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See a sample rate comparisonHealthcare 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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 11 - Office |
| Common Modifiers | None 50 - Bilateral Procedure LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 67903 |
| Medicaid Fee Schedule | View Medicaid rates for 67903 |
National average reimbursement for CPT 67903 by major payers:

$725.60

$783.96

$826.66

$955.08
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California Colon And Rectal Cancer Screening Center LLC
Deaconess Hospital Inc
Rochester Endoscopy Surgery Center LLC
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Rate Benchmarking
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See a sample payer proposalCPT 67903 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67903 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 67903 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 |
|---|---|---|
| 67900-CPT | Moderate | Rpair Of Brow Ptosis (Suprciliary Mid-Forehead Or Coronal Approa, Repair Of Brow Ptosis (Supraciliary Mid-Forehead Or Coronal Approach) |
| 67901-CPT | Moderate | Rpair Of Blepharoptosis; Frontalis Muscl Techniq W/ Suture Or Ot, Repair Of Blepharoptosis; Frontalis Muscle Technique With Suture Or Ot |
| 67902-CPT | Moderate | Rpair Of Blepharoptosis; Frontalis Muscl Techniq W/ Autologous F, Repair Of Blepharoptosis; Frontalis Muscle Technique With Autologous F |
| 67903-CPT | Moderate | Rpair Of Blepharoptosis; (Tarso) Levator Resct Or Advancem In, Repair Of Blepharoptosis; (Tarso) Levator Resection Or Advancement In |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67903. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67903 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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