CPT 20665 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 20665 |
National average reimbursement for CPT 20665 by major payers:
$159.48
$152.55
$157.44
$193.59
| 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 20665 | ||||||
United | 20665 | $954.46 | 1043094527 - WAUKEE SURGERY CENTER LLC | 881808321 - (IA) WAUKEE SURGERY CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $175.00 | 1225414246 - LV SURGERY CENTER LLC | 473021380 - (NV) LV SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $286.00 | 1104907328 - ANDREWS INSTITUTE ASC LLC | 352274952 - (FL) ANDREWS INSTITUTE ASC, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $484.00 | 1578525283 - PRINCETON ENDOSCOPY CENTER LLC | 200445094 - (NJ) PRINCETON ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $258.00 | 1932145109 - VALLEY DIGESTIVE CENTER INC, VALLEY DIGESTIVE HEALTH CENTER | 204484163 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $511.00 | 1902070832 - GASTRO OPERATING COMPANY LLC, (DBA) MEADOWBROOK ENDOSCOPY CENTER | 202432134 - (NY) GASTRO OPERATING COMPANY, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $195.52 | 1013117621 - MATTHEW GILBERT | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 20665 | $531.00 | 1356307565 - AMBULATORY SURGICAL ASSOCIATES LLC, TULLAHOMA SURGERY CENTER | 61658016 - (TN) AMBULATORY SURGICAL ASSOCIATES LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $52.00 | 1639618036 - PRESENCE LAKESHORE GASTROENTEROLOGY, LLC | 811750563 - (IL) PRESENCE LAKESHORE GASTROENTEROLOGY LLC DBA DES PLAINES ENDOSCOPY CENT | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $250.00 | 1518955897 - BONITA COMMUNITY HEALTH CENTER INC, BONITA SPRINGS HEALTH CENTER | 593544102 - (FL) BONITA COMMUNITY HEALTH CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $100.00 | 1104214261 - WEST CENTRAL SURGICAL CENTER-BAYSIDE | 472619181 - (OH) WEST CENTRAL SURGICAL CENTERBAYSIDE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $83.00 | 1316969058 - BETHESDA ENDOSCOPY CENTER, LLC | 521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $75.00 | 1083624225 - UNIVERSITY OF MARYLAND SURGCIAL ASSOC PA, UNIVERSITY OF MARYLAND UROLOGICAL SURGERY CENTER | 521557551 - (MD) UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES P A | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $688.00 | 1629559208 - ORTHOARIZONA SURGERY CENTER GILBERT, LLC, ORTHOARIZONA SURGERY CENTER GILBERT | 823624585 - (AZ) ORTHOARIZONA SURGERY CENTER GILBERT LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20665 | $688.00 | 1790344182 - BRISTOL AMBULATORY SURGERY CENTER, LLC | 834345983 | 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 20665 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20665 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal 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 20665 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 |
|---|---|---|
| 20660-CPT | Moderate | Application Tongs/Caliper |
| 20664-CPT | High | Application Of Halo, Including Removal, Cranial, 6 Or More Pins Placed For Thin Skull Osteology (Eg, Peds Patients, Hydrocephalus, Osteogenesis Imperfecta) (Revision 2011) |
| 20665-CPT | Low | Removal Of Tongs Or Halo Applied By Another Individual (Revised 1/1/2013) |
| 20665-CPT | Low | Removal Of Tongs Or Halo Applied By Another Individual (Revised 1/1/2013) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20665. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20665 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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