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See a sample rate comparisonCPT 67560 Fee Schedule
Last Verified: October 2026
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 Implnt (Implnt Outside Muscl Cone); Remval Or Revisn, Orbital Implant (Implant Outside Muscle Cone); Removal Or Revision
| Key Fact | Detail |
|---|---|
| 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 Level | High |
| Medicare Fee Schedule | View Medicare rates for 67560 |
| Medicaid Fee Schedule | View Medicaid rates for 67560 |
National average reimbursement for CPT 67560 by major payers:
$1,340.59
$1,308.97
$1,463.17
$1,712.12
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CPT 67560
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Northwest, LLP, Memorial Hermann Surgery Center Greater Heights
Memorial Hermann Surgery Center Northwest LLP
$6,904.00Published rateCdi Twin Cities Asc LLC, Rayus Twin Cities Asc
$2,500.00Published rateAvi Arora
Deaconess Hospital Inc
$1,778.43Published rateThe Plastic Surgery Center Land, LLC
The Plastic Surgery Center Land LLC
$1,383.00Published rateGastroenterology Consultants Of Tuscaloosa Inc, Tuscaloosa Endoscopy Center
$100.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 67550-CPT | High | Insert Implant Orbital |
| 67560-CPT | High | Orbital Implnt (Implnt Outside Muscl Cone); Remval Or Revisn, Orbital Implant (Implant Outside Muscle Cone); Removal Or Revision |
| 67570-CPT | High | Optic Nrve Dcompress (Eg Ncision Or Fenestrat Of Optic Nrve, Optic Nerve Decompression (Eg Incision Or Fenestration Of Optic Nerve |
| 67599-CPT | High | Unlisted 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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