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See a sample rate comparisonCPT 65125 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.
Modification Of Ocular Implant, Modification Of Ocular Implant With Placement Or Replacementof Pegs (Eg Drilling Receptacle For Prosthesis Appendage) (Separate Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 65125 |
| Medicaid Fee Schedule | View Medicaid rates for 65125 |
National average reimbursement for CPT 65125 by major payers:
$541.62
$585.82
$619.45
$478.80
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CPT 65125
5 of 25 sample ratesHigher to lower in this preview
Toms River Surgery Center, LLC, Toms River Surgery Center
Toms River Surgery Center LLC
$3,710.00Published rateWestgate Surgery Center, LLC, Westgate Surgery Center
Westgate Surgery Center LLC
$2,388.00Published rateCharleston Ent Associates, LLC, Surgery Center Of Charleston
Charleston Ent Associates, LLC
$1,750.00Published rateEverett Road Asc, LLC, Everett Road Surgery Center
Everett Road Asc LLC
$868.00Published rateAndy Sahadeo
Deaconess Hospital Inc
$370.97Published rate
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See a sample payer proposalCPT 65125 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65125 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 65125 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 |
|---|---|---|
| 65112-CPT | High | Remove Eye Socket Contents, Surgery To Remove The Orbital Contents (Includes Eyeball Muscles Nerves And Blood Vessels). May Include Removal Of Bone. |
| 65114-CPT | High | Remove Eye Socket Contents, Surgery To Remove The Orbital Contents (Includes Eyeball Muscles Nerves And Blood Vessels). May Include Removal Of Bone. |
| 65125-CPT | Moderate | Modification Of Ocular Implant, Modification Of Ocular Implant With Placement Or Replacementof Pegs (Eg Drilling Receptacle For Prosthesis Appendage) (Separate Procedure) |
| 65130-CPT | High | Surgery For Eye Implant, Surgery To Implant A Prosthetic Eye After A Surgery To Remove The Injured Eye. The Procedure May Involve Attaching The Eye Muscles To The Implant. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65125. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65125 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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