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CPT 65101 Fee Schedule

Last Verified: November 2025

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 FactDetail
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 LevelHigh

National average reimbursement for CPT 65101 by major payers:

bcbs

$1,021.06

uhc

$989.17

aetna

$1,129.39

cigna

$1,337.44

Preview provider-level rates for...
For billing codeCPT 65101
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 65101

United
65101$2243.001467979443 - MVH ENDOSCOPY LLC, PCS ENDOSCOPY SUITE822606374 - (ID) MVH ENDOSCOPY LLCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$1200.001043205040 - ST LUKES SURGICAL CENTER INC592407224 - (FL) ST LUKES SURGICAL CENTER INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$4600.001043708019 - OAK POINT SURGICAL SUITES LLC823437812 - (TX) OAK POINT SURGICAL SUITES LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$1658.001487609335 - THE CENTER FOR AESTHETIC SURGERY LLC200431536 - (MD) THE CENTER FOR AESTHETIC SURGERY LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$1188.001831217231 - THE ENDOSCOPY CENTER AT BAINBRIDGE LLC205430025 - (OH) THE ENDOSCOPY CENTER AT BAINBRIDGE LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$1222.001760447866 - MOBILE-SC, LTD, MOBILE SURGERY CENTER630883553ALAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$3555.001205545860 - PROVIDENCE SURGERY AND PROCEDURE CENTER LLC881232814 - (WA) PROVIDENCE SURGERY AND PROCEDURE CENTER LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$957.001578679726 - SURGEYECARE, INC., SURGEYECARE GENERAL PARTNERSHIP752184300TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$1223.001770802555 - FAIRLAWN SURGERY CENTER, LLC271762713 - (VA) FAIRLAWN SURGERY CENTER, LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$3588.001396784252 - FRONTENAC AMBULATORY SURGERY & SPINE CARE CENTER LP, FRONTENAC SURGERY & SPINE CARE CENTER205953268 - (MO) FRONTENAC AMBULATORY SURGERY SPINE CARE CENTER LPMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$2080.001912547746 - PORT ARTHUR SURGICAL CENTER, LLC, GULF COAST SURGERY CENTER843158723 - (TX) PORT ARTHUR SURGICAL CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$3623.001205949245 - MEMORIAL SURGERY CENTER, LLC201167151 - (OK) MEMORIAL SURGERY CENTER LLCOKAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$1235.001609955517 - KNOXVILLE EYE SURGERY CENTER LLC, TENNESSEE VALLEY EYE CENTER621680280 - (TN) KNOXVILLE EYE SURGERY CENTER, LLC; DBA TENNESSEE VALLEY EYE CENTERTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$1825.001881911451 - SURGERY CENTER OF BJI, LLC264737296 - (GA) SURGERY CENTER OF BJI LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65101$1300.001801855127 - CENTER FOR THE SURGICAL ARTS LLC, CSA113741353 - (PA) CENTER FOR THE SURGICAL ARTS LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 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.

CodeComplexityDescription
65091ModerateEvisceration Ocular Wo Implant
65093ModerateEvisceration Ocular Contents; With Impla
65101HighEnucleation Eye Wo Implant
65103HighEnucleation Eye;W Implant, Muscles Not A

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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