CPT 65135 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 65135 by major payers:
$994.04
$996.03
$1,134.89
$1,351.60
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 65135 | ||||||
United | 65135 | $5015.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $1500.00 | 1053852236 - SURGERY CENTER OF ANAHEIM HILLS, LLC | 814260687 - (CA) SURGERY CENTER OF ANAHEIM HILLS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $679.00 | 1881616357 - CINCINNATI HEALTH CARE GROUP PSC | 621719097 | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $4140.00 | 1073694550 - ROCKWALL AMBULATORY SURGERY CENTER LLP, BAYLOR SCOTT & WHITE SURGICARE - ROCKWALL | 205506447 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $4209.00 | 1992058325 - SOUTH BEND SPECIALTY SURGERY CENTER, LLC | 460571418 - (IN) SOUTH BEND SPECIALTY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $4107.00 | 1306201124 - CHRISTUS SANTA ROSA OUTPATIENT SURGERY, CHRISTUS PHYSICIANS SURGERY CENTER - SAN MARCOS | 810571409 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $2637.00 | 1801450986 - DOCTORS HOSPITAL, INC, BAPTIST HEALTH SURGERY CENTER CORAL GABLES | 43775926 - (FL) DOCTORS HOSPITAL INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $1417.00 | 1215990627 - WESTSIDE SURGERY CENTER LLC, WESTSIDE SURGERY CENTER LTD | 593026856 - (FL) WESTSIDE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $3124.00 | 1912090432 - MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE, LLC | 812557673 - (DC) MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE LLC | DC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $5213.00 | 1528121316 - SAINT LUKES SOUTH SURGERY CENTER LLC | 201721929 - (KS) SAINT LUKES SOUTH SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $3461.00 | 1942231204 - SURGICAL INSTITUTE, LLC | 810911558 - (NJ) SURGICAL INSTITUTE LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $4574.00 | 1619245230 - AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | 800768614 - (NJ) AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $2307.00 | 1477503175 - PALMS WEST SURGERY CENTER LTD | 201008459 - (FL) PALMS WEST SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $2010.00 | 1083643852 - AMARILLO COLONOSCOPY CENTER LP, PANHANDLE ENDOSCOPY CENTER LP | 202528490 - (TX) AMARILLO COLONOSCOPY CENTER, LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65135 | $1880.00 | 1104087089 - CONGRESS MEDICAL SURGERY CENTER LLC | 262785454 - (CA) CONGRESS MEDICAL SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 65135 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65135 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 65135 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 | High | Exenteration Orbit W Removal Bone |
| 65114 | High | Exenteration Orbit/Contents W/Muscle/Myo |
| 65125 | Moderate | Modification Of Ocular Implant With Placement Or Replacement Of Pegs (Eg, Drilling Receptacle For Prosthesis Appendage) (Separate Procedure) |
| 65135 | Moderate | Insert Implant Ocular 2nd Wo Integr |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65135. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65135 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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