CPT 67912 Fee Schedule
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.
| 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 • E1 - Upper left, eyelid • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 67912 by major payers:
$1,037.59
$1,167.95
$1,267.58
$1,445.92
| 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 67912 | ||||||
United | 67912 | $2307.00 | 1861740508 - ADVANCED SURGERY CENTER OF SARASOTA, LLC | 454909647 - (FL) ADVANCED SURGERY CENTER OF SARASOTA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $814.00 | 1598275703 - LIBERTY ENDOSCOPY CENTER | 821414044 - (OH) LIBERTY ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $1114.00 | 1972778579 - G A ENDOSCOPY CENTER, LLC | 262346936 - (MO) G A ENDOSCOPY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $1200.00 | 1447319603 - NORTHERN BALTIMORE SURGERY CENTER, LLC | 522234559 - (MD) NORTHERN BALTIMORE SURGERY CENTER 401(K) PLAN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $2353.00 | 1053714758 - TEXAS PRECISION SURGERY CENTER | 471332895 - (TX) TEXAS PRECISION SURGERY CENTER L | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $975.00 | 1194708792 - OPHTHALMOLOGY CONSULTANTS OF FORT WAYNE PC, SURGERY CENTER OF OPHTHALMOLOGY CONSULTANTS | 351581864 - (IN) OPHTHALMOLOGY CONSULTANTS OF FORT WAYNE, P.C. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $2007.00 | 1669075495 - SAINT JOSEPH HEALTH ASC LLC | 852155230 | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $1495.00 | 1356314249 - COLUMBIA ASC LLC, COLUMBIA GASTROINTESTINAL ENDOSCOPY CENTER | 621657449 - (SC) THE COLUMBIA ASC, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $1190.00 | 1487978789 - CENTER OF MOREHEAD CITY, LLC, THE SURGICAL CENTER OF MOREHEAD CITY | 272095799 - (NC) SURGICAL CENTER OF MOREHEAD | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $1836.00 | 1689222317 - FLAGSTAFF BONE & JOINT SURGICAL CENTER, LLC, SURGERY CENTER AT FLAGSTAFF BONE & JOINT | 832734129 - (AZ) FLAGSTAFF BONE JOINT SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $3139.00 | 1487933172 - MT. SCOTT SURGERY CENTER, LLC | 832600045 | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $1258.00 | 1053031237 - FRESENIUS VASCULAR CARE EL PASO ASC LLC | 861628275 - (TX) FRESENIUS VASCULAR CARE EL PASO ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $3422.00 | 1639452444 - CHILDREN'S AMBULATORY SURGERY CENTER OF NEW JERSEY, LLC | 271462884 - (NJ) CHILDRENS AMBULATORY SURGERY CENTER OF NEW JERSEY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $1954.00 | 1770048225 - BAPTIST SURGERY AND ENDOSCOPY CENTERS, LLC | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67912 | $4588.00 | 1194997965 - INDIANAPOLIS ENDOSCOPY CENTER LLP | 352010874 - (IN) INDIANAPOLIS ENDOSCOPY CENTER LLP | IN | 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 67912 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67912 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 67912 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 67912. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67912 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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