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 | $1744.00 | 1639664089 - AIKEN REGIONAL MEDICAL CENTERS SURGERY CENTER LLC | 830879278 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $2011.00 | 1659842128 - MILESTONE SURGICAL CENTER LLC | 824967929 - (CO) MILESTONE SURGICAL CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $11871.00 | 1730212879 - TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | 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 | $744.00 | 1265907885 - APEX SURGERY CENTER, LLC | 814252902 - (OK) APEX SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $2063.00 | 1689748758 - PARK AVENUE SURGERY CENTER LLC | 721565454 - (CO) PARK AVENUE SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $1900.00 | 1629313739 - COLTON CA MULTI ASC LP, PREMIER OUTPATIENT SURGERY CENTER | 461462978 - (CA) COLTON CA MULTI ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $5329.00 | 1952364499 - DENTON REGIONAL AMBULATORY SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DENTON | 200270605 - (TX) DENTON REGIONAL AMBULATORY SURGERY CENTER LP | 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 | $576.00 | 1447661145 - ADVANCED OUTPATIENT SURGERY OF OKLAHOMA, LLC | 371751472 - (OK) ADVANCED OUTPATIENT SURGERY OF | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $2434.00 | 1528021573 - SUMMIT SURGERY CENTER LP | 621777535 - (TN) SUMMIT SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $744.00 | 1326444688 - BRYAN COLLEGE STATION ASC, LP, THE HEART AND VASCULAR SURGERY CENTER | 471615354 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $2771.00 | 1821249616 - LINCOLN SURGERY CENTER LLC | 261790900 - (CO) LINCOLN SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67312 | $1376.00 | 1457968430 - PARK VENTURA ENDOSCOPY CENTER, LLC, DIGESTIVE HEALTH CENTER OF ALLEN | 412059014 - (TX) PARK VENTURA ENDOSCOPY CENTER LLC | TX | 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 | 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-CPT | Moderate | Strab. Surag.;1 Horiz. Muscle |
| 67312-CPT | Moderate | Op For Strabismus 2 Muscles |
| 67314-CPT | Moderate | Strabismus Surgery, Recession Or Resection Procedure (Patient Not Previously Operated On); One Vertical Muscle (Excludi |
| 67316-CPT | 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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