CPT (Current Procedural Terminology) codes are a standardized set of five-digit numeric and alphanumeric codes used by medical professionals to describe medical, surgical, and diagnostic services. They are crucial for billing, insurance claims, and tracking healthcare services.

How can I find the cost of a medical procedure?

Finding the exact cost of a medical procedure can be complex due to varying factors like location, provider, insurance plan, and facility. A good starting point is to talk to your healthcare provider or insurance company. For a more direct way to look up prices based on your specific situation, you can use specialized tools.

Where can I look up specific medical procedure prices for my area?

To look up specific medical procedure prices based on CPT codes and your location, you should use a dedicated fee schedule lookup tool. For this purpose, Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and specific location to get an estimate of costs. This can provide more granular and relevant pricing information for your specific situation.

What factors influence the cost of medical procedures?

The cost of medical procedures is influenced by several factors, including the specific CPT code for the service, the geographic location (urban vs. rural), the type of facility (hospital, outpatient clinic, doctor's office), the physician's fees, your insurance coverage (deductibles, co-pays, co-insurance), and whether the provider is in-network or out-of-network.

Is there a tool to compare prices for medical services?

Yes, there are tools designed to help compare prices for medical services. For comparing prices based on CPT codes and specific locations, you can utilize platforms like Payerprice. Their fee schedule lookup tool allows you to input the CPT code and your location to find potential costs, helping you make more informed decisions about your healthcare spending.

CPT 90867 Fee Schedule

Q: What factors affect fee schedules?

Fee schedules are affected by several factors including 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), and Provider Type (hospital providers may have different rates than private practice).

Last Verified: August 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Brain Stimulation Planning, Treatment Planning For Tms (Transcranial Magnetic Stimulation) A Technique For Gently Stimulating The Brain Using Magnetic Pulses. Tms Is A Treatment For Depression And Anxiety.

Key Fact	Detail
Service Type	Medicine Services and Procedures Psychiatry Services and Procedures
Common Place of Service	11 - Office 22 - On Campus Outpatient Hospital
Common Modifiers	None 59 - Distinct Procedural Service U6
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 90867
Medicaid Fee Schedule	View Medicaid rates for 90867

National average reimbursement for CPT 90867 by major payers:

$327.55

$360.05

$271.83

$547.22

Preview provider-level rates for...

For billing codeCPT 90867

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	90867	$277.54	1649697764 - LEILANI SHARPE	310537048 - (OH) ST ALOYSIUS ORPHANAGE	OH	Psychiatry Physician (2084P0800X)
United	90867	$291.42	1568541803 - VICTOR RUTERBUSCH	881676782 - (CA) OPEN MIND MENTAL HEALTH PHYSICIANS INC	CA	Psychiatry Physician (2084P0800X)
United	90867	$360.00	1629152541 - HIMABINDU RAVI	581588823 - THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION	CA	Psychiatry Physician (2084P0800X)
United	90867	$277.54	1043330970 - CHRISTOPHER BURKY	510064318 - BAYHEALTH MEDICAL CENTER INC	CA	Psychiatry Physician (2084P0800X)
United	90867	$1116.38	1902241821 - ELLEN BRADLEY	943281673	CA	Psychiatry Physician (2084P0800X)
United	90867	$316.23	1790059194 - MATTHEW CARPINELLO	541581185 - MCV ASSOCIATED PHYSICIANS	CA	Psychiatry Physician (2084P0800X)
United	90867	$1259.43	1144562737 - DAVID TRAN	943281657	CA	Psychiatry Physician (2084P0800X)
United	90867	$534.65	1154635811 - MARISSA STRIDIRON	910565539 - (WA) VIRGINIA MASON MEDICAL CENTER	VA	Psychiatry Physician (2084P0800X)
United	90867	$291.42	1346271194 - CHARLES LEWIS	1346271194 - (CA) CHARLES LEWIS	CA	Psychiatry Physician (2084P0800X)
United	90867	$291.42	1679044523 - ARIEL GOITIA	852831731 - (FL) FLORIDA SOCIAL HEALTH SOLUTIONS LLC	FL	Psychiatry Physician (2084P0800X)
United	90867	$257.50	1578908604 - ATEF SHAIKH	941706811 - (CA) COMPREHENSIVE PSYCHIATRIC SERVICES	CA	Psychiatry Physician (2084P0800X)
United	90867	$336.60	1255590329 - ANITA CHU	830925715 - (CA) FORESIGHT MENTAL HEALTH INC	CA	Psychiatry Physician (2084P0800X)
United	90867	$1133.11	1497993356 - FARZIN YAGHMAIE	800543544	CA	Psychiatry Physician (2084P0800X)
United	90867	$500.00	1548672926 - NATALY BECK	942578620 - (CA) WK MEDICAL GROUP	TN	Psychiatry Physician (2084P0800X)
United	90867	$277.54	1962664789 - JAMIE EVANS	541015378 - (VA) SOUTHSIDE BEHAVIORAL HEALTH	CA	Psychiatry Physician (2084P0800X)
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 90867 vs. Other Psychiatry Services and Procedures Codes

The CPT 90867 code is part of the Medicine Services and Procedures services used for Psychiatry Services and Procedures. 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 90867 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
90865-CPT	Low	Psychiatric Interview, A Psychiatrist Interviews A Person After They Have Been Given Sodium Amobarbital (Amytal) To Induce A Hypnotic State. The Drug Helps To Access Repressed Memories. Drug Effects Are Monitored Overnight.
90867-CPT	Moderate	Brain Stimulation Planning, Treatment Planning For Tms (Transcranial Magnetic Stimulation) A Technique For Gently Stimulating The Brain Using Magnetic Pulses. Tms Is A Treatment For Depression And Anxiety.
90868-CPT	Moderate	Brain Activity Stimulation, Tms (Transcranial Magnetic Stimulation) Treatment A Technique For Gently Stimulating The Brain Using Magnetic Pulses. Tms Is A Treatment For Depression And Anxiety.
90869-CPT	Moderate	Tcran Magn Stim Redetemine, Transcranial Magnetic Stimulation Treatment (Stimulates Nerve Cells In Brain To Improve Symptoms Of Depression) Subsequent Motor Threshold Re-Determination With Delivery And Management

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90867. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 90867 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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