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See a sample rate comparisonCPT 67413 Fee Schedule
Last Verified: October 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 Without Bone Flap (, Orbitotomy Without Bone Flap (Frontal Or Transconjunctivalapproach) With Removal Of Foreign Body Orbitotomy Without Bone Flap (Frontal Or Transconjunctival
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 67413 |
| Medicaid Fee Schedule | View Medicaid rates for 67413 |
National average reimbursement for CPT 67413 by major payers:
$1,219.89
$1,149.57
$1,285.47
$1,503.49
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CPT 67413
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Main Street, LLC
$5,048.00Published rateThe Maryland Center For Digestive Health LLC
$2,353.00Published ratePacific Cataract And Laser Institute Inc PC
Pacific Cataract And Laser Institute, Inc., PC
$1,514.00Published rateGreeley Endoscopy Center, LLC, Northern Colorado Endoscopy Center
Greeley Endoscopy Center LLC
$1,050.00Published rateTampa Bay Specialty Surgery Center LLC, Tampa Bay Specialty Surgery Center
Tampa Bay Specialty Surgery Center LLC
$504.00Published rate
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See a sample payer proposalCPT 67413 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67413 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 67413 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 |
|---|---|---|
| 67400-CPT | High | Orbitotomy Without Bone Flap (, Orbitotomy Without Bone Flap (Frontal Or Transconjunctivalapproach) For Exploration With Or Without Biopsy |
| 67405-CPT | High | Orbitotomy W/O Bone Flap (Frntal Or Transconjunctival Approa);, Orbitotomy Without Bone Flap (Frontal Or Transconjunctival Approach); |
| 67412-CPT | High | Orbitotomy W/O Bone Flap (Frntal Or Transconjunctival Approa);, Orbitotomy Without Bone Flap (Frontal Or Transconjunctival Approach); |
| 67413-CPT | High | Orbitotomy Without Bone Flap (, Orbitotomy Without Bone Flap (Frontal Or Transconjunctivalapproach) With Removal Of Foreign Body Orbitotomy Without Bone Flap (Frontal Or Transconjunctival |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67413. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67413 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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