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CPT 67412 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; 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$1377.001770042111 - O'FALLON SURGICAL CENTER, LLC, PHYSICIANS SURGICAL CENTER814388166 - (IL) OFALLON SURGICAL CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$2750.001033668587 - LANCASTER SPECIALTY SURGERY CENTER812461923 - (OH) LANCASTER SPECIALTY SURGICAL CENTEROHAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$751.001720227176 - ST. AGNES HEALTHCARE, INC., GEORGE THOMAS GRACE M.D. SURGERY CENTER520591657 - ST AGNES HEALTHCARE INCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$5729.001124492541 - MEMORIAL HERMANN SURGERY CENTER PINECROFT, LLC371796296 - (TX) MEMORIAL HERMANN SURGERY CENTER PINECROFT LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$2307.001831420694 - TITUSVILLE CENTER FOR SURGICAL EXCELLENCE LLC263531997 - (FL) TITUSVILLE CENTER FOR SURGICALFLAmbulatory 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$2353.001295176139 - LOWCOUNTRY AMBULATORY CENTER, LLC274109893 - (SC) LOWCOUNTRY AMBULATORY CENTER LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$1148.001467415513 - LAS VEGAS SURGICARE LTD880244070 - (NV) LAS VEGAS SURGICARE LTDNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$1419.001609825298 - SURGERY CENTER OF IDAHO LLC204831740 - (ID) SURGERY CENTER OF IDAHO LLCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$2252.251073149365 - MEDFORD SURGERY CENTER LLC384079196 - (MA) MEDFORD SURGERY CENTER LLCMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$1486.001184635955 - SAN RAMON ENDOSCOPY CENTER INC680466508 - (CA) SAN RAMON ENDOSCOPY CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$2353.001255373601 - CHESTERFIELD AMBULATORY SURGERY CENTER LP, CHESTERFIELD SURGERY CENTER203834076 - (MO) CHESTERFIELD AMBULATORY SURGERY CENTER LPMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$3993.001619218096 - SAN MARCOS ASC LLC800899088TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$2307.001104974310 - NORTHWEST SURGERY CENTER, LLP, NORTHWEST SURGERY CENTER205537270 - (TX) NORTHWEST SURGERY CENTER LLPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
67412$2388.001023349909 - PICCARD SURGERY CENTER, LLC270433723 - (MD) PICCARD SURGERY CENTER, LLCMDAmbulatory 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
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 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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