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See a sample rate comparisonCPT 67973 Fee Schedule
Last Verified: October 2026
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.
Reconstruction Of Eyelid Full, Reconstruction Of Eyelid Full Thickness By Transfer Oftarsoconjunctival Flap From Opposing Eyelid Total Eyelid Lower One Stage Or First Stage
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 67973 |
| Medicaid Fee Schedule | View Medicaid rates for 67973 |
National average reimbursement for CPT 67973 by major payers:
$1,164.77
$1,205.37
$1,265.11
$1,492.60
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CPT 67973
5 of 25 sample ratesHigher to lower in this preview
The Western Pennsylvania Hospital, Forbes Regional Campus
Highmark Health
$6,548.33Published ratePiedmont Asc LLC
$2,621.00Published rateSierra Eye Ambulatory Surgery Center, LLC
Sierra Eye Ambulatory Surgery Center LLC
$1,436.00Published rateBelmar Ambulatory Surgical Center, LLC
Belmar Ambulatory Surgical Center LLC
$1,003.00Published rateAmbulatory Surgery Center LLC, Ambulatory Surgery Center
Ambulatory Surgery Center LLC
$706.00Published rate
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See a sample payer proposalCPT 67973 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67973 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 67973 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 |
|---|---|---|
| 67971-CPT | Moderate | Reconstruction Of Eyelid Full, Reconstruction Of Eyelid Full Thickness By Transfer Oftarsoconjunctival Flap From Opposing Eyelid Up To Two-Thirds Of Eyelid One Stage Or First Stage |
| 67973-CPT | High | Reconstruction Of Eyelid Full, Reconstruction Of Eyelid Full Thickness By Transfer Oftarsoconjunctival Flap From Opposing Eyelid Total Eyelid Lower One Stage Or First Stage |
| 67974-CPT | High | Reconstruction Of Eyelid Full, Reconstruction Of Eyelid Full Thickness By Transfer Oftarsoconjunctival Flap From Opposing Eyelid Total Eyelid Upper One Stage Or First Stage |
| 67975-CPT | Moderate | Reconstruction Of Eyelid Full, Reconstruction Of Eyelid Full Thickness By Transfer Oftarsoconjunctival Flap From Opposing Eyelid Second Stage |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67973. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67973 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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