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See a sample rate comparisonCPT 67415 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Fine Needle Aspiration Orbital Contents
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 22 - On Campus Outpatient Hospital 19 - Off Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 67415 |
| Medicaid Fee Schedule | View Medicaid rates for 67415 |
National average reimbursement for CPT 67415 by major payers:
$138.77
$135.94
$143.54
$168.46
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CPT 67415
5 of 25 sample ratesHigher to lower in this preview
Court Street Surgery Center, Lp
$6,021.00Published rateAdvanced Surgical Care Of St. Louis, LLC
Advanced Surgical Care Of St Louis LLC
$2,621.00Published rateThe Polyclinic, Asc Polyclinic Surgery Center
The Polyclinic, PLLC
$2,043.00Published rateWinchester Eye Surgery Center, LLC
$1,400.00Published rateThe Endoscopy Center Of Bristol
$425.00Published rate
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See a sample payer proposalCPT 67415 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67415 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 67415 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 |
|---|---|---|
| 67415-CPT | Low | Fine Needle Aspiration Orbital Contents |
| 67420-CPT | High | Surgery On The Eye Socket, Surgery On The Eye Socket To Remove A Portion Of Bone. The Procedure May Include Removing A Sample Of Tissue For Testing (Biopsy) Or Removing Abnormal Tissue. |
| 67430-CPT | High | Orbitotomy With Bone Flap Or W, Orbitotomy With Bone Flap Or Window Lateral Approach (Egkroenlein) With Removal Of Foreign Body Orbitotomy With Bone Flap Or Window Lateral Approach (Eg |
| 67440-CPT | High | Surgery On The Eye Socket, Surgery On The Eye Socket To Remove A Portion Of Bone. The Procedure Includes Removing Fluid From The Eye And Replacing The Bone. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67415. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67415 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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