CPT 67909 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 67909 by major payers:

$651.50

$700.53

$752.75

$902.34
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 67909 | ||||||
United | 67909 | $1273.00 | 1154034429 - CROSSINGS SURGERY CENTER, LLC | 881346867 - (RI) CROSSINGS SURGERY CENTER LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $2307.00 | 1407275282 - SURGCENTER CAMELBACK LLC | 464169482 - (AZ) SURGCENTER CAMELBACK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $1700.00 | 1780871319 - SURGICAL SPECIALISTS ASC, LLC | 208066886 - (FL) SURGICAL SPECIALISTS ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $663.00 | 1750927190 - HERMITAGE ENDOSCOPY CENTER INC | 841815468 - (PA) HERMITAGE ENDOSCOPY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $1072.50 | 1144827114 - GULFSTREAM SURGICAL FORT WORTH LLC | 851495125 - (TX) GULFSTREAM SURGICAL FORT WORTH | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $966.00 | 1487043386 - DENTAL SURGICENTER OF LOUISVILLE INC | 464672803 - (KY) DENTAL SURGICENTER | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $1120.00 | 1982788220 - CASCADE REGIONAL EYE CENTER INC PS, THE HARMAN EYE CLINIC ASC | 911719913 - SIGHT PARTNERS, LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $2307.00 | 1902959190 - RIVA ROAD SURGICAL CENTER, LLC | 870774597 - (MD) RIVA ROAD SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $1761.00 | 1871939082 - RAYMOND RENAISSANCE SURGERY CENTER LLC | 462035014 - (CA) RAYMOND RENAISSANCE SURGERY CE | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $1000.00 | 1912423633 - NWO SURGERY CENTER LLC | 821773714 - (OH) NWO SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $1871.00 | 1184978637 - INLAND VALLEY SURGERY CENTER, LLC | 263900973 - (CA) INLAND VALLEY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $2206.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $858.00 | 1710952130 - MARYLAND ENDOSCOPY CENTER LLC, MARYLAND ENDOSCOPY CENTER | 521888989 - (MD) MARYLAND ENDOSCOPY CENTER, LLC. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $1417.00 | 1851055362 - SAND PLASTIC SURGERY, PLLC, SIXTH AVENUE SURGERY CENTER | 871494902 - (WA) SAND PLASTIC SURGERY PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67909 | $3348.22 | 1508213810 - ALEGENT CREIGHTON HEALTH, CHI HEALTH AMBULATORY SURGERY CENTER AT MIDLANDS | 470757164 - ALEGENT CREIGHTON HEALTH | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 67909 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67909 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 67909 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67909. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67909 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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