How much does Medicare pay for CPT 67311?

Medicare allowed an average of $594.70 per service and paid $470.78 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4479.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67311?

Realignment of horizontal eye muscle. It was billed 2,711 times to 2,309 Medicare beneficiaries by 115 providers in 2024.

Does 67311 pay differently in an office than a hospital?

Yes. The allowed amount averaged $482.76 in an office setting and $597.88 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 67311 most?

Ophthalmology, with 1,542 services from 79 clinicians. Next are Ambulatory Surgical Center.

CPT 67311

Realignment of horizontal eye muscle

$594.70Medicare-allowed amount per service, averaged across 2,711 services

Providers submitted

$4479.35

Asking price, not received

Medicare allowed

$594.70

The fee schedule figure

Medicare paid

$470.78

Balance is patient coinsurance

Providers submitted an average of $4479.35 for this code and Medicare allowed $594.70 — 7.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $470.78 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $482.76
Hospital / facility: $597.88

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 75 services were billed in an office setting and 2,636 in a facility.

Services: 2,711
Beneficiaries: 2,309
Providers billing it: 115
Total allowed: $1,612,232

What Medicare pays for CPT 67311

Across 2,711 services billed by 115 providers to 2,309 beneficiaries, Medicare allowed an average of $594.70 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 67311

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	1,542	1,488	$489.44	79
Ambulatory Surgical Center	1,169	821	$733.54	36

67311 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	471	$670.29	$457.80	16
Texas	351	$613.85	$493.44	13
Georgia	242	$625.08	$552.77	6
Arizona	154	$623.37	$506.59	7
Tennessee	131	$573.04	$493.24	4
North Carolina	105	$546.32	$460.23	6
New York	101	$535.57	$374.00	4
Indiana	88	$605.19	$496.05	4
Nevada	82	$604.84	$481.10	4
Colorado	81	$639.55	$508.39	3
Florida	78	$524.24	$453.35	4
Pennsylvania	76	$559.54	$430.37	4
Missouri	76	$508.42	$413.07	3
South Carolina	71	$558.75	$462.49	2
Illinois	66	$460.85	$359.42	4
Kansas	61	$638.85	$546.77	2
Oklahoma	59	$627.41	$526.50	2
Massachusetts	50	$600.74	$435.88	3
Washington	40	$455.97	$333.72	3
Iowa	39	$530.01	$654.10	2
Minnesota	39	$483.95	$393.01	2
Michigan	35	$615.99	$513.41	2
Oregon	33	$530.76	$391.66	2
Alabama	30	$585.69	$515.64	2
Utah	30	$635.29	$531.27	2
Virginia	17	$377.08	$305.29	1
Vermont	16	$432.26	$351.46	1
Montana	15	$633.65	$498.47	1
Arkansas	15	$442.35	$381.36	1
Ohio	13	$617.52	$502.12	1
Kentucky	13	$436.07	$356.88	1
Idaho	11	$491.12	$398.80	1
Maine	11	$507.42	$384.46	1
Maryland	11	$618.71	$463.26	1

Related codes

67314Realignment of vertical eye muscle$613.45

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.