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See a sample rate comparisonCPT 65101 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Enucleation Eye Wo Implant
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 65101 |
| Medicaid Fee Schedule | View Medicaid rates for 65101 |
National average reimbursement for CPT 65101 by major payers:
$1,021.06
$989.17
$1,129.39
$1,309.73
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CPT 65101
5 of 25 sample ratesHigher to lower in this preview
North Denver Musculoskeletal Surgical Partners LLC
$4,339.00Published ratePort Arthur Surgical Center, LLC, Gulf Coast Surgery Center
Port Arthur Surgical Center LLC
$2,080.00Published rateCenter For The Surgical Arts LLC, Csa
Center For The Surgical Arts LLC
$1,300.00Published rateIndependence Asc LLC, The Endoscopy Center - East
$767.00Published rateGlendora Ca Endoscopy Asc Lp, Glendora Digestive Disease Institute
$443.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 65101 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65101 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 65101 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 65101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65101 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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