CPT 67312 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 | • 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 67312 by major payers:
$855.93
$910.92
$978.68
$1,125.31
| 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 67312 | ||||||
United | 67312 | $1523.50 | 1851848253 - PINNACLE SURGERY CENTER OF AUSTIN | 813117589 - (TX) PINNACLE SURGERY CENTER OF AUSTIN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $576.00 | 1992788384 - ASPEN SURGERY VENTURE LLC, ASPEN SURGERY CENTER | 263913327 - (CA) ASPEN SURGERY VENTURE LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $2278.00 | 1093230450 - CENTER FOR UROLOGIC SURGERY LLC | 822344535 - (MO) CENTER FOR UROLOGIC SURGERY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $576.00 | 1912094509 - APOGEE OUTPATIENT SURGERY CENTER | 383897570 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $1523.50 | 1366422479 - VALLEY ENDOSCOPY CENTER LP, THE VALLEY ENDOSCOPY CENTER | 621550829 - (CA) VALLEY ENDOSCOPY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $1523.50 | 1033817168 - SUTTER BAY MEDICAL FOUNDATION | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $4339.00 | 1952814386 - ADVANCED SURGICAL CARE OF BOERNE, LLC | 821680961 - (TX) ADVANCED SURGICAL CARE OF BOERNE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $576.00 | 1053353359 - VISION SURGERY & LASER CENTER, LLC | 931308251 - (OR) VISION SURGERY LASER CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $744.00 | 1669414306 - FREEDOM VISION SURGERY CENTER LLC, FREEDOM VISION SURGERY CENTER LLC | 954673469 - (CA) FREEDOM VISION SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $1635.00 | 1043272750 - WEST PARK SURGERY CENTER LLC | 260092101 - (FL) WEST PARK SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $1986.00 | 1457898215 - PROSPECT BLACKSTONE VALLEY SURGICARE, LLC, BLACKSTONE VALLEY SURGICARE | 814871794 - (RI) PROSPECT BLACKSTONE VALLEY SURGICARE LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $2376.00 | 1033195912 - SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC, AVERA ENDOSCOPY/SURGICAL CENTER | 460461429 - (SD) SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $1703.00 | 1255607628 - MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, PC, ALLSPINE SURGERY CENTER | 274395849 - (GA) MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $744.00 | 1265907885 - APEX SURGERY CENTER, LLC | 814252902 - (OK) APEX SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $1889.00 | 1386858595 - ALDERWOOD SURGERY CENTER LLC | 204979154 - (WA) ALDERWOOD SURGICAL CENTER | WA | 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 67312 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67312 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 67312 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 |
|---|---|---|
| 67311 | Moderate | Strab. Surag.;1 Horiz. Muscle |
| 67312 | Moderate | Op For Strabismus 2 Muscles |
| 67314 | Moderate | Strabismus Surgery, Recession Or Resection Procedure (Patient Not Previously Operated On); One Vertical Muscle (Excludi |
| 67316 | Moderate | Strabismus Surgery, Recession Or Resection Procedure (Patient Not Previously Operated On); Two Or More Vertical Muscles |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67312. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67312 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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