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See a sample rate comparisonCPT 67250 Fee Schedule
Last Verified: October 2026
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.
Surgery On Whites Of Eyes, Surgery To Strengthen Or Reinforce Thinning Of The White Protective Surface Of The Eye (Sclera). A Graft May Be Used In The Procedure.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | RT - Right side of body LT - Left side of body None |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 67250 |
| Medicaid Fee Schedule | View Medicaid rates for 67250 |
National average reimbursement for CPT 67250 by major payers:
$1,120.08
$1,050.62
$1,190.35
$1,391.56
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CPT 67250
5 of 25 sample ratesHigher to lower in this preview
Vadnais Heights Surgery Center LLC, Vadnais Heights Surgery Center
$3,344.00Published rateMiami Surgical Suites LLC
$2,388.00Published ratePotomac View Surgery Center, LLC
Potomac View Surgery Center LLC
$2,101.00Published rateNorth Mississippi Ambulatory Surgery Center LLC
$1,368.00Published rateNisenfeld & Chilton, Md PA, Orthopaedic Associates Of Frederick, Asc
Nisenfeld & Chilton, M.D., P.A.
$542.00Published rate
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See a sample payer proposalCPT 67250 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67250 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 67250 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 |
|---|---|---|
| 67227-CPT | Moderate | Treat Blood Vessels In The Eye, Laser Or Other Treatment To Destroy Abnormal Growths Of Blood Vessels On The Retina (Layer Of Tissue At The Back Of The Eye). |
| 67228-CPT | Moderate | Treat Blood Vessels In The Eye, Laser Or Other Treatment To Destroy Abnormal Growths Of Blood Vessels On The Retina (Layer Of Tissue At The Back Of The Eye). |
| 67250-CPT | High | Surgery On Whites Of Eyes, Surgery To Strengthen Or Reinforce Thinning Of The White Protective Surface Of The Eye (Sclera). A Graft May Be Used In The Procedure. |
| 67255-CPT | Moderate | Surgery On Whites Of Eyes, Surgery To Strengthen Or Reinforce Thinning Of The White Protective Surface Of The Eye (Sclera). A Graft May Be Used In The Procedure. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67250 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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