What is CPT code 15823?

CPT code 15823 describes a blepharoplasty procedure for the upper eyelid, specifically when excess skin weighs down the lid.

What factors affect fee schedules for CPT 15823?

Fee schedules are affected by Medicare & Medicaid rates, private insurance negotiations, geographic location, and provider type (e.g., hospital vs. private practice).

How can I find out the exact cost of a medical procedure or service before I receive it?

To find the exact cost of a medical procedure or service before you receive it, it's best to use a specialized tool that provides localized and service-specific pricing. You can utilize Payerprice's fee schedule lookup tool. It allows you to search for costs using a CPT code and your specific location, providing transparent pricing information relevant to your area.

What is a CPT code and why is it important for understanding healthcare costs?

CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by medical professionals and facilities to describe medical, surgical, and diagnostic services provided to patients. They are crucial for understanding healthcare costs because they provide a universal language for billing and reporting services, allowing you to accurately identify and look up the price for a specific procedure or service. When using tools like Payerprice, having the correct CPT code ensures you're looking up the price for the exact service you need.

Why do healthcare prices vary significantly by location and provider?

Healthcare prices can vary significantly by location and provider due to several factors, including regional cost of living, differing negotiation tactics between providers and insurers, varying operational costs, technological advancements, and the complexity or specialization of the service. These variations make it important to check prices specific to your location and the particular provider if possible. Tools like Payerprice account for these geographical differences when providing fee schedule information.

What information do I need to have to look up a specific medical service's price?

To accurately look up the price of a specific medical service, you generally need the CPT (Current Procedural Terminology) code for the service, as well as your specific location (e.g., zip code or city and state). Having these details will allow you to use tools like Payerprice's fee schedule lookup to find relevant cost information. If you don't have the CPT code, you might need to ask your doctor's office or the medical facility for it.

Where can I find reliable information about medical service prices?

For reliable and specific information about medical service prices tailored to your situation, you should use a dedicated fee schedule lookup tool. Payerprice offers such a tool where you can search for costs using a CPT code and your specific location to get accurate pricing data. This is often more precise than general estimates or information from non-specialized sources, as it's designed to provide transparency for healthcare consumers.

CPT 15823 Fee Schedule

Last Verified: October 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.

Surgery Of The Eyelid, Surgery To Remove Excess Skin And Fatty Tissue From The Upper Or Lower Eyelid. The Procedure Is Sometimes Done For Cosmetic Reasons.

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Integumentary System
Common Place of Service	24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital
Common Modifiers	None 50 - Bilateral Procedure RT - Right side of body
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 15823
Medicaid Fee Schedule	View Medicaid rates for 15823

National average reimbursement for CPT 15823 by major payers:

$787.17

$791.74

$814.48

$895.46

Compare published rates across providers.

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CPT 15823

5 of 25 sample ratesHigher to lower in this preview

Florida Lakes Surgical PLLC
FLSurgery PhysicianNPI 1174727937Tax ID 20-8995750
$1,792.96Published rate
Anupama Saigal
Florida Hospital Medical Group Inc
FLSurgery PhysicianNPI 1487707261Tax ID 59-3214635
$1,087.07Published rate
Bernard Burgess
Hmc Physician Services Inc
FLSurgery PhysicianNPI 1063598373Tax ID 45-0600790
$843.64Published rate
Claire Peeples
Oakland Colon & Rectal Associates, P.C.
FLSurgery PhysicianNPI 1275796310Tax ID 38-1899403
$644.95Published rate
Donna Bridge
Donna M. Bridge, Md, PA
FLSurgery PhysicianNPI 1851352314Tax ID 59-3626930
$429.47Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 15823 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 15823 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. 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 15823 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
15820-CPT	Moderate	Surgery Of The Eyelid, Surgery To Remove Excess Skin And Fatty Tissue From The Upper Or Lower Eyelid. The Procedure Is Sometimes Done For Cosmetic Reasons.
15821-CPT	Moderate	Surgery Of The Eyelid, Surgery To Remove Excess Skin And Fatty Tissue From The Upper Or Lower Eyelid. The Procedure Is Sometimes Done For Cosmetic Reasons.
15822-CPT	Moderate	Surgery Of The Eyelid, Surgery To Remove Excess Skin And Fatty Tissue From The Upper Or Lower Eyelid. The Procedure Is Sometimes Done For Cosmetic Reasons.
15823-CPT	Moderate	Surgery Of The Eyelid, Surgery To Remove Excess Skin And Fatty Tissue From The Upper Or Lower Eyelid. The Procedure Is Sometimes Done For Cosmetic Reasons.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15823. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 15823 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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CPT 15823 Fee Schedule

Florida Lakes Surgical PLLC

Anupama Saigal

Bernard Burgess

Claire Peeples

Donna Bridge