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See a sample rate comparisonCPT 65091 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.
Evisceration Ocular Wo Implant
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 65091 |
| Medicaid Fee Schedule | View Medicaid rates for 65091 |
National average reimbursement for CPT 65091 by major payers:
$893.63
$860.88
$977.59
$1,167.68
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CPT 65091
5 of 25 sample ratesHigher to lower in this preview
South Denver Musculoskeletal Surgical Partners, LLC, South Denver Surgery Center
South Denver Musculoskeletal Surgical Partners LLC
$4,339.00Published rateChandler Endoscopy Ambulatory Surgery Center, LLC, Chandler Endoscopy Center
$3,500.00Published rateWooster Clinic, LLC
$1,297.00Published rateMirage Endoscopy Center, L.P.
Mirage Endoscopy Center Lp
$922.00Published rateHowerton Surgical Center, LLC
Howerton Surgical Center LLC
$480.00Published rate
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See a sample payer proposalCPT 65091 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65091 code is part of the Surgery services used for Surgical Procedures on the Eye and Ocular Adnexa. 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 65091 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 |
|---|---|---|
| 65091-CPT | Moderate | Evisceration Ocular Wo Implant |
| 65093-CPT | Moderate | Evisceration Ocular Contents; With Impla |
| 65101-CPT | High | Enucleation Eye Wo Implant |
| 65103-CPT | High | Enucleati Of Eye; W/ Implnt Muscl Not Attachd To Implnt, Enucleation Of Eye; With Implant Muscles Not Attached To Implant |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65091. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65091 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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