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See a sample rate comparisonCPT 67500 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.
Retrobulbar Inject; Medicat (Sepa Proc Does Not Inclu, Retrobulbar Injection; Medication (Separate Procedure Does Not Includ
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | 79 - Unrelated procedure - postop period RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 67500 |
| Medicaid Fee Schedule | View Medicaid rates for 67500 |
National average reimbursement for CPT 67500 by major payers:
$102.41
$98.66
$105.95
$124.26
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CPT 67500
5 of 25 sample ratesHigher to lower in this preview
Willow Park Endoscopy Center, LLC
Willow Park Endoscopy Center LLC
$1,029.00Published rateSsm St Clare Surgical Center LLC, Ssm St Clare Surgical Center
Ssm St Clare Surgical Center LLC
$582.00Published rateFreeman Surgical Center LLC
Freeman Health System
$294.00Published ratePatrick Duffy
Deaconess Hospital Inc
$126.91Published rateNorth Florida Surgery Center Inc, North Florida Surgery Center
North Florida Surgery Center Inc
$69.00Published rate
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See a sample payer proposalCPT 67500 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67500 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 67500 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 |
|---|---|---|
| 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. |
| 67445-CPT | High | Surgery On The Eye Socket, Surgery On The Eye Socket To Remove One Or More Of The Four Walls Of The Eye Socket And Replace It With New Bone Or A Synthetic Equal. |
| 67500-CPT | Low | Retrobulbar Inject; Medicat (Sepa Proc Does Not Inclu, Retrobulbar Injection; Medication (Separate Procedure Does Not Includ |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67500. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67500 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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