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See a sample rate comparisonCPT 67805 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.
Remove Lumps From Eyelid, Remove One Or More Lumps (Chalazion) From One Or Both Eyelids. Occasionally The Procedure Is Performed Under General Anesthesia.
| 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 | None E1 - Upper left, eyelid E3 - Upper right, eyelid |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 67805 |
| Medicaid Fee Schedule | View Medicaid rates for 67805 |
National average reimbursement for CPT 67805 by major payers:
$249.79
$264.21
$274.13
$332.19
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CPT 67805
5 of 25 sample ratesHigher to lower in this preview
Texas Health Arlington Memorial Hospital
$1,551.00Published rateNorthern Michigan Surgical Suites, LLC
$531.00Published rateBlake Houser
Deaconess Hospital Inc
$359.07Published ratePrecision Ambulatory Surgery Center, LLC
Precision Ambulatory Surgery Center LLC
$200.00Published rateBarbour Orthopaedics Surgery Center, LLC
Barbour Orthopaedics Surgery Center LLC
$79.00Published rate
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See a sample payer proposalCPT 67805 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67805 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 67805 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 |
|---|---|---|
| 67800-CPT | Low | Remove Lumps From Eyelid, Remove One Or More Lumps (Chalazion) From One Or Both Eyelids. Occasionally The Procedure Is Performed Under General Anesthesia. |
| 67801-CPT | Moderate | Remove Lumps From Eyelid, Remove One Or More Lumps (Chalazion) From One Or Both Eyelids. Occasionally The Procedure Is Performed Under General Anesthesia. |
| 67805-CPT | Moderate | Remove Lumps From Eyelid, Remove One Or More Lumps (Chalazion) From One Or Both Eyelids. Occasionally The Procedure Is Performed Under General Anesthesia. |
| 67808-CPT | Moderate | Excision Of Chalazion Under G, Excision Of Chalazion Under General Anesthesia Andorrequiring Hospitalization Single Or Multiple Excision Of Chalazion Under General Anesthesia A Ndor |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67805. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67805 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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