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CPT 67412 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; Rem Les
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

LT - Left side of body

RT - Right side of body

Complexity LevelHigh

National average reimbursement for CPT 67412 by major payers:

bcbs

$1,274.68

uhc

$1,158.13

aetna

$1,295.24

cigna

$1,561.49

Preview provider-level rates for...
For billing codeCPT 67412
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 67412

United
67412$2555.001144265539 - THE MIDLAND SURGICAL CENTER LLC352194610 - (IL) THE MIDLAND SURGICAL CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$825.001144213547 - DERMATOLOGY & COSMETIC SURGERY CENTER PC251820229 - (PA) DERMATOLOGY COSMETIC SURGERY CENTER PCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$2300.001164584066 - NAPERVILLE SURGICAL CENTRE LLC200433367 - (IL) NAPERVILLE SURGICAL CENTRE, LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$2307.001134613979 - SUMMIT AMBULATORY SURGICAL CENTER LLC522148280MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$905.001407820962 - WINTER HAVEN SEBRING FL OPHTHALMOLOGY ASC LLC, EYE SURGERY & LASER CENTER743072437FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$1490.001346288032 - ENDOSCOPY CENTER AT RIDGE PLAZA LP, ENDOSCOPY CENTER AT MEDPOINT383656538 - (TX) ENDOSCOPY CENTER AT MED POINTTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$1539.021922447135 - MICHAEL HOBSON350593390 - DEACONESS HOSPITAL INCINHospitalist Physician (208M00000X)
United
67412$2775.001013493824 - ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, LURIE CHILDREN'S SURGERY CENTER IN NORTHBROOK362170833 - ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGOILAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$2586.001417077090 - BAPTIST MEDICAL PARK SURGERY CENTER LLC593535262 - (FL) BAPTIST MEDICAL PARK SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$1301.001336553833 - CENTER FOR CARDIOVASCULAR RESEARCH AND EDUCATION LLC465327973 - (AZ) CENTER FOR CARDIOVASCULAR RESEARCH AND EDUCATION LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$530.001023039195 - CAPE SURGERY CENTER, LLC200649544 - (TN) CAPE SURGERY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$1387.001871095489 - EVERGREEN EYE CENTER, PLLC, EVERGREEN EYE SURGERY CENTER911628032 - (WA) EVERGREEN EYE CENTER, INC. P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$1200.001992034763 - CENTRAL ARKANSAS SURGICAL CENTER, LLC270564540 - (AR) CENTRAL ARKANSAS SURGICAL CENTER LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$6874.001699445981 - ELKO COMMUNITY HEALTH CENTER, LLC851569152 - (NV) ELKO COMMUNITY HEALTH CENTER LLCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$774.001972578771 - SUN CITY AZ ENDOSCOPY ASC LLC, SUN CITY ENDOSCOPY CENTER201519369 - (AZ) SUN CITY AZ ENDOSCOPY ASC LLCAZAmbulatory 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 67412 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 67412 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 67412 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 67412. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 67412 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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