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 | $1283.00 | 1114491073 - ASC DEVELOPMENT COMPANY LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $2388.00 | 1396919783 - SURGCENTER OF SOUTHERN MARYLAND, LLC | 261572885 - (MD) SURGCENTER OF SOUTHERN MARYLAND | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $2105.00 | 1922248517 - AIDEN CENTER FOR DAY SURGERY LLC | 800161881 - (IL) AIDEN CENTER FOR DAY SURGERY LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $2353.00 | 1144954165 - ADVANCED SURGICAL CARE OF LUTZ, LLC, ADVANCED SURGICAL CARE OF NEW TAMPA | 871390521 - (FL) ADVANCED SURGICAL CARE OF LUTZ LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1750.00 | 1376269324 - THE SURGEON'S POINT SURGERY CENTER, LLC, THE SURGEON'S POINT AT CEDAR PARK | 301282509 - (TX) THE SURGEONS POINT SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $630.00 | 1285333914 - ARIZONA SURGICAL SPECIALISTS CENTER, LLC, ARIZONA SURGICAL SPECIALISTS CENTER, LLC - SCOTTSDALE | 760737449 - (AZ) ARIZONA SURGICAL SPECIALISTS CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1117.00 | 1194163576 - CEC SURGICAL SERVICES, LLC | 461929574 - (MD) CEC SURGICAL SERVICES LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 | $2859.00 | 1659793040 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $4304.00 | 1770810798 - MIDTOWN SURGERY CENTER, LLC | 271462435 - (NY) MIDTOWN SURGERY CENTER, LLC | NY | 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 | $1131.00 | 1063905818 - INNOVATIVE EYE SURGERY CENTER, PLLC | 822843902 - (KY) INNOVATIVE EYE SURGERY CENTER PLLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $3373.00 | 1003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $1945.00 | 1902043284 - AESTHETIC & GENERAL DERMATOLOGY OF SEATTLE | 911886576 - (WA) ELIE LEVY, M.D., P.C. DBA AESTHETIC & GENERAL DERMATOLOGY OF SEATTLE | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67966 | $937.00 | 1700881539 - ARTURO BETANCOURT, M.D., P.A., BALTIMORE WASHINGTON EYE CENTER | 522032553 - (MD) ARTURO BETANCOURT, MD, PA | MD | 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 | Moderate | Suture Of Recent Wound, Eyelid, Involving Lid Margin, Tarsus, And/Or Palpebral Conjunctiva Direct Closure; Partial Thickness |
| 67950 | Moderate | Canthoplasty (Reconstruction Of Canthus) |
| 67961 | 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 | 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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