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CPT 65125 Fee Schedule

Last Verified: January 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 With Placement Or Replacement Of Pegs (Eg, Drilling Receptacle For Prosthesis Appendage) (Separate Procedure)
Key FactDetail
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 LevelModerate

National average reimbursement for CPT 65125 by major payers:

bcbs

$541.62

uhc

$585.82

aetna

$619.45

cigna

$732.10

Preview provider-level rates for...
For billing codeCPT 65125
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 65125

United
65125$868.001164083911 - EVERETT ROAD ASC, LLC, EVERETT ROAD SURGERY CENTER833542382 - (NY) EVERETT ROAD ASC LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$2634.001659316917 - SUGAR LAND SURGERY CENTER LTD621742196 - (TX) SUGAR LAND SURGERY CENTER LTDTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$1658.001497011308 - BENJAMIN CHUNG MD INC, RIVERWALK SURGERY CENTER454738248 - (CA) BENJAMIN CHUNG MD INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$2388.001366444929 - EAST WEST SURGERY CENTER LP621797897 - (GA) EAST WEST SURGERY CENTER LPGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$700.001679605729 - METROPOLITAN SURGICAL ASSOCIATES INC. DBA METROPOLITAN MEDICAL ASSOC222306421 - (NJ) METROPOLITAN SURGICAL ASSOCIATES, INC.NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$2388.001548241623 - GASTROENTEROLOGY ASSOCIATES, LLC, GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER912104493 - (WA) GASTROENTEROLOGY ASSOCIATES PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$3710.001023070026 - TOMS RIVER SURGERY CENTER, LLC, TOMS RIVER SURGERY CENTER752854783 - (NJ) TOMS RIVER SURGERY CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$2307.001295060069 - TIMONIUM SURGERY CENTER, LLC270399689 - (MD) TIMONIUM SURGERY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$759.001649443367 - SKIN SURGERY CENTER OF VIRGINIA262319829 - (VA) SKIN SURGERY CENTER OF VIRGINIAVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$3624.001730227992 - MEMORIAL AMBULATORY SURGERY CENTER, LLC210634562 - (NJ) VIRTUA-MEMORIAL HOSPITAL BURLINGTON COUNTY INCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$2166.001710924899 - DMG SURGICAL CENTER LLC, SURGICAL CENTER OF DUPAGE MEDICAL GROUP371474161ILAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$2430.001942230024 - LUTHERVILLE ENDOSCOPY CENTER LLC823193901MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$1750.001124026422 - CHARLESTON ENT ASSOCIATES, LLC, SURGERY CENTER OF CHARLESTON582281023 - (SC) CHARLESTON ENT ASSOCIATES, LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$1213.001609465269 - OKLAHOMA SPINE SURGERY CENTER861507485 - (OK) OKLAHOMA SPINE SURGERY CENTEROKAmbulatory Surgical Clinic/Center (261QA1903X)
United
65125$644.001467472688 - WEST CLINIC ASTC, WEST CLINIC, PC621526296 - THE WEST CLINIC, PLLCTNAmbulatory 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 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.

CodeComplexityDescription
65112-CPTHighExenteration Orbit W Removal Bone
65114-CPTHighExenteration Orbit/Contents W/Muscle/Myo
65125-CPTModerateModification Of Ocular Implant With Placement Or Replacement Of Pegs (Eg, Drilling Receptacle For Prosthesis Appendage) (Separate Procedure)
65130-CPTHighInsert.Ocular Implant 2ndary;After Evisc

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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