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CPT 67560 Fee Schedule

Last Verified: November 2025

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.

Orbital Implant;Removalor Revision
Key FactDetail
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 LevelHigh

National average reimbursement for CPT 67560 by major payers:

bcbs

$1,340.59

uhc

$1,308.97

aetna

$1,463.17

cigna

$1,748.31

Preview provider-level rates for...
For billing codeCPT 67560
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 67560

United
67560$2502.001508135658 - SURGERY CENTER OF ATHENS LLC450581955 - (GA) SURGERY CENTER OF ATHENS LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$2056.001407539539 - RSC SURGERY CENTER, LLC352345966CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$2946.001346270329 - MARY IMMACULATE AMBULATORY SURGERY CENTER LLC200485202 - (VA) MARY IMMACULATE AMBULATORY SURGERY CENTER LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$1429.001023088473 - PANAMA CITY SURGERY CENTER,LLC481255983 - (FL) PANAMA CITY SURGERY CENTER, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$1476.001104214261 - WEST CENTRAL SURGICAL CENTER-BAYSIDE472619181 - (OH) WEST CENTRAL SURGICAL CENTERBAYSIDEOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$1778.431417246877 - SHIV BHANDARI350593390 - DEACONESS HOSPITAL INCAZInternal Medicine Physician (207R00000X)
United
67560$1549.001538336219 - PACIFIC CATARACT AND LASER INSTITUTE INC PC911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$2000.001912909169 - KIPS BAY ENDOSCOPY CENTER, LLC134243635 - (NY) KIPS BAY ENDOSCOPY CENTER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$1783.001427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$897.001780651075 - FOX EYE SURGERY, LLC, FIRST CHOICE SURGERY CENTER202126099 - (IA) FOX EYE SURGERY LLCIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$2549.001659953636 - VCU HEALTH AMBULATORY SURGERY CENTER, LLC863310585 - (VA) VCU HEALTH AMBULATORY SURGERY CENTER LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$1630.001417958729 - MENTOR SURGERY CENTER LTD341863257 - (OH) MENTOR SURGERY CENTER,LTDOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$3956.001700661212 - PUYALLUP AMBULATORY SURGERY CENTER, LLC931376698 - (WA) PUYALLUP AMBULATORY SURGERY CENTER LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$2500.001255397808 - JOLIET SURGERY CENTER LIMITED PARTNERSHIP, AMSURG SURGERY CENTER742544709 - (IL) JOLIET SURGERY CENTER LIMITED PARTNERSHIPILAmbulatory Surgical Clinic/Center (261QA1903X)
United
67560$1410.001376115816 - BARNET DULANEY PERKINS EYE CENTER, PC, AMERICAN VISION PARTNERS562589722 - BARNET DULANEY PERKINS EYE CENTER PLLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 67560 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 67560 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 67560 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.

CodeComplexityDescription
67550HighInsert Implant Orbital
67560HighOrbital Implant;Removalor Revision
67570HighOptic Nerve Decompression
67599HighUnlisted Procedure Orbit

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67560. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 67560 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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