CPT 67973 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 • 11 - Office |
| Common Modifiers | • None • E2 - Lower left, eyelid • E4 - Lower right, eyelid |
| Complexity Level | High |
National average reimbursement for CPT 67973 by major payers:
$1,164.77
$1,205.37
$1,265.11
$1,526.51
| 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 67973 | ||||||
United | 67973 | $1412.00 | 1801844386 - SOUTHEASTERN UROLOGICAL PARTNERS LTD, SOUTHEASTERN SURGERY CENTER | 593470900 - (FL) SOUTHEASTERN UROLOGICAL PARTNERS, LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $767.00 | 1447271713 - COLUMBUS ORTHOPEDIC OUTPATIENT | 900069344 - (MS) COLUMBUS ORTHOPEDIC OUTPATIENT | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $1776.00 | 1558363549 - SUSQUEHANNA VALLEY SURGERY CENTER | 251847818 - (PA) SUSQUEHANNA VALLEY SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $3500.00 | 1245798826 - SURGCENTER OF GREATER DALLAS, LLC., SURGCENTER OF GREATER DALLAS | 831498677 - (TX) SURGCENTER OF GREATER DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $706.00 | 1639142706 - AMBULATORY SURGERY CENTER LLC, AMBULATORY SURGERY CENTER | 311545306 - (KY) AMBULATORY SURGERY CENTER LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $1400.00 | 1093842270 - NORTH GEORGIA EYE SURGERY CENTER LLC | 201510754 - (GA) NORTH GEORGIA EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $1025.00 | 1235706888 - SOUTHERN SURGICAL CENTER, LLC | 844035828 - (LA) SOUTHERN SURGICAL CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $614.00 | 1821166521 - PHYSICIANS SURGERY CENTER LLC | 860936521 - (AZ) PHYSICIANS SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $2206.00 | 1841395894 - FRANKLIN ENDOSCOPY CENTER, LLC, FRANKLIN ENDOSCOPY CENTER | 383730672 - (TN) FRANKLIN ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $2353.00 | 1851710735 - SURGCENTER TUCSON, LLC | 462350774 - (AZ) SURGCENTER TUCSON, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $1548.00 | 1174588206 - CHARLESTON SURGERY CENTER LIMITED PARTNERSHIP | 581709761 - (SC) CHARLESTON SURGERY CENTER LIMITED PARTNERSHIP | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $1913.00 | 1457329963 - SEQUOIA SURGERY CENTER, LLC, CYPRESS SURGERY CENTER, A LIMITED PARTNERSHIP | 770326275 - (CA) SEQUOIA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $1429.00 | 1396214938 - GRACE SURGERY CENTER LLC | 830543417 - (FL) GRACE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $1446.00 | 1154199859 - WATSON CLINIC ASC, LLC | 934728316 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67973 | $2206.00 | 1972092146 - SURGERY CENTRE OF SW FLORIDA LLC, FORT MYERS SURGERY CENTER | 454068750 | FL | 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 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 |
|---|---|---|
| 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 |
| 67971 | Moderate | Reconstruction Of Eyelid, Full Thickness By Transfer Of Tarsoconjunctival Flap From Opposing Eyelid; Up To Two-Thirds Of Eyelid, 1 Stage Or First Stage |
| 67973 | High | Reconstruction Of Eyelid, Full Thickness By Transfer Of Tarsoconjunctival Flap From Opposing Eyelid; Total Eyelid, Lower, 1 Stage Or First Stage |
| 67974 | High | Reconstruction Of Eyelid, Full Thickness By Transfer Of Tarsoconjunctival Flap From Opposing Eyelid; Total Eyelid, Upper, 1 Stage Or First 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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