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CPT 67400 Fee Schedule

Last Verified: November 2025

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$3347.001841251501 - ST AUGUSTINE ENDOSCOPY CENTER LLC592947745 - (FL) ST AUGUSTINE ENDOSCOPY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$3570.001902807159 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF SCOTTSDALE731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$2208.001629536826 - MEADOWVIEW ASC, LLC832440695 - (TN) MEADOWVIEW ASC LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$3347.001730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$1379.001942553300 - COLUMBIA SURGICAL INSTITUTE, LLC454449408 - (MD) COLUMBIA SURGICAL INSTITUTE LLCMDAmbulatory 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$3500.001730151168 - HAWTHORN PLACE OUTPATIENT SURGERY CENTER LP, HAWTHORN SURGERY CENTER582065044 - (IL) HAWTHORN PLACE OUTPATIENT SURGERY CENTER LPILAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$1109.001326494147 - CENTER FOR SPINE & PAIN MEDICINE PC, CSPM GAINESVILLE ASC341976829 - CENTER FOR SPINE AND PAIN MEDICIGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$1672.061336138650 - WILLIAM ROBERTS350593390 - DEACONESS HOSPITAL INCINAnesthesiology Physician (207L00000X)
United
67400$988.001619065273 - SHENANDOAH TX ENDOSCOPY ASC LLC, WOODLANDS ENDOSCOPY CENTER205301383TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$2770.001023734084 - WEST GEORGIA SURGERY CENTER, LLC833671516 - (GA) TANNER MEDICAL CENTERGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$1590.001831238773 - CORPUS CHRISTI ENDOSCOPY CENTER LLP, CORPUS CHRISTI ENDOSCOPY CENTER202595593 - (TX) CORPUS CHRISTI ENDOSCOPY CENTER LLPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$2799.001154088490 - BSC 3 LLC, BANNER SURGERY CENTER - SPORTS MEDICINE871712552 - (AZ) BSC 3 LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$1980.001174502561 - YANKTON MEDICAL CLINIC PC460363830 - (SD) YANKTON MEDICAL CLINIC, P.C.SDAmbulatory Surgical Clinic/Center (261QA1903X)
United
67400$2287.001881134815 - PORT JEFFERSON ASC, LLC371794376 - (NY) PORT JEFFERSON ASC LLCNYAmbulatory 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
67400HighOrbitotomy W/O Bone Flap; Explore
67405HighOrbitotomy Wo Bone Flap W Drain
67412HighOrbitotomy W/O Bone Flap; Rem Les
67413HighOrbitotomy 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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