CPT 67966 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 | • 24 - Ambulatory Surgical Center • 11 - Office |
| Common Modifiers | • None • E2 - Lower left, eyelid • E4 - Lower right, eyelid |
| Complexity Level | Moderate |
National average reimbursement for CPT 67966 by major payers:
$952.07
$978.73
$1,047.57
$1,252.11
| 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 67966 | ||||||
United | 67966 | $2243.00 | 1346207875 - GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | 364053840 - (NC) GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $3373.00 | 1003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $2289.00 | 1740918887 - ORTHOMIDWEST SURGERY CENTER BELOIT, LLC | 881260648 - (WI) ORTHOMIDWEST SURGERY CENTER BELOIT LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1368.41 | 1386091767 - DAVID CORADIN | 350593390 - DEACONESS HOSPITAL INC | FL | Geriatric Medicine (Internal Medicine) Physician (207RG0300X) |
United | 67966 | $2107.00 | 1598165664 - WESTHEALTH SURGERY CENTER LLC | 371763155 - (MN) WESTHEALTH SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1010.00 | 1013999580 - INTEG HEALTH SYSTEM, P.C., BLOOMINGTON SURGERY CENTER | 352045236 - (IN) INTEG HEALTH SYSTEM PC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1154.00 | 1528099207 - DEER CREEK SURGERY CENTER, LLC | 202255269 - (KS) DEER CREEK SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $2101.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1045.00 | 1487187076 - GREEN VALLEY SURGERY CENTER LLC | 812240255 - (NV) GREEN VALLEY SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1955.00 | 1952698078 - EXECUTIVE SURGERY CENTER, INC. | 452484347 - (CA) EXECUTIVE SURGERY CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1368.41 | 1336142728 - MOHAMMED ALLAW | 350593390 - DEACONESS HOSPITAL INC | IN | Internal Medicine Physician (207R00000X) |
United | 67966 | $1131.00 | 1063905818 - INNOVATIVE EYE SURGERY CENTER, PLLC | 822843902 - (KY) INNOVATIVE EYE SURGERY CENTER PLLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1134.00 | 1013980317 - LOS ANGELES-INGLEWOOD ENDOSCOPY LP, AIRPORT ENDOSCOPY CENTER | 621814135 - (CA) LOS ANGELESINGLEWOOD ENDOSCOPY LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $2045.00 | 1699401802 - ALLEGHENY CLINIC | 251838458 - HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $846.00 | 1225440969 - COPPEL SURGICAL SOLUTIONS, NEVADA SURGICAL SUITES | 460641933 - (NV) COPPEL SURGICAL SOLUTIONS | NV | 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 67966 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67966 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 67966 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 |
|---|---|---|
| 67930-CPT | Moderate | Suture Of Recent Wound, Eyelid, Involving Lid Margin, Tarsus, And/Or Palpebral Conjunctiva Direct Closure; Partial Thickness |
| 67950-CPT | Moderate | Canthoplasty (Reconstruction Of Canthus) |
| 67961-CPT | Moderate | Excision And Repair Of Eyelid, Involving Lid Margin, Tarsus, Conjunctiva, Canthus, Or Full Thickness, May Include Preparation For Skin Graft Or Pedicle Flap With Adjacent Tissue Transfer Or Rearrangement; Up To One-Fourth Of Lid Margin |
| 67966-CPT | Moderate | Excision And Repair Of Eyelid, Involving Lid Margin, Tarsus, Conjunctiva, Canthus, Or Full Thickness, May Include Preparation For Skin Graft Or Pedicle Flap With Adjacent Tissue Transfer Or Rearrangement; Over One-Fourth Of Lid Margin |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67966. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67966 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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