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 | $1000.00 | 1083220123 - QUEENS SURGICAL CENTER LLC | 471041427 - (NY) QUEENS SURGICAL CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $77.00 | 1053417402 - KEYSTONE KIDNEY ASSOCIATES, PC | 232470181 - (PA) KEYSTONE KIDNEY ASSOCIATES PC | DE | 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 | $328.00 | 1083670970 - GLENWOOD SURGICAL CENTER L P | 330595220 - (CA) GLENWOOD SURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $361.00 | 1407993132 - DIGESTIVE DISEASE ENDOSCOPY CENTER | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $150.00 | 1770588584 - PHYSICIANS SURGERY CENTER LLC, NATIONAL SPINE & ORTHO SURGERY CENTER OF FT. MYERS | 592924183 - (FL) PHYSICIANS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $225.00 | 1437615929 - BANNER ENTICARE TEMPE SURGERY CENTER LLC, BANNER TEMPE SURGERY CENTER | 833567835 - (AZ) BANNER ENTICARE TEMPE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $230.00 | 1881225639 - BANNER SURGERY CENTER | 843441285 - (AZ) BANNER SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $118.00 | 1881031235 - KEARNEY PAIN TREATMENT CENTER, LLC | 461807684 - (NE) KEARNEY PAIN TREATMENT CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $495.00 | 1396823381 - HEAD AND NECK SURGERY ASSOCIATES, PSC, CENTER FOR SURGICAL CARE | 610938951 - HEAD & NECK SURGERY ASSOC., PSC | KY | 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 | $1187.00 | 1154454205 - TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | 751748586 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL AZLE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $119.00 | 1376650911 - ELM PLACE AMBULATORY SURGICAL CENTER | 752142438 - (TX) ELM PLACE AMBULATORY SURGICAL CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $1096.00 | 1871912485 - HEALTHONE RIDGE VIEW ENDOSCOPY CENTER, LLC, SOUTH DENVER ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 67999 | $170.00 | 1649244211 - KINGSPORT TN OPHTHALMOLOGY ASC LLC, THE REGIONAL EYE SURGERY CENTER | 331031979 | TN | 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 | Moderate | Suture Of Recent Wound, Eyelid, Involving Lid Margin, Tarsus, And/Or Palpebral Conjunctiva Direct Closure; Partial Thickness |
| 67935 | Moderate | Suture Of Recent Wound, Eyelid, Involving Lid Margin, Tarsus, And/Or Palpebral Conjunctiva Direct Closure; Full Thickness |
| 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 |
| 67999 | 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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