CPT 67415 Fee Schedule
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.
| 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 | Moderate |
National average reimbursement for CPT 67415 by major payers:

$138.77

$135.94

$143.54

$171.00
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 67415 | ||||||
United | 67415 | $2388.00 | 1346693124 - VILLAGES ENDOSCOPY CENTER LLC | 813250494 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $2388.00 | 1427152073 - PATIENT PARTNERS LLC | 201400198 - (TN) PATIENT PARTNERS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $2044.00 | 1548322829 - GASTROINTESTINAL MEDICAL CENTER | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $1861.00 | 1972805299 - ST. VINCENT'S OUTPATIENT SURGERY SERVICES LLC | 200708162 - (AL) ST VINCENTS OUTPATIENT SURGERY SERVICES LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $843.00 | 1942793823 - STARKVILLE SURGERY CENTER LLC | 465332869 - (MS) STARKVILLE SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $1151.00 | 1669474748 - ARC KENTUCKY LLC, DUPONT SURGERY CENTER | 621754364 - (KY) ARC KENTUCKY LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $1576.00 | 1871257071 - SOUTHDALE SPECIALTY SURGERY CENTER, LLC, BHATTI GI CONSULTANTS, P.A. | 873212683 - (MN) SOUTHDALE SPECIALTY SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $916.00 | 1619065273 - SHENANDOAH TX ENDOSCOPY ASC LLC, WOODLANDS ENDOSCOPY CENTER | 205301383 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $649.00 | 1073598066 - UROLOGY SURGERY CENTER LP | 621543096 - (TN) UROLOGY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $1200.00 | 1255894051 - NEW JERSEY INTERVENTIONAL ASSOCIATES LLC | 262178516 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $2746.00 | 1225064736 - NMC SURGERY CENTER, L.P., THE SURGERY CENTER OF NACOGDOCHES | 752793512 - (TX) NMC SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $1048.00 | 1730152869 - BEL AIR ENDOSCOPY ASC LLC, HARFORD ENDOSCOPY CENTER | 621827593 - (MD) BEL AIR ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $4141.00 | 1386983260 - TEXAS HEALTH CRAIG RANCH SURGERY CENTER LLC | 383897811 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $1170.00 | 1891406328 - CEI PHYSICIANS PSC, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67415 | $1505.00 | 1053934919 - DOYLESTOWN SURGERY CENTER, LLC | 834549561 - (PA) DOYLESTOWN SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 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.
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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