Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 67255 Fee Schedule
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.
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 | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 67255 |
| Medicaid Fee Schedule | View Medicaid rates for 67255 |
National average reimbursement for CPT 67255 by major payers:
$956.78
$946.22
$966.64
$1,158.22
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 67255.
CPT 67255
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Southwest Fort Worth
$6,245.00Published rateSouthern Illinois Orthopedic Center,LLC
Southern Illinois Orthopedic Centerllc
$1,786.00Published rateBoise Center For Foot Surgery PLLC, Millennium Surgery Center
Boise Center For Foot Surgery PLLC
$1,350.00Published rateOrland Park Surgical Center LLC
Orland Park Surgical Center, LLC
$987.00Published rateZion Ambulatory Center LLC
$509.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 67255 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67255 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 67255 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 |
|---|---|---|
| 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. |
| 67229-CPT | High | Tr Retinal Les Preterm Inf, Treatment Of Extensive Or Progressive Retinopathy 1 Or More Sessions Preterm Infant Less Than 37 Weeks Gestation At Birth Performed From Birth Up To 1 Year Of Age Eg Retinopathy Of Prematurity Photocoagulation Or Cryotherapy |
| 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 67255. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67255 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 67255) and we'll show you how you compare in 15 minutes or less.