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CPT 67400 Fee Schedule

Last Verified: January 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.

Orbitotomy W/O Bone Flap; Explore
Key FactDetail
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 LevelHigh

National average reimbursement for CPT 67400 by major payers:

bcbs

$1,304.52

uhc

$1,236.62

aetna

$1,378.33

cigna

$1,647.59

Preview provider-level rates for...
For billing codeCPT 67400
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 67400

United
67400$1643.001972675668 - TEXAS REGIONAL EYE CENTER ASC LLC, TEXAS REGIONAL EYE CENTER ASC LLC710967940 - (TX) TEXAS REGIONAL EYE CENTER ASC LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$9159.001053770149 - AURORA SURGERY CENTERS, LLC811401714 - (WI) AURORA SURGERY CENTERS LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$2287.001881134815 - PORT JEFFERSON ASC, LLC371794376 - (NY) PORT JEFFERSON ASC LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$1075.001891724936 - ARKLAMISS SURGERY CENTER,LLC870741444 - (LA) ARKLAMISS SURGERY CENTERLLCLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$2280.001639650161 - TRAILS EDGE SURGERY CENTER, LLC831528858 - (FL) TRAILS EDGE SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$2800.001538280284 - PHYSICIANS SURGERY CENTER OF MODESTO INC, RIVER SURGICAL INSTITUTE201088433 - (CA) PHYSICIANS SURGERY CENTER OF MODESTO DBA RIVER SURGICAL INSTITUTECAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$2050.001154034429 - CROSSINGS SURGERY CENTER, LLC881346867 - (RI) CROSSINGS SURGERY CENTER LLCRIAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$3347.001841251501 - ST AUGUSTINE ENDOSCOPY CENTER LLC592947745 - (FL) ST AUGUSTINE ENDOSCOPY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$2117.001932430816 - SURGCENTER OF GREENBELT, LLC270408064 - (MD) SURGCENTER OF GREENBELT LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$3570.001598767154 - NORTHWEST GEORGIA ORTHOPAEDIC SURGERY CENTER, LLC582132641 - (GA) NORTHWEST GEORGIA ORTHOPAEDIC SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$3900.001407317019 - RIVERSIDE SURGICAL CENTER OF MEADOWLANDS, LLC, RIVERSIDE SURGICAL CENTER OF RUTHERFORD832735771 - (NJ) RIVERSIDE SURGICAL CENTER OF MEADOWLANDS LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$3500.001518154517 - SUMMIT AMBULATORY SURGICAL CENTER, LLC522148280MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$3546.001306905815 - UAS MANAGEMENT, INC., UNIVERSITY SURGERY CENTER611845381CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$1300.001215028469 - DEL VAL ASC LLC, THE EYE SURGERY CENTER760788813 - (PA) DEL VAL ASC LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$3000.001497791040 - CANYON PINOLE SURGERY CENTER, LP201582302 - (CA) CANYON PINOLE SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 67400 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 67400 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 67400 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.

CodeComplexityDescription
67400-CPTHighOrbitotomy W/O Bone Flap; Explore
67405-CPTHighOrbitotomy Wo Bone Flap W Drain
67412-CPTHighOrbitotomy W/O Bone Flap; Rem Les
67413-CPTHighOrbitotomy Wo Bone Flap W Rem Fb

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 67400 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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