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See a sample rate comparisonCPT 67516 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.
Suprachoroidal Space Njx Pharmacologic Agent, Suprachoroidal Space Injection Of Pharmacologic Agent (Separate Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 67516 |
| Medicaid Fee Schedule | View Medicaid rates for 67516 |
National average reimbursement for CPT 67516 by major payers:
$157.62
$166.46
$141.23
$176.59
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CPT 67516
5 of 25 sample ratesHigher to lower in this preview
Surgical Center At Columbia Orthopaedic Group LLC
$2,989.00Published rateRefocus Surgery Centers, LLC
$1,150.00Published rateIsland Digestive Health Center, LLC
Island Digestive Health Center LLC
$517.00Published rateLake Ridge Ambulatory Surgery Center, LLC, Lake Ridge Surgery Center
Lake Ridge Ambulatory Surgery Center LLC
$424.00Published rateCentral Texas Endoscopy Center LLC, Central Texas Endoscopy Center
Central Texas Endoscopy Center LLC
$163.00Published rate
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See a sample payer proposalCPT 67516 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67516 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 67516 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 |
|---|---|---|
| 67516-CPT | Low | Suprachoroidal Space Njx Pharmacologic Agent, Suprachoroidal Space Injection Of Pharmacologic Agent (Separate Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67516. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67516 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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