How much does Medicare pay for CPT 67314?

Medicare allowed an average of $613.45 per service and paid $485.37 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4487.54, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 67314?

Realignment of vertical eye muscle. It was billed 1,095 times to 1,029 Medicare beneficiaries by 56 providers in 2024.

Does 67314 pay differently in an office than a hospital?

Yes. The allowed amount averaged $510.62 in an office setting and $617.55 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 67314 most?

Ophthalmology, with 673 services from 35 clinicians. Next are Ambulatory Surgical Center.

CPT 67314

Realignment of vertical eye muscle

$613.45Medicare-allowed amount per service, averaged across 1,095 services

Providers submitted

$4487.54

Asking price, not received

Medicare allowed

$613.45

The fee schedule figure

Medicare paid

$485.37

Balance is patient coinsurance

Providers submitted an average of $4487.54 for this code and Medicare allowed $613.45 — 7.3× 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 $485.37 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $510.62
Hospital / facility: $617.55

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 42 services were billed in an office setting and 1,053 in a facility.

Services: 1,095
Beneficiaries: 1,029
Providers billing it: 56
Total allowed: $671,728

What Medicare pays for CPT 67314

Across 1,095 services billed by 56 providers to 1,029 beneficiaries, Medicare allowed an average of $613.45 per service. 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 67314

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	673	644	$422.99	35
Ambulatory Surgical Center	422	385	$917.20	21

67314 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	245	$573.00	$398.69	10
Texas	166	$723.96	$578.76	8
Georgia	116	$684.61	$549.22	4
Arizona	55	$646.36	$525.86	4
New York	48	$480.29	$341.85	1
Florida	47	$657.62	$573.27	3
South Carolina	45	$613.56	$517.23	2
Tennessee	38	$663.70	$552.17	2
North Carolina	35	$405.52	$334.11	2
Iowa	30	$671.23	$600.01	2
Colorado	26	$630.78	$503.32	2
Michigan	25	$610.51	$498.98	2
Minnesota	24	$431.28	$323.67	1
Indiana	24	$909.72	$766.14	1
Oregon	20	$366.63	$278.33	1
Nevada	20	$951.73	$707.62	1
Vermont	15	$431.85	$351.12	1
Ohio	15	$875.78	$701.86	1
North Dakota	14	$420.96	$319.52	1
Oklahoma	14	$875.79	$712.91	1
Massachusetts	13	$426.37	$291.53	1
Virginia	13	$326.06	$291.08	1
Maryland	12	$438.84	$329.71	1
Missouri	12	$348.44	$301.79	1
Louisiana	12	$310.79	$255.38	1
Nebraska	11	$376.25	$321.47	1

Related codes

67311Realignment of horizontal eye muscle$594.70

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.