.00 | 1053328781 - LOS ALAMITOS SURGERY CENTER L P | 550823348 - (CA) LOS ALAMITOS SURGERY CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $81.00 | 1174679054 - CROSSROADS SURGERY CENTER, LLC | 562622609 - (TN) CROSSROADS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67225 | $75.00 | 1841304797 - SOUTH GEORGIA ENDOSCOPY CENTER, INC | 593737668 - (GA) SOUTH GEORGIA ENDOSCOPY CENTER INC | GA | 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 67225 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67225 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 67225 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 |
|---|---|---|
| 67221 | Moderate | Destruction Of Localized Lesion Of Choroid (Eg, Choroidal Neovascularization); Photodynamic Therapy (Includes Intravenous Infusion) |
| 67225 | Low | Destruction Of Localized Lesion Of Choroid (Eg, Choroidal Neovascularization); Photodynamic Therapy, Second Eye, At Single Session (List Separately In Addition To Code For Primary Eye Treatment) |
| 67227 | Moderate | Destruction Of Extensive Or Progressive Retinopathy (Eg Diabetic Retinopathy) Cryotherapy Diathermy Revised 01/01/2016 |
| 67228 | Moderate | Treatment Of Extensive Or Progressive Retinopathy, One Or More Sessions (Eg Diabetic Retinopathy), Photocoagulation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67225 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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