CPT 67999 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 | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • GA - Required ABN issued and on file • 50 - Bilateral Procedure |
| Complexity Level | High |
National average reimbursement for CPT 67999 by major payers:
$1,179.97
$98.75
$48.76
$957.31
| 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 67999 | ||||||
United | 67999 | $970.00 | 1669415451 - BOUNTIFUL SURGERY CENTER LLC | 364581088 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $882.00 | 1952874182 - SAME DAY SC OF CENTRAL NJ LLC | 831832261 - (NJ) SAME DAY SC OF CENTRAL NJ LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $79.00 | 1740876671 - FRESENIUS VASCULAR CARE DAYTON ASC LLC | 852997056 - (OH) FRESENIUS VASCULAR CARE DAYTON ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $179.00 | 1073818654 - ROYAL OAK SURGICAL CENTER, LLC, ROYAL OAK SURGICAL CENTER PLLC | 320323562 - (MI) ROYAL OAK SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $325.00 | 1730124561 - SURGERY CENTER OF WESTON LLC | 650933685 - (FL) SURGERY CENTER OF WESTON LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $149.00 | 1659657856 - ALFA SURGERY CENTER, LLC | 452748642 - (CA) ALFA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $750.00 | 1003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $574.00 | 1992713176 - DESERT RIDGE OUTPATIENT SURGERY LLC | 202528902 - (AZ) DESERT RIDGE OUTPATIENT SURGERY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $225.00 | 1104341353 - BANNER PEORIA SURGERY CENTER LLC | 901182685 - (AZ) BANNER PEORIA SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $115.00 | 1790756237 - BIRMINGHAM SURGERY CENTER, LLC | 201788573 - (AL) BIRMINGHAM SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $65.00 | 1265966444 - CHILDREN'S SURGERY CENTER OF LEHIGH VALLEY, LLC | 611830897 - (PA) CHILDRENS SURGERY CENTER OF LEHIGH VALLEY LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $566.00 | 1992713176 - DESERT RIDGE OUTPATIENT SURGERY LLC | 202528902 - (AZ) DESERT RIDGE OUTPATIENT SURGERY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $171.00 | 1457670648 - THE RETINA SURGERY CENTER LLC, THE RETINA SURGERY CENTER | 853784941 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $126.00 | 1144370784 - BELLINGHAM EAR NOSE THROAT AND FACIAL SURGERY INC, WHATCOM SURGERY CENTER | 911009308 - (WA) BELLINGHAM EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY, INC. P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $1520.00 | 1144275629 - FOUNDATION SURGERY AFFILIATE OF FORT WAYNE, LLC, PARKVIEW SOUTHWEST SURGERY CENTER | 201394120 - (IN) FOUNDATION SURGERY AFFILIATES OF FW INVERNESS SURGERY CENTER | IN | 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 67999 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 67999 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 67999 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 |
| 67935-CPT | Moderate | Suture Of Recent Wound, Eyelid, Involving Lid Margin, Tarsus, And/Or Palpebral Conjunctiva Direct Closure; Full Thickness |
| 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 |
| 67999-CPT | High | Unlisted Procedure Eyelids |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 67999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 67999 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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