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See a sample rate comparisonCPT 67974 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 Upper 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 22 - On Campus Outpatient Hospital |
| Common Modifiers | None E3 - Upper right, eyelid E1 - Upper left, eyelid |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 67974 |
| Medicaid Fee Schedule | View Medicaid rates for 67974 |
National average reimbursement for CPT 67974 by major payers:
$1,226.76
$1,202.36
$1,272.56
$1,490.64
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CPT 67974
5 of 25 sample ratesHigher to lower in this preview
East Mequon Surgery Center LLC
$10,099.00Published rateJonesboro Ambulatory Surgery Center, LLC
Jonesboro Ambulatory Surgery Center LLC
$3,350.00Published rateEhi Surgery Center Austin, LLC
Ehi Surgery Center Austin LLC
$2,277.00Published rateNuvision Same Day Procedure Center LLC
$1,450.00Published rateClarizel Yarbrough
Deaconess Hospital Inc
$759.95Published rate
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See a sample payer proposalCPT 67974 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67974 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 67974 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 67974. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67974 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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